Introduction: Incentives can increase healthy food purchases, but less is known about whether they improve dietary quality. The Smart Cart Study evaluated whether healthful food incentives based on customer preferences and purchase history increased grocery purchase quality and the proportion of spending on targeted foods. Hypothesis: Targeted incentives will increase grocery purchase quality as measured by the Grocery Purchase Quality Index- 2016 (GPQI) and percent spending on targeted healthful foods. Methods: Adults (n=224) who shopped at an independent supermarket for ≥50% of their groceries, participated in the store’s loyalty program, and completed study questionnaires were enrolled in summer 2018. All participants received a 5% loyalty card discount. The intervention group received targeted weekly coupons (~$10 value) with brief education to improve purchase quality for 13-weeks. A computerized study algorithm allocated targeted healthy food coupons to participants’ loyalty cards by using purchase history, dietary preferences, and diet quality. The control group received weekly brief education and occasional generic coupons. After a brief washout, the groups crossed over. GPQI-16 scores (range 0-75) were calculated from cumulative food purchasing data by comparing actual to recommended spending within 11 food groups, with higher scores reflecting higher purchase quality; % spending on targeted vs. all foods was also compared. Paired t-tests examined differences between groups. Results: Participants with extreme spending (i.e. top/bottom 1%) were excluded, leaving an analytic sample of 207 mostly white adults (95%), with mean age of 56 and 50% with household incomes ≥100K. The Table shows changes in GPQI-16 scores and % spending in the first 13-week intervention period, followed by the cross-over intervention period. Conclusions: Results from this pilot trial suggest that targeted healthy supermarket incentives are feasible and are promising tools to help improve diet quality and health.
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