A Pilot Randomized Controlled Trial of a Digital Intervention Aimed at Improving Food Purchasing Behavior: The Front-of-Pack Food Labels Impact on Consumer Choice Study

Richard A. Harrington, Peter Scarborough*, Charo Hodgkins, Monique M. Raats, Gill Cowburn, Moira Dean, Aiden Doherty, Charlie Foster, Edmund Juszczak, Cliona Ni Mhurchu, Naomi Winstone, Richard Shepherd, Lada Timotijevic, Mike Rayner

*Corresponding author for this work

Research output: Contribution to journalArticle

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Abstract

Background: Most food in the United Kingdom is purchased in supermarkets, and many of these purchases are routinely tracked through supermarket loyalty card data. Using such data may be an effective way to develop remote public health interventions and to measure objectively their effectiveness at changing food purchasing behavior. Objective: The Front-of-pack food Labels: Impact on Consumer Choice (FLICC) study is a pilot randomized controlled trial of a digital behavior change intervention. This pilot trial aimed to collect data on recruitment and retention rates and to provide estimates of effect sizes for the primary outcome (healthiness of ready meals and pizzas purchased) to inform a larger trial. Methods: The intervention consisted of a website where participants could access tailored feedback on previous purchases of ready meals and pizzas, set goals for behavior change, and model and practice the recommended healthy shopping behavior using traffic light labels. The control consisted of Web-based information on traffic light labeling. Participants were recruited via email from a list of loyalty card holders held by the participating supermarket. All food and drink purchases for the participants for the 6 months before recruitment, during the 6-week intervention period, and during a 12-week washout period were transferred to the research team by the participating supermarket. Healthiness of ready meals and pizzas was measured using a predeveloped scale based solely on the traffic light colors on the foods. Questionnaires were completed at recruitment, end of the intervention, and end of washout to estimate the effect of the intervention on variables that mediate behavior change (eg, belief and intention formation). Results: We recruited 496 participants from an initial email to 50,000 people. Only 3 people withdrew from the study, and purchase data were received for all other participants. A total of 208 participants completed all 3 questionnaires. There was no difference in the healthiness of purchased ready meals and pizzas between the intervention and control arms either during the intervention period (P=.32) or at washout (P=.59). Conclusions: Although the FLICC study did not find evidence of an impact of the intervention on food purchasing behavior, the unique methods used in this pilot trial are informative for future studies that plan to use supermarket loyalty card data in collaboration with supermarket partners. The experience of the trial showcases the possibilities and challenges associated with the use of loyalty card data in public health research.

Original languageEnglish
Article numbere9910
Number of pages16
JournalJournal of Medical Internet Research
Volume21
Issue number4
DOIs
Publication statusPublished - 08 Apr 2019

Keywords

  • Diet
  • Randomized controlled trial

ASJC Scopus subject areas

  • Health Informatics

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    Harrington, R. A., Scarborough, P., Hodgkins, C., Raats, M. M., Cowburn, G., Dean, M., Doherty, A., Foster, C., Juszczak, E., Mhurchu, C. N., Winstone, N., Shepherd, R., Timotijevic, L., & Rayner, M. (2019). A Pilot Randomized Controlled Trial of a Digital Intervention Aimed at Improving Food Purchasing Behavior: The Front-of-Pack Food Labels Impact on Consumer Choice Study. Journal of Medical Internet Research, 21(4), [e9910]. https://doi.org/10.2196/formative.9910