Randomized Trial of Financial Incentives to Reduce Sugar-sweetened Beverage Purchases by Low-income, Latino Families

Approximately 15% of the US population is enrolled in the Supplemental Nutrition Assistance
Program (SNAP), and 50% are children. Although the goal is to improve nutritional health,
preliminary data suggest that enrollment in SNAP is associated with obesity and metabolic
risks and that SNAP reimburses $4 billion annually for sugar-sweetened beverages (SSBs).
This pilot project tests an innovative strategy to reduce purchase of non-nutritive, SSBs by
low-income families with children by combining targeted point-of-purchase education with a
randomized trial of financial incentives to discourage purchase of unhealthy beverages. The
study will take place at a mid-size grocery store that is located in a low-income, Latino
community and where 30% of purchases are made with SNAP. Targeted beverage education will be
provided to all study subjects with a traffic-light system to identify healthy and unhealthy
beverages at the point-of-purchase. Individual beverage purchases will be tracked by
electronically stored cash register sales. Supplementary validation of beverage consumption
will be assessed by 24 hour dietary recall. Aim 1 is to conduct a randomized controlled
trial to compare purchase and consumption of SSBs by families assigned to a financial
incentive to reduce purchase of SSBs with families assigned to control (no incentives). Aim
2 is to compare the purchase of SSBs by families in both arms during the study period when
they are exposed to the traffic-light system to a baseline period prior to traffic-light
education. Results of this project will provide pilot data for larger scale interventions to
promote healthy choices among low-income families.