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- Title
Comparison of Sales From Vending Machines With 4 Different Food and Beverage Messages: A Randomized Trial.
- Authors
Gibson, Laura A.; Stephens-Shields, Alisa J.; Hua, Sophia V.; Orr, Jennifer A.; Lawman, Hannah G.; Bleich, Sara N.; Volpp, Kevin G.; Bleakley, Amy; Thorndike, Anne N.; Roberto, Christina A.
- Abstract
Key Points: Question: What was the relative effectiveness of 4 food and beverage messages on vending machine sales and calories purchased? Findings: In this randomized trial of 267 vending machines, machines labeled with physical activity calorie equivalents or traffic lights had significantly lower sales of unhealthy beverages (34% and 30%, respectively) compared with machines with beverage tax posters. Traffic lights compared with physical activity labels significantly decreased total calories purchased among 1065 customers (147 vs 178 kcal). Meaning: Traffic light and physical activity calorie equivalent labels encouraged healthier beverage, but not snack, purchases compared with a poster about a beverage tax. This randomized trial uses vending machine data to examine the relative effects of food and beverage messages on vending machine sales and calories purchased. Importance: Point-of-sale food messaging can encourage healthier purchases, but no studies have directly compared multiple interventions in the field. Objective: To examine which of 4 food and beverage messages would increase healthier vending machine purchases. Design, Setting, and Participants: This randomized trial assessed 13 months (February 1, 2019, to February 29, 2020) of vending sales data from 267 machines and 1065 customer purchase assessments from vending machines on government property in Philadelphia, Pennsylvania. Data analysis was performed from March 5, 2020, to November 8, 2022. Interventions: Study interventions were 4 food and beverage messaging systems: (1) beverage tax posters encouraging healthy choices because of the Philadelphia tax on sweetened drinks; (2) green labels for healthy products; (3) traffic light labels: green (healthy), yellow (moderately healthy), or red (unhealthy); or (4) physical activity equivalent labels (minutes of activity to metabolize product calories). Main Outcomes and Measures: Sales data were analyzed separately for beverages and snacks. The main outcomes analyzed at the transaction level were calories sold and the health status (using traffic light criteria) of each item sold. Additional outcomes were analyzed at the monthly machine level: total units sold, calories sold, and units of each health status sold. The customer purchase assessment outcome was calories purchased per vending trip. Results: Monthly sales data came from 150 beverage and 117 snack vending machines, whereas 1065 customers (558 [52%] male) contributed purchase assessment data. Traffic light labels led to a 30% decrease in the mean monthly number of unhealthy beverages sold (mean ratio [MR], 0.70; 95% CI, 0.55-0.88) compared with beverage tax posters. Physical activity labels led to a 34% (MR, 0.66; 95% CI, 0.51-0.87) reduction in the number of unhealthy beverages sold at the machine level and 35% (MR, 0.65; 95% CI, 0.50-0.86) reduction in mean calories sold. Traffic light labels also led to a 30-calorie reduction (b = −30.46; 95% CI, −49.36 to −11.56) per customer trip in the customer purchase analyses compared to physical activity labels. There were very few significant differences for snack machines. Conclusions and Relevance: In this 13-month randomized trial of 267 vending machines, the traffic light and physical activity labels encouraged healthier beverage purchases, but no change in snack sales, compared with a beverage tax poster. Corporations and governments should consider such labeling approaches to promote healthier beverage choices. Trial Registration: ClinicalTrials.gov Identifier: NCT06260176
- Subjects
PENNSYLVANIA; STATISTICAL correlation; DATA analysis; RESEARCH funding; SHOPPING; STATISTICAL sampling; FOOD security; COST analysis; CONSUMER attitudes; FOOD service; SALES personnel; RANDOMIZED controlled trials; DESCRIPTIVE statistics; MARKETING; FOOD; ADVERTISING; TAXATION; FOOD labeling; SURVEYS; BUSINESS; STATISTICS; RESEARCH; HEALTH behavior; QUALITY of life; FOOD preferences; COMPARATIVE studies; DATA analysis software; CONFIDENCE intervals; VENDING machines; BEVERAGES
- Publication
JAMA Network Open, 2024, Vol 7, Issue 1, pe249438
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.9438