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The goal of this randomized controlled trial is to test whether using behavioral economic strategies to promote healthy food choices on a food bank's online ordering platform increases the use of the traffic light nutrition ranking system and increases healthier food selections by the food agencies (e.g., food pantries) who use the food bank.
This study will use behavioral economic strategies to promote utilization of traffic-light nutrition ranking in the Greater Boston Food Bank (GBFB) order system to improve the dietary quality of food ordered by GBFB agencies. Supporting Wellness at Pantries (SWAP) is a program to guide both traffic light labeling for use on ordering platforms and pantry shelves, as well as food pantry layout to inform clients and encourage healthy food choice.This study is a collaboration with the Greater Boston Food Bank (GBFB) to test BE strategies (choice architecture, framing, social norms) for implementation of an evidence-based intervention (traffic light nutrition ranking, SWAP). We will determine if behavioral economic interventions on the GBFB online ordering platform increase agencies' use of traffic light nutrition labels when placing orders and increases their healthy food orders. We will conduct a 12-month randomized controlled trial comparing agencies' ordering experiences and outcomes with the current user interface (control) to a "SWAP-enhanced" user interface (intervention). All GBFB partner agencies will be randomized to see either the control or intervention interfaces when they log on to ShopGBFB, GBFB's online food ordering platform. In addition, intervention group agencies will receive monthly emails from GBFB about SWAP labeling, such as why common items receive certain rankings (e.g., canned green beans will have a yellow label if there is added sodium) and common misunderstandings people have about SWAP labels (e.g., explaining why all chicken items do not get the same SWAP ranking). At the end of 12 months, agency staff will complete a survey about their online ordering experiences at GBFB. In the next phase, the SWAP-enhanced ShopGBFB interface will be updated, adapted, and implemented for all 364 agencies that place orders. Agency ordering outcomes will be monitored for 12 additional months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Behavioral economics-enhanced user interface | Experimental | Food agencies will see the behavioral economics (BE)-enhanced interface by default; food items will be sorted with green-labeled items listed first, followed by yellow, then red. If users search for a specific item type (e.g., chicken) the results returned for that item type will also be sorted so that green-labeled items are listed first. At any time during the ordering episode, users will have the option to switch from the BE-enhanced default to an alternate sorting or filtering choice, such as alphabetical or cost. Users will be shown the percent of items (by weight) that are labeled green in a prominent location on the ordering screen. The percent green-labeled items in the order will appear alongside messaging reporting the average percent green-labeled items ordered by GBFB pantries that rank in the top 10% based on this metric. Agencies will receive monthly emails from GBFB about SWAP, describing why common items receive certain SWAP rankings (e.g., item is yellow vs green). |
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| Usual user interface | No Intervention | When agency staff log on to the food bank platform, by default, foods are listed in alphabetical order. If they wish, users can change how items are sorted or filtered using pull-down menus and check-boxes, including the ability to have items sorted or filtered based on traffic light labels. As orders are created, an information section at the top of the page is updated with details on the order weight and cost. Agencies will not receive emails about SWAP. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Behavioral economics-enhanced user interface | Behavioral | The intervention changes the ordering platform visible to food agencies using behavioral economics strategies to promote healthier food choices. |
| Measure | Description | Time Frame |
|---|---|---|
| Healthy food agency orders from the food bank | This will be the change from baseline to 12 months in the percentage of foods ordered (by weight) that have green labels. | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of agencies that ever used the traffic light label sorting or filtering when ordering from the food bank | This outcome will be the proportion of agencies in the intervention vs. control group that report using the traffic-light sorting/filtering when making orders during the 12 month intervention period. | 12 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Anne Thorndike, MD, MPH | Contact | 617-724-4608 | athorndike@mgh.harvard.edu | |
| Douglas Levy, PhD | Contact | 617-643-3595 | dlevy3@mgh.harvard.edu |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Massachusetts General Hospital | Boston | Massachusetts | 02114 | United States |
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Food agencies will be randomized to one of two interfaces on the online food bank ordering platform.
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Outcomes will be automatically obtained from the food bank database.