Abstract MP39: Peer Comparison Feedback and Financial Incentives to Promote Employees’ Healthy Food Choices: a Randomized Controlled Trial

Abstract

Objective: New strategies are needed to promote healthy food choices. We conducted a 3-arm randomized controlled trial to compare the effectiveness of: 1) peer comparison feedback about food purchases (FB), 2) feedback plus financial incentives (FB+INC), or 3) no feedback (control) to promote healthy purchases by employees in a large hospital cafeteria. Methods: Subjects were 2672 employees who made ≥ 6 purchases in 2 months prior to study. All items were labeled green (healthy), yellow (less healthy), and red (unhealthy). The FB group received monthly letters from Oct-Dec 2012 reporting proportion of the individual’s purchases that were green/yellow/red in the prior month, comparing to purchases by “all” and by “healthiest” employees. The FB+INC group received a similar letter plus an incentive ($10) to increase their proportion of green in the next month. Control received no contact. We compared changes in green and red purchases from baseline (Sept) to intervention end (Dec) and to end of a 3 month wash-out (Mar 2013) using random effects models of employee-specific changes in purchases. Results: Subjects were: 73% female; 48% > 40 years; 75% white. At baseline, mean proportion of green purchases was 50% for all groups. The Figure shows monthly percentage change in proportion of green purchases compared to baseline. At end of intervention compared to baseline, control had no change, FB increased 1.8% (p=0.07 vs. control), and FB+INC increased 2.2% (p=0.03 vs. control). At end of wash-out compared to baseline, control increased 1.7%, FB increased 2.6% (p=0.4 vs. control), and FB+INC increased 3.0% (p=0.2 vs. control). Red purchases decreased in both intervention groups compared to control at end of intervention (p=0.07 for both) and wash-out (p≤0.04 for both). Conclusions: Providing peer comparison feedback with small financial incentives increased healthy purchases by employees. This population-based approach for promoting healthy eating could be effective in other worksite, institutional, and retail settings.