A Default Option to Enhance Nutrition Within Financial Constraints: A Randomized, Controlled Proof-of-Principle Trial

Abstract

Objective: This study aimed to examine the feasibility and initial efficacy of a novel default option intervention targeting nutritional quality of online grocery purchases within the financial constraints of food insecurity.

Methods: Female undergraduates (n = 59) without eating disorder symptoms or dietary restrictions selected foods online with a budget corresponding to maximum Supplemental Nutrition Assistance Program benefits. Before completing the task again, participants were randomly assigned to receive a $10 incentive for selecting nutritious groceries (n = 17), education about nutrition (n = 24), or a default online shopping cart containing a nutritionally balanced selection of groceries (n = 18) to which they could make changes. Nutritional quality was quantified by using the Thrifty Food Plan Calculator.

Results: Compared with the education condition, participants in the default condition selected significantly more whole grains and fruits and foods lower in cholesterol, saturated fats, sodium, and overall calories. There were no statistically significant differences in nutritional outcomes between the incentive condition and the other two groups.

Conclusions: Findings provide initial support for the efficacy of a default option in facilitating healthier food choice behaviors within financial constraints.

Trial registration: ClinicalTrials.gov NCT03248583.