Economic incentives to promote healthier food purchases: exploring acceptability and key factors for success

Mhurchú, Cliona Ní; Eyles, Helen; Dixon, Robyn; Matoe, Leonie; Teevale, Tasileta; Meagher-Lundberg, Patricia

doi:10.1093/heapro/dar042

Cited by 18 publications

(17 citation statements)

References 34 publications

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“…This is one of only a few qualitative studies on acceptability of HPFI [ 19 , 20 , 22 , 27 , 30 , 33 , 45 - 48 , 62 - 66 ] and one of only a limited number of empirical research studies on this topic including UK participants. In a cross-section of the public we found a range of views on the acceptability of HPFI which mostly reflected the themes we developed in a systematic review on this topic [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of the included papers were scholarly pieces rather than empirical evidence, and most of this scholarly writing appeared to lack an empirical evidence base. Where empirical evidence exists it is largely in the form of survey data rather than qualitative data providing detailed opinions on the acceptability of HPFI [ 18 - 27 ]. Thus, most of the debate within the literature on the acceptability of financial incentives appears to be unsubstantiated and represent the opinions of authors, rather than being underpinned by evidence.…”

Section: Introductionmentioning

confidence: 99%

“…Our review identified few previous qualitative studies on acceptability of HPFI. Those that have been conducted were restricted to alcohol, drug, and smoking cessation practitioners, managers and service providers, [ 21 , 20 ] pregnant women [ 26 ] and Maori, Pacific Islanders and low income groups [ 27 ]. Thus, growing, but still limited qualitative research on acceptability of HPFI has been conducted with a cross-section of participants, with limited research having been carried out in the United Kingdom (UK) [ 19 , 27 , 30 , 45 - 48 ].…”

Section: Introductionmentioning

confidence: 99%

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Acceptability of financial incentives and penalties for encouraging uptake of healthy behaviours: focus groups

Giles

Sniehotta

McColl³

et al. 2015

BMC Public Health

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BackgroundThere is evidence that financial incentive interventions, which include both financial rewards and also penalties, are effective in encouraging healthy behaviours. However, concerns about the acceptability of such interventions remain. We report on focus groups with a cross-section of adults from North East England exploring their acceptance of financial incentive interventions for encouraging healthy behaviours amongst adults. Such information should help guide the design and development of acceptable, and effective, financial incentive interventions.MethodsEight focus groups with a total of 74 adults were conducted between November 2013 and January 2014 in Newcastle upon Tyne, UK. Focus groups lasted approximately 60 minutes and explored factors that made financial incentives acceptable and unacceptable to participants, together with discussions on preferred formats for financial incentives. Verbatim transcripts were thematically coded and analysed in Nvivo 10.ResultsParticipants largely distrusted health promoting financial incentives, with a concern that individuals may abuse such schemes. There was, however, evidence that health promoting financial incentives may be more acceptable if they are fair to all recipients and members of the public; if they are closely monitored and evaluated; if they are shown to be effective and cost-effective; and if clear health education is provided alongside health promoting financial incentives. There was also a preference for positive rewards rather than negative penalties, and for shopping vouchers rather than cash incentives.ConclusionsThis qualitative empirical research has highlighted clear suggestions on how to design health promoting financial incentives to maximise acceptability to the general public. It will also be important to determine the acceptability of health promoting financial incentives in a range of stakeholders, and in particular, those who fund such schemes, and policy-makers who are likely to be involved with the design, implementation and evaluation of health promoting financial incentive schemes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1409-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acceptability of financial incentives and penalties for encouraging uptake of healthy behaviours: focus groups

Giles

Sniehotta

McColl³

et al. 2015

BMC Public Health

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“…The US Department of Agriculture currently has a pilot project in place to examine the effectiveness of a 30% discount on fruit and vegetables, applied through a reward-type program, in changing dietary behaviour among low income residents enrolled in the Supplemental Nutrition Assistance Program[52]. Customer loyalty programs appear to be promising and acceptable in delivering incentive schemes to promote healthy eating[53]. The acceptability and feasibility of such programs needs to be evaluated in the remote Aboriginal context.…”

Section: Discussionmentioning

confidence: 99%

Optimisation Modelling to Assess Cost of Dietary Improvement in Remote Aboriginal Australia

et al. 2013

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BackgroundThe cost and dietary choices required to fulfil nutrient recommendations defined nationally, need investigation, particularly for disadvantaged populations.ObjectiveWe used optimisation modelling to examine the dietary change required to achieve nutrient requirements at minimum cost for an Aboriginal population in remote Australia, using where possible minimally-processed whole foods.DesignA twelve month cross-section of population-level purchased food, food price and nutrient content data was used as the baseline. Relative amounts from 34 food group categories were varied to achieve specific energy and nutrient density goals at minimum cost while meeting model constraints intended to minimise deviation from the purchased diet.ResultsSimultaneous achievement of all nutrient goals was not feasible. The two most successful models (A & B) met all nutrient targets except sodium (146.2% and 148.9% of the respective target) and saturated fat (12.0% and 11.7% of energy). Model A was achieved with 3.2% lower cost than the baseline diet (which cost approximately AUD$13.01/person/day) and Model B at 7.8% lower cost but with a reduction in energy of 4.4%. Both models required very large reductions in sugar sweetened beverages (−90%) and refined cereals (−90%) and an approximate four-fold increase in vegetables, fruit, dairy foods, eggs, fish and seafood, and wholegrain cereals.ConclusionThis modelling approach suggested population level dietary recommendations at minimal cost based on the baseline purchased diet. Large shifts in diet in remote Aboriginal Australian populations are needed to achieve national nutrient targets. The modeling approach used was not able to meet all nutrient targets at less than current food expenditure.

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“…Amongst families of low socio-economic position (SEP), cost is cited as one of the most common barriers to both maternal and child healthy eating [1-3], and there is evidence that when funds are limited, more affordable options high in sugar and fat are often consumed, resulting in poor nutrition and increased obesity risk [4,5]. While it is noted that actual food prices impact food decision making, changing food prices can be difficult and expensive.…”

Section: Introductionmentioning

confidence: 99%

Improving perceptions of healthy food affordability: results from a pilot intervention

Williams

Abbott

Thornton

et al. 2014

Int J Behav Nutr Phys Act

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BackgroundDespite strong empirical support for the association between perceived food affordability and dietary intake amongst families with a lower socioeconomic position (SEP), there is limited evidence of the most effective strategies for promoting more positive perceptions of healthy food affordability among this group. This paper reports findings from a pilot intervention that aimed to improve perceptions of healthy food affordability amongst mothers.FindingsParticipants were 66 mothers who were the parents of children recruited from primary schools located in socioeconomically disadvantaged suburbs. Intervention group participants viewed a slideshow focussed on healthy snack food affordability that illustrated cheaper healthier alternatives to common snack foods as well as food budgeting tips and price comparison education. A mixed between-within ANCOVA was conducted to examine group differences in perceived affordability of healthy food across three time points. Results revealed no difference in perceived affordability of healthy food between the two groups at baseline whereas at post-intervention and follow-up, mothers in the intervention group perceived healthy food as more affordable than the control group.ConclusionsFocussing on education-based interventions to improve perceptions of healthy food affordability may be a promising approach that complements existing nutrition promotion strategies.

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Economic incentives to promote healthier food purchases: exploring acceptability and key factors for success

Cited by 18 publications

References 34 publications

Acceptability of financial incentives and penalties for encouraging uptake of healthy behaviours: focus groups

Acceptability of financial incentives and penalties for encouraging uptake of healthy behaviours: focus groups

Optimisation Modelling to Assess Cost of Dietary Improvement in Remote Aboriginal Australia

Improving perceptions of healthy food affordability: results from a pilot intervention

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