Behavioral Economics to Implement a Traffic Light Nutrition Ranking System: Study 2

NCT06298253 | Recruiting

• 1 other identifier: 2024P000832
• Study Type: interventional
• Target: 3,750
• Locations: 1 country
• Sites: 1

Brief Summary

This is a cluster randomized controlled trial of 30 food pantries affiliated with the Greater Boston Food Bank to test the use of behavioral economics (BE) tools to encourage food pantries to implement the Supporting Wellness at Pantries (SWAP) program, with the goal of fostering accurate use of SWAP traffic light labels on pantry shelves and increasing the healthfulness of foods chosen by pantry clients. Primary outcomes will be assessed at 6 and 12 months to compare the implementation and effectiveness of the SWAP program in the intervention vs. control pantries.

Conditions

Food Insecurity; Implementation Science; Diet, Healthy; Behavioral Economics

Outcome Measures

Primary Outcomes (4)

• Pantry SWAP implementation

  Proportion of pantries in the intervention vs. control group that implement SWAP (e.g., traffic-light labels on shelves)

  6 months and 12 months

• Percent items (by weight) ordered by pantry that are labeled green or red

  Using data collected from the food bank ordering platform, this outcome will be the proportions (by weight) of the overall orders from GBFB that are green-labeled and red-labeled according to SWAP ranking categories

  6 months and 12 months

• Percent of pantry clients' selected food that is green or red

  Using pantry client basket assessments, the total proportion (by weight) of food selected by the client that is labeled green (or red) will be calculated for each participant

  6 months and 12 months

• Client dietary quality score

  Rapid Prime Dietary Quality Score (range 0 to 52, higher is healthier) collected at the time clients are leaving the pantry

  6 months and 12 months

Secondary Outcomes (1)

• Skin carotenoid level

  6 months and 12 months

Study Arms (2)

Behavioral economics-enhanced SWAP implementation strategy

EXPERIMENTAL

Pantries assigned to the intervention group will receive behavioral nudges for implementing the SWAP nutrition program. These include: 1) invoice labeling with the food labeled as red, yellow, or green; 2) receipt of the SWAP toolkit at no cost; 3) pantry learning communities; 4)incentives to purchase SWAP implementation materials (e.g., shelves); 5) food bank recognition for SWAP implementation.

Behavioral: Behavioral economics-enhanced SWAP implementation

Basic SWAP implementation strategy

ACTIVE COMPARATOR

Pantries assigned to the control arm will receive email communication from the food bank dietitian providing them with information about SWAP, online links to SWAP implementation guides, and encouragement to purchase SWAP Toolkits on their own.

Behavioral: Basic SWAP implementation

Interventions

Behavioral economics-enhanced SWAP implementation BEHAVIORAL

Intervention will include behavioral nudges at baseline and over 12 months to promote use of the SWAP nutrition program for pantries.

Behavioral economics-enhanced SWAP implementation strategy

Basic SWAP implementation BEHAVIORAL

Intervention will include basic information about the SWAP program and encouragement to obtain SWAP toolkits.

Basic SWAP implementation strategy

Eligibility Criteria

• Age: 18 Years - 90 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Food pantries enrolled in the study will be partner agencies of the Greater Boston Food Bank that are maximum client choice, are located within approximately 1 hour driving time of Boston (for logistical feasibility), and are not actively using traffic-light nutrition ranking.
• Food pantry clients that complete assessments must be 18 years or older and speak English or Spanish.

You may not qualify if:

• Food pantries that are not affiliated with the Greater Boston Food Bank and are not maximum client choice.
• Food pantry clients that do not speak English or Spanish.

Sponsors & Collaborators

• Massachusetts General Hospital: lead

Study Sites (1)

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

RECRUITING

Related Publications (1)

• Perez PD, Faulkner KC, Wu Y, Schwartz MB, Caspi C, Burgun R, Ortiz L, Jia J, Cheng J, Chang Y, Levy DE, Thorndike AN. Behavioural economics intervention to implement a nutrition ranking system in food pantries: Be Well cluster randomised controlled trial protocol. BMJ Public Health. 2025 Dec 30;3(2):e003650. doi: 10.1136/bmjph-2025-003650. eCollection 2025.

  PMID: 41496767 DERIVED

Study Officials

• Anne N Thorndike, MD, MPH

  Massachusetts General Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Anne N Thorndike, MD, MPH

CONTACT

617-724-4608; athorndike@mgh.harvard.edu

Douglas Levy, PhD

CONTACT

617-643-3595; dlevy3@mgh.harvard.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Medicine

Study Record Dates

• First Submitted: March 1, 2024
• First Posted: March 7, 2024
• Study Start: October 1, 2024
• Primary Completion (Estimated): June 1, 2027
• Study Completion (Estimated): June 1, 2028
• Last Updated: April 30, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: Analytic plans and details will be made available no later than the official publication date of a peer-reviewed article and will be available for at least five years after the study period ends. De-identified data from the study will be made publicly available through the data repository within 90 days of the closeout of the project and made available according to the Harvard Dataverse's data retention policy. Additionally, data for each publication will be deposited by the time of publication.
• Access Criteria: In accordance with the data repository methods, completion of a data use agreement form, that stipulates data sharing under an IRB-approved protocol, will be required for accessing the data.

Locations

US (1)