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The pervasiveness of high-calorie, nutrient-poor snacks in the environment is believed to have contributed to the epidemic levels of obesity and cardiometabolic disease in the U.S. This project tests whether a novel snack vending machine system that uses brief time delays to reduce the immediacy of reward from unhealthy snacks will improve the healthfulness of snack choices. If successful, this project will identify a new environmental intervention that could contribute substantially to obesity and cardiometabolic disease prevention efforts in schools, worksites, and other settings.
Environmental interventions that address the high availability of unhealthy snacks in the environment are needed to prevent a large projected increase in the incidence of obesity and cardiometabolic disease in the U.S. Prior studies from the investigators group and others suggests that the human preference for immediate gratification from food drives dietary overconsumption, but this knowledge has not yet translated to more effective dietary intervention strategies. This project tests whether a novel snack vending machine system that uses brief time delays to reduce the immediacy of reward from unhealthy snacks will improve the healthfulness of snack choices. This study uses an experimental design to compare brief time delays, two forms of 25% differential pricing, and time delays combined with both forms of 25% differential pricing on their ability to increase purchasing of healthy snacks. Test machines will be placed in existing, high-volume vending locations, and each of these five experimental conditions will run for roughly four weeks. Additionally, baseline purchasing under no intervention will be monitored for four weeks before and four weeks after the five experimental conditions. Specific Aim 2 compares the effects of these five interventions against baseline on the proportion of total vending sales from healthy snacks. Specific Aim 3 tests whether time delays or differential pricing harm overall vending machine sales in the test machines. This study not only tests a compelling theory about the effects of time delays and immediate reward on food choice, but evaluates the efficacy and feasibility of a novel intervention to improve the healthfulness of snack choices in worksites, schools, and other settings.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| A | Snacks sold under equal pricing, no delays | ||
| B | Healthier snacks sold at 25% or $0.25 discount, no delays |
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| C | Less healthy snacks sold at equal pricing with delays |
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| D | Healthy snacks sold at 25% or $0.25 discount, plus delays on less healthy snacks |
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| E | Less healthy snacks sold at 25% or $0.25 higher price, no delays |
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| F | Less healthy snacks sold at 25% or $0.25 higher price, plus delays |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Time delays on delivery of less healthy snacks | Other |
| ||
| 25%/$0.25 discount on healthy snacks |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Healthy Snacks Purchased | For each experimental condition, we will calculate the proportion of healthy vs unhealthy snacks sold over 4 weeks. | 28 weeks per vending location |
| Measure | Description | Time Frame |
|---|---|---|
| Total Daily Vending Revenue in US$/Day | Total vending machine revenue under each condition | Number of days per condition were as follows - Baseline: 119 days, Discount only: 59 days, Delay only: 68 days, Delay + Discount: 49 days, Tax only: 73 days, Delay + Tax: 60 days |
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Inclusion Criteria:
Exclusion Criteria:
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This is an environmental intervention. No subjects will be recruited or enrolled.
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| Name | Affiliation | Role |
|---|---|---|
| Bradley M Appelhans, PhD | Associate Professor | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rush University Medical Center | Chicago | Illinois | 60612 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29551401 | Derived | Appelhans BM, French SA, Olinger T, Bogucki M, Janssen I, Avery-Mamer EF, Powell LM. Leveraging delay discounting for health: Can time delays influence food choice? Appetite. 2018 Jul 1;126:16-25. doi: 10.1016/j.appet.2018.03.010. Epub 2018 Mar 15. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Baseline 1 | Snacks sold under equal pricing, no delays. Baseline 1 was always the first condition at all vending sites. |
| FG001 | Discount Only | Healthier snacks sold at 25% or $0.25 discount, no delays 25%/$0.25 discount on healthy snacks |
| FG002 | Delay Only | Less healthy snacks sold at equal pricing with delays 25-second time delays on delivery of less healthy snacks |
| FG003 | Delay + Discount | Healthy snacks sold at 25% or $0.25 discount, plus delays on less healthy snacks 25-second time delays on delivery of less healthy snacks 25%/$0.25 discount on healthy snacks |
| FG004 | Tax Only | Less healthy snacks sold at 25% or $0.25 higher price, no delays 25%/$0.25 tax on less healthy snacks |
| FG005 | Delay + Tax | Less healthy snacks sold at 25% or $0.25 higher price, plus delays Time delays on delivery of less healthy snacks 25%/$0.25 tax on less healthy snacks |
| FG006 | Baseline 2 | Snacks sold under equal pricing, no delays. Baseline 2 was always the last condition at all vending sites. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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The unit of analysis for this study were vending machine sales ("vends"). No data was collected from individual participants. The number of unique individuals in this study is unknown.
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| ID | Title | Description |
|---|---|---|
| BG000 | Baseline 1 | Snacks sold under equal pricing, no delays. Baseline 1 was always the first condition at all vending sites. |
| BG001 | Discount Only | Healthier snacks sold at 25% or $0.25 discount, no delays 25%/$0.25 discount on healthy snacks |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | Age was not collected in this study |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Proportion of Healthy Snacks Purchased | For each experimental condition, we will calculate the proportion of healthy vs unhealthy snacks sold over 4 weeks. | In this table, each vend is treated as an analyzed participant. No data were collected from individual human subjects. Analyses included all available data on healthy and regular snack vends. Data from Baseline 1 and Baseline 2 were combined into a single arm/group ("Baseline") in statistical analyses. | Posted | Number | proportion of vends from healthy snacks | 28 weeks per vending location | Vends | Vends |
|
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Adverse events were not collected in this study.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Baseline | Snacks sold under equal pricing, no delays | 0 |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Brad Appelhans, PhD (PI) | Rush University Medical Center | 312-942-3477 | brad_appelhans@rush.edu |
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| G | Snacks sold under equal pricing, no delays |
| Other |
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| 25%/$0.25 tax on less healthy snacks | Other |
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| BG002 | Delay Only | Less healthy snacks sold at equal pricing with delays 25-second time delays on delivery of less healthy snacks |
| BG003 | Delay + Discount | Healthy snacks sold at 25% or $0.25 discount, plus delays on less healthy snacks 25-second time delays on delivery of less healthy snacks 25%/$0.25 discount on healthy snacks |
| BG004 | Tax Only | Less healthy snacks sold at 25% or $0.25 higher price, no delays 25%/$0.25 tax on less healthy snacks |
| BG005 | Delay + Tax | Less healthy snacks sold at 25% or $0.25 higher price, plus delays Time delays on delivery of less healthy snacks 25%/$0.25 tax on less healthy snacks |
| BG006 | Baseline 2 | Snacks sold under equal pricing, no delays. Baseline 2 was always the last condition at all vending sites. |
| BG007 | Total | Total of all reporting groups |
| Sex/Gender, Customized | Sex/Gender was not collected in this study |
| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. |
Healthier snacks sold at 25% or $0.25 discount, no delays 25%/$0.25 discount on healthy snacks |
| OG002 | Delay Only | Less healthy snacks sold at equal pricing with delays 25-second time delays on delivery of less healthy snacks |
| OG003 | Delay + Discount | Healthy snacks sold at 25% or $0.25 discount, plus delays on less healthy snacks 25-second time delays on delivery of less healthy snacks 25%/$0.25 discount on healthy snacks |
| OG004 | Tax Only | Less healthy snacks sold at 25% or $0.25 higher price, no delays 25%/$0.25 tax on less healthy snacks |
| OG005 | Delay + Tax | Less healthy snacks sold at 25% or $0.25 higher price, plus delays Time delays on delivery of less healthy snacks 25%/$0.25 tax on less healthy snacks |
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| Secondary | Total Daily Vending Revenue in US$/Day | Total vending machine revenue under each condition | The unit of analysis is vending revenue per day ($/day). Data from Baseline 1 and Baseline 2 were combined into a single arm/group ("Baseline") in this analysis. | Posted | Mean | Standard Deviation | $/day | Number of days per condition were as follows - Baseline: 119 days, Discount only: 59 days, Delay only: 68 days, Delay + Discount: 49 days, Tax only: 73 days, Delay + Tax: 60 days | Days | Days |
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| 0 |
| 0 |
| 0 |
| 0 |
| 0 |
| EG001 | Discount Only | Healthier snacks sold at 25% or $0.25 discount, no delays 25%/$0.25 discount on healthy snacks | 0 | 0 | 0 | 0 | 0 | 0 |
| EG002 | Delay Only | Less healthy snacks sold at equal pricing with delays 25-second time delays on delivery of less healthy snacks | 0 | 0 | 0 | 0 | 0 | 0 |
| EG003 | Delay + Discount | Healthy snacks sold at 25% or $0.25 discount, plus delays on less healthy snacks 25-second time delays on delivery of less healthy snacks 25%/$0.25 discount on healthy snacks | 0 | 0 | 0 | 0 | 0 | 0 |
| EG004 | Tax Only | Less healthy snacks sold at 25% or $0.25 higher price, no delays 25%/$0.25 tax on less healthy snacks | 0 | 0 | 0 | 0 | 0 | 0 |
| EG005 | Delay + Tax | Less healthy snacks sold at 25% or $0.25 higher price, plus delays Time delays on delivery of less healthy snacks 25%/$0.25 tax on less healthy snacks | 0 | 0 | 0 | 0 | 0 | 0 |
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| Days |
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