Abstract
In the transition from high school to university, vegetable consumption tends to deteriorate, potentially influencing immediate and longer-term health outcomes. Nudges, manipulation of the environment to influence choice, have emerged as important to behavior change goals. This quasi-experimental pilot study examined the impact of a contextually feasible evidence-informed nudge intervention on food purchasing behavior of older adolescents (1st year students) in a university residence cafeteria in British Columbia, Canada. A co-design process with students and staff identified a student relevant and operationally feasible nudge intervention; a placement nudge, fresh vegetables at the hot food table, combined with a sensory and cognitive nudge, signage encouraging vegetable purchase). Using a 12-week single-case A-B-A-B design, observations of the proportion of vegetables purchased were used to assess intervention efficacy. Data analysis included visual trend inspection, central tendency measures, data overlap, variability and latency. Visual trend inspection showed a positive trend when nudges were in place, which was more apparent with female purchases and during the first intervention (B) phase. However, further analysis showed lack of baseline stability, high variability across phases and overlapping data, limiting efficacy conclusions. Menu choices, staff encouragement, term timing and student finances are other potential influences. Further ‘real world’ nudge research is needed.
Highlights
Vegetables are one of the most important foods we consume as humans due to their nutrient density and fiber, as well as their low energy contribution to the diet
Visual inspection of the means used to assess the potential efficacy of the nudge interventions (B1, B2) showed neither intervention had an effect on the mean proportion of vegetables purchased between phases for the overall sample or for females or males analyzed separately
Co-design of interventions in real-life settings is related to better implementation, as interventions typically reflect and/or are relevant for the context [17,18]. The impact of this intervention on older adolescent vegetable purchasing remains in question but the effect sizes were promising
Summary
Vegetables are one of the most important foods we consume as humans due to their nutrient density and fiber, as well as their low energy contribution to the diet. The consumption of vegetables can promote satiety and reduce the risk of obesity, which is a growing concern globally and affects the target population of this study—older adolescents (17–19) in their first year of university, who have documented weight gain [2]. It has been found that unhealthy eating habits and weight gain established in youth tend to be maintained during. Nutrients 2019, 11, 1786 aging [4,5] This worldwide scenario highlights the importance of developing strategies to increase vegetable consumption in this population and attempt to slow the global obesity epidemic
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