Determinants of Food Choice and Perceptions of Supermarket-Based Nudging Interventions among Adults with Low Socioeconomic Position: The SUPREME NUDGE Project.

Yvonne T. van der Schouw,Femke Rutters,Josine M. Stuber,Joline W.J. Beulens,Marjolein C. Harbers,Cédric N.H. Middel

doi:10.3390/ijerph18116175

Abstract

Nudging has received ample attention in scientific literature as an environmental strategy to promote healthy diets, and may be effective for reaching populations with low socioeconomic position (SEP). Therefore, the objective of this study was to investigate how the determinants of food choice shape the perceptions regarding supermarket-based nudging strategies among adults with low SEP. We conducted semi-structured interviews among fifteen adults with low SEP using a pre-defined topic list and visual examples of nudges. Interviews were recorded and transcribed verbatim and content analysis was used to analyse the data. The results show that food costs, convenience, healthiness, taste, and habits were frequently mentioned as determinants of food choice. However, the relative importance of these determinants seemed to be context-dependent. Interviewees generally had a positive attitude towards nudges, especially when they were aligned with product preferences, information needs, and beliefs about the food environment. Still, some interviewees also expressed distrust towards nudging strategies, suspecting ulterior motives. We conclude that nudging strategies should target foods which align with product preferences and information needs. However, the suspicion of ulterior motives highlights an important concern which should be considered when implementing supermarket-based nudging strategies.

Highlights

Obesity presents a global threat to public health: in 2016, more than 1.9 billion adults suffered from overweight and obesity worldwide [1], predisposing them to a range of noncommunicable diseases, including type 2 diabetes and cardiovascular disease
For the design of the nudges in this project, we aimed to explore how the determinants of food choice shape the perceptions regarding supermarket-based nudging strategies among adults with low socioeconomic position (SEP), in order to better inform the design of the nudges
Instead of using the term of nudging, we introduced the photos as strategies that supermarkets could implement in order to assist customers in making more healthy food choices

Summary

Introduction

Obesity presents a global threat to public health: in 2016, more than 1.9 billion adults suffered from overweight and obesity worldwide [1], predisposing them to a range of noncommunicable diseases, including type 2 diabetes and cardiovascular disease. In the Netherlands, those with the lowest educational attainment—a key indicator for socioeconomic position (SEP)—are 1.6 times more likely to be overweight and 2.7 times more likely to be obese, compared to people with the highest educational attainment [2] and similar inequalities have been observed in other European countries [3]. Addressing social inequalities is an important step to improving general public health. One of the major drivers of overweight and obesity is an unhealthy diet, characterized by high intakes of nutrient-poor and energy-dense foods [4], stressing the need for improvement of diet quality, especially among populations with low SEP. Not all interventions that aim to improve healthy food choices are effective across levels of SEP. Individual-based interventions (e.g., mainly focusing on information provision) preferentially improve healthy eating outcomes in individuals with high SEP [5], whereas

Objectives

Results

Discussion

Conclusion