Comparison of Sales From Vending Machines With 4 Different Food and Beverage Messages: A Randomized Trial

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Author(s)Gibson, Laura A.
Author(s)Stephens-Shields, Alisa J.
Author(s)Hua, Sophia V.
Author(s)Orr, Jennifer A.
Author(s)Lawman, Hannah G.
Author(s)Bleich, Sara N.
Author(s)Volpp, Kevin G.
Author(s)Bleakley, Amy
Author(s)Thorndike, Anne N.
Author(s)Roberto, Christina A.
Date Accessioned2024-05-14T18:27:17Z
Date Available2024-05-14T18:27:17Z
Publication Date2024-05-08
DescriptionThis article was originally published in Jama Network Open. The version of record is available at: https://doi.org/10.1001/jamanetworkopen.2024.9438. This is an open access article distributed under the terms of the CC-BY License (https://jamanetwork.com/pages/cc-by-license-permissions). © 2024 Gibson LA et al. JAMA Network Open.
AbstractImportance 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
SponsorConflict of Interest Disclosures: Dr Stephens-Shields reported receiving personal fees from Gilead Sciences outside the submitted work. Dr Volpp reported being a part owner of VALHealth, a behavioral economics consulting firm. Dr Lawman contributed to this study in her own capacity, not on behalf of Novo Nordisk. No other disclosures were reported. Funding/Support: This study was funded by award R01DK113307 from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (Dr Roberto, principal investigator). Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
CitationGibson, Laura A., Alisa J. Stephens-Shields, Sophia V. Hua, Jennifer A. Orr, Hannah G. Lawman, Sara N. Bleich, Kevin G. Volpp, Amy Bleakley, Anne N. Thorndike, and Christina A. Roberto. “Comparison of Sales From Vending Machines With 4 Different Food and Beverage Messages: A Randomized Trial.” JAMA Network Open 7, no. 5 (May 8, 2024): e249438. https://doi.org/10.1001/jamanetworkopen.2024.9438.
ISSN2574-3805
URLhttps://udspace.udel.edu/handle/19716/34405
Languageen_US
PublisherJama Network Open
dc.rightsAttribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
TitleComparison of Sales From Vending Machines With 4 Different Food and Beverage Messages: A Randomized Trial
TypeArticle
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