Effectiveness of a low-value financial-incentive program for increasing vegetable-rich restaurant meal selection and reducing socioeconomic inequality: a cluster crossover trial

International Journal of Behavioral Nutrition and Physical Activity

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[1] 0000 0001 2151 536X, grid.26999.3d, Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-0033, Tokyo, Japan;0000 0001 2151 536X, grid.26999.3d, Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-0033, Tokyo, Japan;0000 0001 2168 5385, grid.272242.3, Division of Prevention, Centre for Public Health Sciences, National Cancer Centre, 5-1-1 Tsukiji, Chuo-ku, 104-0045, Tokyo, Japan;

关键词: Health inequality;    Diet;    Health behaviour;    Marketing;    Nudge;    Japan;   

DOI  :  10.1186/s12966-019-0830-5

来源: publisher

【 摘 要 】

BackgroundIn light of recent theories in behavioural economics, an intervention program with monetary incentives could be effective for helping patrons order healthy food, even if the incentive is small and less than one’s perceived marginal value.MethodsIn this single-arm cluster crossover trial at 26 local restaurants, a 1-week campaign offered a 50-yen (approximately 0.5 US dollars) cash-back payment to customers ordering vegetable-rich meals, while no pre-order incentives were offered during the control period.ResultsIn total, 511 respondents out of 7537 customers (6.8%), and 704 respondents out of 7826 customers (9.0%), ordered vegetable-rich meals during the control and intervention periods, respectively. During the intervention period, the covariate-adjusted proportion of vegetable-rich meal orders was 1.50 times higher (95% confidence interval [CI]: 1.29 to 1.75), which increased daily sales by 1.77 times (95% CI: 1.11 to 2.83), even when subtracting the cost of cash-back payments. Respondents who reported spending the least amount of money on eating out (used as a proxy measure for income) were the least likely to order vegetable-rich meals during the control period. However, these individuals increased their proportion of purchasing such meals during the intervention period (a 3.8 percentage point increase (95% CI: 2.82 to 4.76) among those spending the least vs a 2.1 percentage point increase (95% CI: 1.66 to 2.62) among those spending the most; P for interaction = 0.001). Similarly, irregular employees exhibited a larger increase (+ 5.2 percentage points, 95% CI: 4.54 to 5.76) than did regular workers (− 1.4, 95% CI: − 1.66 to − 1.05, P for interaction = 0.001).ConclusionsA program with an immediate low-value monetary incentive could be a public health measure for reducing inequalities in making healthy food choices.Trial registrationUMIN Clinical Trials Registry, UMIN000022396. Registered 21 May 2016.

【 授权许可】

CC BY