Objective:To evaluate the association between three behavioural economics ‘nudges’ and store sales of promoted healthier foods.Design:Multiple interrupted time series.Setting:Two predominantly rural counties in central North Carolina, USA.Participants:Aggregated store transaction data from two grocery stores (one intervention, one control) and two convenience stores (one intervention, one control) were analysed using ANOVA to examine the association between three ‘nudges’ and store sales of promoted items. The nudges included: a ‘cognitive fatigue’ experiment, in which floor arrows guided customers to the produce sections; a ‘scarcity’ experiment, in which one sign in one area of the produce section portrayed a ‘limited amount’ message; and a ‘product placement’ experiment, where granola bars were moved into the candy bar aisle.Results:In convenience stores, there were no significant differences between sales of the promoted items during the intervention period for any of the nudges when implemented individually. However, compared with baseline sales, implementation of all three nudges simultaneously was associated with an increase in sales during the intervention period based on proportional computations (P = 0·001), whereas no significant changes in sales were observed in the control convenience store. Among the grocery stores, there were no significant differences in sales during the intervention period for any of the nudges or the combined intervention compared with baseline sales.Conclusions:Implementing three nudges concurrently in a convenience store setting may increase sales of promoted items. However, before stores consider implementing these nudges to increase sales of nutritious foods, additional research is warranted.
Purpose: In the United States, 42% of adults, and 81% of adults over 65 years of age live with multiple chronic condition (MCC). Current interventions to facilitate engagement in care focus primarily on the patient; however, many individuals with MCC manage and live with their conditions within the context of their family. This review sought to identify interventions used to facilitate patient and/or family engagement among adults with MCC. Methods: We adhered as closely as possible to PRISMA guidelines and conducted a systematic scoping review using a modified approach by Arksey and O’Malley. We searched PubMed, Web of Science, and Scopus using terms related to MCC, patient and family engagement, and intervention. We included articles that: (1) were published in English; (2) were peer-reviewed; (3) described an engagement intervention (with or without a comparator); and (4) targeted individuals with MCC. We abstracted data from included articles and classified them using the Multidimensional Framework for Patient and Family Engagement in Health and Health Care, and the Classification Model of Patient Engagement. Results: We identified 21 discrete interventions. Six (29%) were classified as having the highest degree of engagement. Eighteen (85%) focused on engagement at the direct care level. Only one was specifically designed to engage families. Conclusions: Many engagement interventions currently exist for adults with MCC. Few of these interventions foster the highest degree of engagement; most focus on engagement at the level of direct care and do not specifically target family member involvement.
Natural experiments are often used for answering research questions in which randomization is implausible. Effective recruitment strategies are well documented for observational cohort studies and clinical trials, unlike recruitment methods for time-sensitive natural experiments. In this time-sensitive study of the impact of a minimum wage policy, we aimed to recruit 900 low-wage workers in Minneapolis, Minnesota, and Raleigh, North Carolina. We present our recruitment strategies, challenges, and successes for participant screening and enrollment of a difficult-to-reach population.
Objectives As type 2 diabetes prevalence increases across Latin America, understanding local approaches to coping with diabetes stress is essential to providing care that incorporates patients’ values and preferences. This study explored a local phenomenon, “ no le doy mente” (I don’t think about it), used by adults with type 2 diabetes in the Dominican Republic to cope with diabetes stress. Methods We conducted 19 qualitative in-depth interviews with adults with type 2 diabetes (10 men, 9 women) recruited from one rural clinic. Using an inductive analytic approach including iterative coding, memos, and matrices, we identified reasons, strategies, and perceived benefits of not thinking about type 2 diabetes among participants. Results Participants described not thinking about diabetes as an active process to maintain a sense of normalcy despite significant life changes following diagnosis. They avoided thinking about diabetes by staying busy, proactively managing type 2 diabetes through diet and medication, and turning to their faith. Participants perceived that enacting no le doy mente helped to protect their overall health and well-being. Discussion Future research should investigate provider perceptions of no le doy mente to align patient and provider communication and mindfulness-based stress reduction as a way to support people with type 2 diabetes avoid dwelling on negative thoughts about diabetes.
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