Soye Shin, Yan Xiaoxi, Bibhas Chakraborty, Eric A Finkelstein
{"title":"A Randomized Trial Using an Online Grocery Store to Evaluate a Multicomponent Digital Intervention to Improve Diet Quality.","authors":"Soye Shin, Yan Xiaoxi, Bibhas Chakraborty, Eric A Finkelstein","doi":"10.1016/j.amepre.2025.03.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Poor diet is a key contributor to rising rates of non-communicable diseases. This study tested the ability of an online grocery store that includes a multicomponent digital intervention identified through the Multiphase Optimization Strategy to improve the nutritional quality of shopper's purchases.</p><p><strong>Study design: </strong>A two-arm randomized controlled trial.</p><p><strong>Setting/participants: </strong>A convenience sample of online grocery shoppers in Singapore who were the primary shoppers for their household were recruited via advertisements on Facebook and Instagram (n=328). Data were collected between January and October 2023.</p><p><strong>Intervention: </strong>Participants were randomized into one of two versions of the online grocery store and asked to complete three weekly orders delivered to their homes. The arms were: (1) an online store with no intervention (Control); (2) the same online store with the multicomponent intervention, including (i) interpretive Front-of-Package nutrition labels, (ii) real-time feedback on the nutritional quality of the grocery cart, (iii) ordering of healthier products first, and (iv) offering healthier substitutes for shoppers' chosen products.</p><p><strong>Main outcome measures: </strong>The primary outcome was the weighted (by number of servings) average Nutri-Score (NS) points of the grocery cart. Secondary outcomes included the weighted average calories and select nutrients (sugar, sodium, total fat, and saturated fat) per serving. These outcomes were analysed using a linear mixed-effects model.</p><p><strong>Results: </strong>The multicomponent intervention led to a statistically significant 4.06-point [95% CI: 3.06, 5.07] increase in the weighted average NS of the grocery cart relative to Control, which equates to improving the nutritional quality of the cart from NS grade C (30-37 points) to B (37.1-40 points). The positive intervention effects were sustained across the three shopping experiences.</p><p><strong>Conclusions: </strong>The multicomponent intervention improved the nutritional quality of online grocery carts over repeated orders, highlighting the potential of digital interventions to improve diet quality.</p><p><strong>Trial registration: </strong>This study is registered at www.</p><p><strong>Clinicaltrials: </strong>gov NCT05537337.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Preventive Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amepre.2025.03.002","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Poor diet is a key contributor to rising rates of non-communicable diseases. This study tested the ability of an online grocery store that includes a multicomponent digital intervention identified through the Multiphase Optimization Strategy to improve the nutritional quality of shopper's purchases.
Study design: A two-arm randomized controlled trial.
Setting/participants: A convenience sample of online grocery shoppers in Singapore who were the primary shoppers for their household were recruited via advertisements on Facebook and Instagram (n=328). Data were collected between January and October 2023.
Intervention: Participants were randomized into one of two versions of the online grocery store and asked to complete three weekly orders delivered to their homes. The arms were: (1) an online store with no intervention (Control); (2) the same online store with the multicomponent intervention, including (i) interpretive Front-of-Package nutrition labels, (ii) real-time feedback on the nutritional quality of the grocery cart, (iii) ordering of healthier products first, and (iv) offering healthier substitutes for shoppers' chosen products.
Main outcome measures: The primary outcome was the weighted (by number of servings) average Nutri-Score (NS) points of the grocery cart. Secondary outcomes included the weighted average calories and select nutrients (sugar, sodium, total fat, and saturated fat) per serving. These outcomes were analysed using a linear mixed-effects model.
Results: The multicomponent intervention led to a statistically significant 4.06-point [95% CI: 3.06, 5.07] increase in the weighted average NS of the grocery cart relative to Control, which equates to improving the nutritional quality of the cart from NS grade C (30-37 points) to B (37.1-40 points). The positive intervention effects were sustained across the three shopping experiences.
Conclusions: The multicomponent intervention improved the nutritional quality of online grocery carts over repeated orders, highlighting the potential of digital interventions to improve diet quality.
Trial registration: This study is registered at www.
期刊介绍：
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.
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