Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT05070442
Other study ID # NIHA-2018-002 (Study 2)
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date April 22, 2022
Est. completion date October 26, 2022

Study information

Verified date February 2023
Source Duke-NUS Graduate Medical School
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study aims to use a three-arm randomized control trial (RCT) implemented in a fully functional experimental online grocery store, to explore the effects of two low-cost information and incentive-based strategies. These strategies comprise of injunctive norm-based messaging and the use of financial incentive leveraging on loss aversion to encourage the purchase of healthy foods. The investigators have set up a store wherein products may be purchased by participants and subsequently delivered to homes in some of the conditions. This increases the external validity of these interventions and enables investigators to establish greater confidence in their generalizability.


Description:

The Asia-Pacific is faced with an epidemic of rising rates of chronic disease. Poor diet quality is a demonstrated risk factor for non-communicable diseases. Excess intake of calories, saturated fat and sodium increases the risk of obesity, heart disease, diabetes, and other chronic conditions. Behavioral economics has emerged as a promising strategy to increase the effectiveness of interventions aimed to address risk factors for non-communicable diseases (NCDs). Yet, there is a gap in knowledge concerning how norm-based messaging and peer influence interventions can be implemented to improve diet quality. Using a three-arm randomized trial with a 3x3 crossover design, investigators aim to determine whether norm-based messaging and peer comparisons, with or without financial incentives, improve diet quality. Each participant will be exposed to all of the following intervention arms in random order: Arm 1: Control arm. Participants will experience an unmodified version of NUSMart which replicates the traditional shopping experience of online grocery stores. Arm 2: Participants will experience a modified version of NUSMart with norm-based messaging and peer comparison features enabled. Nutri-Score labels will be enabled and displayed on all products within the store. A floating side panel will provide a visual indicator of the participants' average weighted Nutri-Score. Arm 3: Same as Arm 2, except participants are notified of an additional $5 reward towards participation reimbursement. However, this additional $5 will be forfeited if the basket average weighted Nutri-Score falls below the average of participants' peers'. (Financial incentive leveraging on loss aversion). Investigators hypothesize the following: Primary hypothesis: Diet quality, as measured by mean Nutri-Score weighted by number of servings of all basket items, will be greatest when exposed to the intervention with norm-based messaging with incentive (Arm 3), followed by the intervention with norm-based messaging without the incentive (Arm 2), followed by Control (Arm 1). Investigators will test this hypothesis in total, and separately for foods and beverages given Singapore's focus on reducing intake of sugar-sweetened beverages.


Recruitment information / eligibility

Status Completed
Enrollment 248
Est. completion date October 26, 2022
Est. primary completion date October 26, 2022
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 21 Years and older
Eligibility Inclusion Criteria: - Singapore resident - Age 21 and above - Must be the primary weekly grocery shopper in their household Exclusion Criteria: - Non-Singapore resident - Non-primary grocery shopper in their household - Less than 21 years old

Study Design


Related Conditions & MeSH terms


Intervention

Behavioral:
Norm-based messaging and peer comparison features
Participants are shown a version of NUSMart which includes Nutri-Score labels that are enabled and displayed besides all the products in the store. Additionally, they are shown a video that gives them background information about Nutri-Score labels and describes the following features enabled in this intervention: Norm-based messaging will be displayed in the form of a happy or sad emoticon based on whether the participant's current basket average Nutri-Score (weighted by number of servings) is above or below "other shoppers" (Nutri-Score=3.98). Peer comparison will be implemented as a vertical ruler display of the participant's current basket average Nutri-Score (weighted by number of servings) as well as that of their "peers". Nutri-Score=3.98 was chosen as it is 10% better than the mean Nutri-Score of baskets purchased by participants in the Nutri-Score labelled intervention arm of a prior study.
Financial Incentives leveraging on loss aversion
Participants are informed that they have received an additional $5 towards their participant reimbursement. However, this amount will be forfeited if they check-out with a basket average Nutri-Score (weighted by the number of servings) that falls below the average Nutri-Score of "other shoppers" i.e. 3.98. An indicator on the screen that informs the participants of this potential forfeiting will be included.

Locations

Country Name City State
Singapore Duke-NUS Graduate Medical School Singapore

Sponsors (1)

Lead Sponsor Collaborator
Duke-NUS Graduate Medical School

Country where clinical trial is conducted

Singapore, 

Outcome

Type Measure Description Time frame Safety issue
Primary Diet Quality Diet quality, as measured by raw Nutri-Score points (-15 to 40) weighted by number of servings of all basket items. Here, a smaller value means a better outcome. Raw Nutri-Score is measured according to the guidelines from the Sante Publique France. After completion of data collection, an average of about 5 months
Secondary Average Nutri-Score Average Nutri-Score (1 to 5) weighted by number of servings of all basket items. Here, a higher value means a better outcome. This is calculated by converting Nutri-Score letters to numbers such that Nutri-Score E is 1, D is 2 and so on till Nutri-Score A which is 5. After completion of data collection, an average of about 5 months
Secondary Average Calories Average calories per shopping trip. After completion of data collection, an average of about 5 months
Secondary Average Sodium Average sodium per shopping trip. After completion of data collection, an average of about 5 months
Secondary Average Sugar Average sugar per shopping trip. After completion of data collection, an average of about 5 months
Secondary Average Fat Average fat per shopping trip. After completion of data collection, an average of about 5 months
Secondary Average Saturated Fat Average saturated fat per shopping trip. After completion of data collection, an average of about 5 months
See also
  Status Clinical Trial Phase
Completed NCT05018026 - Understanding Grocery Shopping Behaviour N/A
Completed NCT05049005 - Alternative Dietary Approaches Online to Promote Tracking N/A
Active, not recruiting NCT05457439 - Sustainable-psycho-nutritional Intervention Program and Its Effects on Health Outcomes and the Environment N/A
Completed NCT05007184 - Understanding Food Choices in Saudi Arabia N/A
Completed NCT03394326 - Eat Healthy for Families N/A
Completed NCT05537337 - Understanding Food Choices (Aim 2) N/A
Not yet recruiting NCT06266468 - Nutricity: An mHealth Nutrition Intervention to Improve Diet Quality Among Latino Children N/A
Recruiting NCT04762251 - What Or When to Eat to Reduce the Risk of Type 2 Diabetes (WOW) N/A
Completed NCT04632212 - Understanding Food Choices N/A
Recruiting NCT04994938 - Peer-Led Diet and Exercise Intervention N/A