Online retail nudges to help parents with lower‐income choose healthy beverages for their children: A randomized clinical trial

Abstract

SummaryBackgroundNudges offer a promising tool to reduce sugary drink intake among children who are most at risk for diet‐related disease.ObjectiveTo examine the impact of online store nudges on purchases of sugary drinks for children in lower‐income households.MethodsCaregivers with lower‐income were recruited to an online shopping experiment and instructed to spend $10–$30 on three beverages for their child aged 1–5 years. Participants were randomized to navigate an online supermarket in its standard version (n = 1106) or a version with nudges (n = 1135), including a product placement nudge (i.e. placing healthy beverages in prominent positions) and a swap nudge (i.e. offering a swap of water, plain milk and/or 100% fruit juice upon selection of sugary drinks).ResultsOn average, participants purchased 1887 (SD = 2113) and 620 (SD = 1528) calories from sugary drinks per basket in the control and experimental conditions, respectively. Model‐based results indicate that those in the experimental condition purchased 1267 (95% CI: 1419, 1114) fewer calories from sugary drinks, and fewer grams of total sugar (β = −253.5 g (95% CI: −286.3, −220.6)) and added sugar (β = −287.8 g (95% CI: −323.1, −252.5)) purchased from sugary drinks.ConclusionNudges may be an effective, acceptable, scalable strategy for leading caregivers in lower‐income households to purchase fewer sugary drinks for their children.