Altering product placement to create a healthier layout in supermarkets: outcomes on store sales, customer purchasing and diet in a prospective matched-controlled cluster study.
Altering product placement to create a healthier layout in supermarkets: outcomes on store sales, customer purchasing and diet in a prospective matched-controlled cluster study.
BACKGROUND: Previous product placement trials in supermarkets are limited in scope and outcome data collected. This study assessed the effects on store-level sales, household-level purchasing, and dietary behaviours of a healthier supermarket layout.
METHODS AND FINDINGS: This is a prospective matched controlled cluster trial with 2 intervention components: (i) new fresh fruit and vegetable sections near store entrances (replacing smaller displays at the back) and frozen vegetables repositioned to the entrance aisle, plus (ii) the removal of confectionery from checkouts and aisle ends opposite. In this pilot study, the intervention was implemented for 6 months in 3 discount supermarkets in England. Three control stores were matched on store sales and customer profiles and neighbourhood deprivation. Women customers aged 18 to 45 years, with loyalty cards, were assigned to the intervention (n = 62) or control group (n = 88) of their primary store. The trial registration number is NCT03518151. Interrupted time series analysis showed that increases in store-level sales of fruits and vegetables were greater in intervention stores than predicted at 3 (1.71 standard deviations (SDs) (95% CI 0.45, 2.96), P = 0.01) and 6 months follow-up (2.42 SDs (0.22, 4.62), P = 0.03), equivalent to approximately 6,170 and approximately 9,820 extra portions per store, per week, respectively. The proportion of purchasing fruits and vegetables per week rose among intervention participants at 3 and 6 months compared to control participants (0.2% versus -3.0%, P = 0.22; 1.7% versus -3.5%, P = 0.05, respectively). Store sales of confectionery were lower in intervention stores than predicted at 3 (-1.05 SDs (-1.98, -0.12), P = 0.03) and 6 months (-1.37 SDs (-2.95, 0.22), P = 0.09), equivalent to approximately 1,359 and approximately 1,575 fewer portions per store, per week, respectively; no differences were observed for confectionery purchasing. Changes in dietary variables were predominantly in the expected direction for health benefit. Intervention implementation was not within control of the research team, and stores could not be randomised. It is a pilot study, and, therefore, not powered to detect an effect.
CONCLUSIONS: Healthier supermarket layouts can improve the nutrition profile of store sales and likely improve household purchasing and dietary quality. Placing fruits and vegetables near store entrances should be considered alongside policies to limit prominent placement of unhealthy foods.
TRIAL REGISTRATION: ClinicalTrials.gov NCT03518151 (pre-results).
Vogel, Christina
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Crozier, Sarah
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Penn-newman, Daniel J
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Ball, Kylie
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Moon, Graham
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Lord, Joanne
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Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Baird, Janis
f4bf2039-6118-436f-ab69-df8b4d17f824
7 September 2021
Vogel, Christina
768f1dcd-2697-4aae-95cc-ee2f6d63dff5
Crozier, Sarah
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Penn-newman, Daniel J
7be13c0e-0019-41c1-b2c9-c82a3b11cd48
Ball, Kylie
fda275b8-c7ae-43f2-ab38-d1b487cbe671
Moon, Graham
68cffc4d-72c1-41e9-b1fa-1570c5f3a0b4
Lord, Joanne
fd3b2bf0-9403-466a-8184-9303bdc80a9a
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Baird, Janis
f4bf2039-6118-436f-ab69-df8b4d17f824
Vogel, Christina, Crozier, Sarah, Penn-newman, Daniel J, Ball, Kylie, Moon, Graham, Lord, Joanne, Cooper, Cyrus and Baird, Janis
(2021)
Altering product placement to create a healthier layout in supermarkets: outcomes on store sales, customer purchasing and diet in a prospective matched-controlled cluster study.
PLoS Medicine, 18 (9), [e1003729].
(doi:10.1371/journal.pmed.1003729).
Abstract
BACKGROUND: Previous product placement trials in supermarkets are limited in scope and outcome data collected. This study assessed the effects on store-level sales, household-level purchasing, and dietary behaviours of a healthier supermarket layout.
METHODS AND FINDINGS: This is a prospective matched controlled cluster trial with 2 intervention components: (i) new fresh fruit and vegetable sections near store entrances (replacing smaller displays at the back) and frozen vegetables repositioned to the entrance aisle, plus (ii) the removal of confectionery from checkouts and aisle ends opposite. In this pilot study, the intervention was implemented for 6 months in 3 discount supermarkets in England. Three control stores were matched on store sales and customer profiles and neighbourhood deprivation. Women customers aged 18 to 45 years, with loyalty cards, were assigned to the intervention (n = 62) or control group (n = 88) of their primary store. The trial registration number is NCT03518151. Interrupted time series analysis showed that increases in store-level sales of fruits and vegetables were greater in intervention stores than predicted at 3 (1.71 standard deviations (SDs) (95% CI 0.45, 2.96), P = 0.01) and 6 months follow-up (2.42 SDs (0.22, 4.62), P = 0.03), equivalent to approximately 6,170 and approximately 9,820 extra portions per store, per week, respectively. The proportion of purchasing fruits and vegetables per week rose among intervention participants at 3 and 6 months compared to control participants (0.2% versus -3.0%, P = 0.22; 1.7% versus -3.5%, P = 0.05, respectively). Store sales of confectionery were lower in intervention stores than predicted at 3 (-1.05 SDs (-1.98, -0.12), P = 0.03) and 6 months (-1.37 SDs (-2.95, 0.22), P = 0.09), equivalent to approximately 1,359 and approximately 1,575 fewer portions per store, per week, respectively; no differences were observed for confectionery purchasing. Changes in dietary variables were predominantly in the expected direction for health benefit. Intervention implementation was not within control of the research team, and stores could not be randomised. It is a pilot study, and, therefore, not powered to detect an effect.
CONCLUSIONS: Healthier supermarket layouts can improve the nutrition profile of store sales and likely improve household purchasing and dietary quality. Placing fruits and vegetables near store entrances should be considered alongside policies to limit prominent placement of unhealthy foods.
TRIAL REGISTRATION: ClinicalTrials.gov NCT03518151 (pre-results).
Text
Vogel manuscript Mar2021_Plos Med_clean_30032021 v1.1_PURE
- Accepted Manuscript
More information
Accepted/In Press date: 12 July 2021
Published date: 7 September 2021
Additional Information:
Publisher Copyright:
© 2021 Vogel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
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Local EPrints ID: 451929
URI: http://eprints.soton.ac.uk/id/eprint/451929
ISSN: 1549-1277
PURE UUID: acaf61a7-aba8-45a3-9284-8f4f90a030b9
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Date deposited: 03 Nov 2021 17:52
Last modified: 06 Jun 2024 01:54
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Author:
Daniel J Penn-newman
Author:
Kylie Ball
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