Document Detail


Food choices of minority and low-income employees: a cafeteria intervention.
MedLine Citation:
PMID:  22898116     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Effective strategies are needed to address obesity, particularly among minority and low-income individuals.
PURPOSE: To test whether a two-phase point-of-purchase intervention improved food choices across racial, socioeconomic (job type) groups.
DESIGN: A 9-month longitudinal study from 2009 to 2010 assessing person-level changes in purchases of healthy and unhealthy foods following sequentially introduced interventions. Data were analyzed in 2011.
SETTING/PARTICIPANTS: Participants were 4642 employees of a large hospital in Boston MA who were regular cafeteria patrons.
INTERVENTIONS: The first intervention was a traffic light-style color-coded labeling system encouraging patrons to purchase healthy items (labeled green) and avoid unhealthy items (labeled red). The second intervention manipulated "choice architecture" by physically rearranging certain cafeteria items, making green-labeled items more accessible and red-labeled items less accessible.
MAIN OUTCOME MEASURES: Proportion of green- (or red-) labeled items purchased by an employee. Subanalyses tracked beverage purchases, including calories and price per beverage.
RESULTS: Employees self-identified as white (73%); black (10%); Latino (7%); and Asian (10%). Compared to white employees, Latino and black employees purchased a higher percentage of red items at baseline (18%, 28%, and 33%, respectively, p<0.001) and a lower percentage of green (48%, 38%, and 33%, p<0.001). Labeling decreased all employees' red item purchases (-11.2%, 95% CI= -13.6%, -8.9%) and increased green purchases (6.6%, 95% CI=5.2%, 7.9%). Red beverage purchases decreased most (-23.8%, 95% CI= -28.1%, -19.6%). The choice architecture intervention further decreased red purchases after the labeling. Intervention effects were similar across all race/ethnicity and job types (p>0.05 for interaction between race or job type and intervention). Mean calories per beverage decreased similarly over the study period for all racial groups and job types, with no increase in per-beverage spending.
CONCLUSIONS: Despite baseline differences in healthy food purchases, a simple color-coded labeling and choice architecture intervention improved food and beverage choices among employees from all racial and socioeconomic backgrounds.
Authors:
Douglas E Levy; Jason Riis; Lillian M Sonnenberg; Susan J Barraclough; Anne N Thorndike
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of preventive medicine     Volume:  43     ISSN:  1873-2607     ISO Abbreviation:  Am J Prev Med     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-17     Completed Date:  2013-01-09     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  8704773     Medline TA:  Am J Prev Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  240-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. dlevy3@partners.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Boston
Choice Behavior
Commerce
Continental Population Groups / psychology,  statistics & numerical data
Female
Food Habits / ethnology,  psychology*
Food Labeling*
Food Preferences / ethnology,  psychology*
Health Behavior / ethnology
Hospitals
Humans
Longitudinal Studies
Male
Minority Groups / psychology,  statistics & numerical data
Personnel, Hospital / economics,  psychology,  statistics & numerical data*
Restaurants
Socioeconomic Factors
Grant Support
ID/Acronym/Agency:
1 K23HL93221/HL/NHLBI NIH HHS; 1 UL1 RR025758-03/RR/NCRR NIH HHS; K23 HL093221/HL/NHLBI NIH HHS; UL1 RR025758/RR/NCRR NIH HHS
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