Plain English Summary
Background and study aims
Unhealthy eating is the risk factor with the greatest contribution to life years lost in Australia. With supermarkets accounting for the majority of food spending in Australia, marketing techniques in the supermarket environment have the potential to improve the healthiness of consumer food purchases at a population level. However, to date, there is limited evidence of the real world feasibility and impact of interventions designed to create supermarket environments that encourage healthy food purchases. A partnership between IGA, the City of Greater Bendigo, Deakin University and VicHealth was formed to test a range of low-cost, scalable changes to supermarket store environments aimed to increase healthy purchasing.
Who can participate?
IGA stores involved in a collaborative marketing group, based in Bendigo Victoria.
What does the study involve?
Participating stores are randomly allocated to one of two groups. Stores in the first group continue as normal for the duration of the study. Stores in the second group receive a range of interventions, including shelf tags promoting the healthiest product store-wide, trolley and basket signage to promote healthy eating, promoting healthier options at the end-of-aisle shelf/checkout counters, and local and in-store promotion (e.g. posters in-store, letter box drops of brochures in the local community). The research team monitors the in-store interventions and promotions on a weekly basis, with minimum disruption to the customers.
What are the possible benefits and risks of participating?
Participating stores will receive the healthy food promotional items (i.e. shelf tags, trolley/basket signs) at no cost and will also receive local community promotion (i.e. letter box drop brochures). Stores will be promoted locally as supermarkets doing something for the health of their customers. The store operation should not be affected and therefore no risks for the participating stores are anticipated.
Where is the study run from?
The study is run by Deakin University and takes place in 11 IGA stores based in Bendigo Victoria (Australia)
When is the study starting and how long is it expected to run for?
December 2016 to March 2018
Who is funding the study?
National Health and Medical Research Council (Australia)
Who is the main contact?
Dr Adrian Cameron
adrian.cameron@deakin.edu.au
Trial website
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
1133090
Study information
Scientific title
A multi-component supermarket intervention to promote healthy eating
Acronym
Study hypothesis
1. A co-developed package of low-cost and scalable interventions in the supermarket environment will lead to short and longer-term improvements in the healthiness of consumer food purchases, with no decrease in retailer profits
2. This multi-component intervention will be cost-effective from a societal perspective.
Ethics approval
Deakin University Human Ethics Advisory Group, Faculty of Health, 15/12/2015 , ref: #HEAG-H 65_2015
Amendments approved 16/05/2016 and 09/01/2017.
Study design
Randomised controlled trial
Primary study design
Interventional
Secondary study design
Randomised controlled trial
Trial setting
Other
Trial type
Other
Patient information sheet
As the trial is at the level of the supermarket, and does not include individual participants, a patient/participant information sheet is not available. Please use the contact details below to request more information on the impact of the trial on participants/customers.
Condition
Population Diet
Intervention
This is a randomized controlled trial in 11 IGA supermarkets in Victoria, Australia, with 5 stores randomised to intervention and 6 to control. The primary aim of the trial is to test the effect on the healthiness of consumer food purchases of a low-cost and scalable multi-component intervention in the supermarket setting. The financial impact of this intervention on the retailer, and the potential cost-effectiveness of the intervention as a nutrition promotion and obesity prevention strategy in Australia will also both be evaluated.
To ensure comparability of intervention and control stores, the stores will be stratified according to socio-demographic characteristics of the community. Disadvantage will be assessed at the suburb level using the Australian Bureau of Statistics socio-economic index for Australia. Of the 11 stores, two are in the top decile (least disadvantaged), two in the lowest decile, and seven in the 5th or 6th deciles.
Randomisation within stratified groups of stores will be conducted by the study statistician, CI Orellana, using computer-generated random numbers.
Baseline sales data will be (retrospectively) collected between May 2016 and May 2017.
The intervention period for the study is between 12th May 2017 (launch date) and March 1st, 2018.
Data collection (sales data) will continue during 2018 to assess the longer-term impact of the interventions, albeit without control stores during this time.
The intervention stores will receive a range of interventions. All stores will install shelf tags promoting the healthiest product store-wide (identified as those with a 4.5 or 5 star rating on the Australian Health Star Rating scheme), and both trolley and basket signage to promote healthy eating. Local promotion for all intervention stores will involve letter box drops of brochures in the local community. Individual stores will also implement additional components, selected from the following based on specific store logistics and constraints: a) the promotion of a dedicated healthier end-of-aisle shelf/checkout counters, b) in-store promotion (e.g. posters in-store), c) promotion on store-specific social media, d) installation of floor decals promoting healthy eating, e) branded island bins near registers containing healthier products, f) shelf tags highlighting specific healthier alternatives or complementary products, g) staff training, h) laminated sheets to help identify healthier catalogue options at store end-plan meetings (meetings where store and department managers select what products to place on end-of-aisle and island bin displays). A public launch of the project will be conducted in May 2017, promoting the intervention only in those stores allocated to receive the intervention.
Control stores will not receive any specific intervention during the main intervention period (May 2017 to February 2018). Since it is important to the retailer and local government partners that each community eventually receives the intervention, it will be implemented in all stores at the conclusion of the trial.
Intervention type
Behavioural
Phase
Drug names
Primary outcome measure
Store sales of healthy (‘core’) and less healthy ('discretionary') foods is assessed using store sales data is aggregated weekly per store and per department (e.g. grocery, dairy, bakery) is assessed by reviewing sales data collected during the the baseline period (12 months prior to the intervention period), intervention period (May 2017 to end Feb 2018) and the post-intervention period (2018).
Secondary outcome measures
1. Mean change between the baseline and intervention periods in sales of packaged foods according to their health star rating (measured both as a dichotomous ≥4.5 vs. <4.5 star rating, as well as a continuous measure) will be assessed using store sales data obtained at the completion of the intervention period (Feb/March 2018)
2. Mean change between the baseline and intervention periods in sales of fresh fruit and vegetables is measured using store sales data of all fresh fruit and vegetables assessed using store sales data obtained at the completion of the intervention period (Feb/March 2018)
3. The nutrient value of all products sold will be obtained by matching the products in the sales database to either the database obtained from the FoodSwitch app (The George Institute), or the AusNut database. Mean change between the baseline and intervention periods in key nutrients, including total energy (kj), fat, saturated fat, sugar, salt, fibre, protein and carbohydrate content will be assessed
5. Mean change between the baseline and intervention periods in profit will be measured using the cost and retail price of all food sold, using store sales data
Overall trial start date
01/12/2016
Overall trial end date
01/03/2018
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
IGA stores involved in a collaborative marketing group, based in Bendigo Victoria.
Participant type
Other
Age group
Other
Gender
Both
Target number of participants
11 supermarkets in regional Victoria
Participant exclusion criteria
Stores not willing to participate.
Recruitment start date
12/05/2017
Recruitment end date
12/05/2018
Locations
Countries of recruitment
Australia
Trial participating centre
Deakin University
221 Burwood Hwy
Burwood
3125
Australia
Sponsor information
Organisation
National Health and Medical Research Council
Sponsor details
GHD Building Level 1
16 Marcus Clarke Street
Canberra
2601
Australia
+61 2 6217 9000
nhmrc.rc@nhmrc.gov.au
Sponsor type
Research council
Website
Funders
Funder type
Research council
Funder name
National Health and Medical Research Council
Alternative name(s)
NHMRC
Funding Body Type
government organisation
Funding Body Subtype
National government
Location
Australia
Results and Publications
Publication and dissemination plan
The investigator team, which includes Jane Martin, the head of the Obesity Policy Coalition (the peak obesity policy advocacy organisation in Australia) will ensure effective translation of findings to researchers, advocates and policy makers both nationally and internationally. The research translation strategy incorporates publications in high-impact peer-reviewed journals in 2019.
IPD Sharing plan:
The participant level data, which is the stores sales data in our case, is commercial in confidence and will therefore not be made available. The data will be password protected and kept on a secure server at Deakin University assessed only by the research team for data analysis purposes.
Intention to publish date
31/12/2019
Participant level data
Not expected to be available
Basic results (scientific)
Publication list