Abstract 34: Traffic-Light Labels and Financial Incentives Reduce Purchase of Sugar-Sweetened Beverages by Low-Income, Latino Families: A Randomized Controlled Trial
Background: Strategies to reduce consumption of sugar-sweetened beverages (SSBs) are needed for obesity prevention, particularly among low-income and minority populations that have both high rates of SSB consumption and of obesity-related diseases.
Methods: We conducted a randomized, controlled trial of 216 frequent customers of a Latino supermarket to determine if providing both in-store traffic light labels on all beverages as well as financial incentives for not purchasing unhealthy (red-labeled) beverages would reduce their purchase. Subjects were recruited in the store and were eligible if they: had > 1 child in the household; purchased > $100 of groceries at the study store/month; and spoke Spanish or English. Regardless of intervention arm, all subjects received a store “loyalty card” that provided a 5% discount on all groceries and identified their purchases in cash register data. After a 2-month period to track subjects’ baseline beverage purchases, traffic-light labels (red=unhealthy=SSB; yellow=less healthy; green=healthy) were posted on all beverage shelves for a 5 month intervention period. The intervention group (N=108) received monthly letters that provided targeted education about healthy beverages and offered a financial incentive ($25 grocery coupon) if they purchased no red-labeled beverages in the following month; the control group (N=108) received monthly letters with general nutrition guidelines. Subject demographics were collected at the time of enrollment. We compared the trend in the proportion of subjects who purchased red beverages during the 5-month intervention period between the two groups, adjusting for pre-intervention (baseline) beverage purchases.
Results: Subjects were 98% female, 97% Latino, and 58% on government food assistance. During the 2-month baseline period (before traffic light labels were posted), 43% of the intervention and 34% of the control group purchased ≥ 1 red-labeled beverage/month. During the study period, 151 subjects (70%) used the loyalty card to pay for purchases at least once during the study period. In the intention-to-treat analysis (N=216) for the 5-month intervention period, the proportion of subjects in the intervention group that purchased red beverages decreased 3% more per month than the control group (p=0.05). In a secondary analysis of only subjects who used the loyalty card to pay for purchases, the proportion of those in the intervention group that purchased red beverages decreased 9% more per month than the control group (p=0.002).
Conclusion: Our results suggest that targeted beverage education and in-store traffic-light labels combined with financial incentives reduced grocery store purchases of sugar-sweetened beverages by low-income, Latino families compared to traffic-light labels alone.
Author Disclosures: A. Thorndike: B. Research Grant; Modest; Harvard Catalyst/The Harvard Clinical and Translational Science Center. D.E. Levy: None. L. Macias-Navarro: None. R.L. Franckle: None. E.B. Rimm: B. Research Grant; Modest; Harvard Catalyst/The Harvard Clinical and Translational Science Center.
- © 2015 by American Heart Association, Inc.