Improving cardiometabolic health through nudging dietary behaviours and physical activity in low SES adults: design of the Supreme Nudge project
Lakerveld, Jeroen; Mackenbach, Joreintje D.; De Boer, Femke; Brandhorst, Boris; Broerse, Jacqueline E.W.; De Bruijn, Gert Jan; Feunekes, Gerda; Gillebaart, Marleen; Harbers, Marjolein; Hoenink, Jody; Klein, Michel; Mensink, Frederike; Middel, Cédric; De Ridder, Denise T.D.; Rutters, Femke; Sluijs, Ivonne; Van Der Schouw, Yvonne T.; Schuitmaker, Tjerk Jan; Te Velde, Saskia J.; Velema, Elizabeth; Waterlander, Wilma; Brug, Johannes; Beulens, Joline W.J.
(2018) BMC Public Health, volume 18, issue 1
(Article)
Abstract
Background: Initiating and maintaining a healthy lifestyle -including healthy eating and sufficient physical activity- is key for cardiometabolic health. A health-promoting environment can facilitate a healthy lifestyle, and may be especially helpful to reach individuals with a lower socio-economic status (SES). In the Supreme Nudge project, we will study the
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effects of pricing and nudging strategies in the supermarket - one of the most important point-of-choice settings for food choices - and of a context-specific mobile physical activity promotion app. This paper describes the stepwise and theory-based design of Supreme Nudge, which aims to develop, implement and evaluate environmental changes for a sustained impact on lifestyle behaviours and cardiometabolic health in low SES adults. Methods: Supreme Nudge uses a multi-disciplinary and mixed methods approach, integrating participatory action research, qualitative interviews, experimental pilot studies, and a randomized controlled trial in a real-life (supermarket) setting. First, we will identify the needs, characteristics and preferences of the target group as well as of the participating supermarket chain. Second, we will conduct a series of pilot studies to test novel, promising and feasible intervention components. Third, a final selection of intervention components will be implemented in a full-scale randomised controlled supermarket trial. Approximately 1000 low SES adults will be recruited across 8-12 supermarkets and randomised at supermarket level to receive 1) no intervention (control); 2) environmental nudges such as food product placement or promotion; 3) nudges and a tailored physical activity app that provides time- and context specific feedback; 4) pricing interventions, nudges, and the physical activity app. The effects on dietary behaviours and physical activity will be evaluated at 3, 6 and 12 months, and on cardiometabolic health at 6 and 12 months. Finally, we will evaluate the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) of the intervention, and we will use insights from System Innovation and Transition Management theories to define the best strategies for implementation and upscaling beyond the study period. Discussion: The Supreme Nudge project is likely to generate thorough evidence relevant for policy and practice on the effects of a mixed method and multi-disciplinary intervention targeting dietary behaviours and physical activity. Trial registration: The real-life trial has been registered on 30 May 2018, NTR7302.
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Keywords: Cardiometabolic health, Dietary behaviour, Food environment, Low socio-economic status, M-health, Nudging, Physical activity, Pricing, Supermarket, Public Health, Environmental and Occupational Health
ISSN: 1471-2458
Publisher: BioMed Central
(Peer reviewed)
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