WRAPPED (Women’s Responses to Adjusted Product Placement and it’s Effects on Diet)

Overview:

Unhealthy diet is a key modifiable risk factor for obesity and noncommunicable diseases (NCDs). Government policy is placing increasing emphasis on improving unhealthy diets by intervening at the environmental level to influence the behaviours of many people simultaneously.

Most UK families acquire food from supermarkets; consumers’ food choices in the supermarket environment are influenced by a range of factors including the availability and positioning of products. The National Institute of Health Research (NIHR) has funded researchers from the MRC Lifecourse Epidemiology Unit at the University of Southampton to evaluate the impact of product placement in supermarkets on diets and product sales.

The WRAPPED study is a natural experiment being conducted with Iceland supermarket chain. The intervention will create a healthier store layout.

To date, this study is the largest supermarket trial internationally to assess the health impact of product placement in stores.

Objective:

To examine whether increasing the availability of fresh fruit and vegetables and positioning them near the store entrance in discount supermarkets influences the purchasing and dietary patterns of women aged 18-45 years and their young children.

Methods:

We are inviting 1,620 women aged 18-45 years who regularly shop at one of 36 Iceland stores located across England to take part in the study. They will either be shopping at stores with modified store layout (intervention) or stores where the layout remains the same (control).

Women are being surveyed once before the stores change, and three times afterwards to find out about the food they, and their young children (aged two to six years), usually eat, and their views on the supermarket environment. Women are also asked to share the food purchasing information from their loyalty cards for the nine-month period of the study. We will look for differences in food purchasing and eating patterns between the women shopping at stores with the healthier layout and those using the unchanged stores. The results will tell us whether having a greater range and prominent positioning of fruit and vegetables improves women’s fresh fruit and vegetable purchasing and their own and young children’s diets.

Public Health benefits:

This study is politically and scientifically important. Study findings will be of interest to the public, researchers, food retailers and the government. The results could be used by the government or supermarkets to create in-store layouts that prompt customers to buy healthy foods. Healthier layouts in supermarkets could help everyone to eat better, not just those who are interested in healthy eating, helping people to have a healthy weight and be less likely to develop diabetes or heart disease.

For more information please see: https://bmjopen.bmj.com/content/bmjopen/10/2/e036758.full.pdf

Pilot study results:

Altering product placement to create a healthier layout in supermarkets: Outcomes on store sales, customer purchasing, and diet in a prospective matched controlled cluster study

• Our research shows that removing confectionery and other unhealthy products from checkouts and the end of aisles opposite, as well as placing fruit and vegetables near store entrances, prompts customers to make healthier food purchases
• Confectionery sales decreased by approximately 1,500 portions in each store on a weekly basis when non-food items and water were placed at checkouts and at the aisle-ends opposite
• Fruit and vegetable sales increased by approximately 10,000 portions in each store on a weekly basis when a bigger fresh fruit and vegetable section was relocated near the store entrance
• Using loyalty card information from customers who agreed to take part in our study, we found that families who shopped at the stores with the fresh fruit and vegetable section near the front entrance bought 5% more fruit and vegetables than customers who shopped at stores with this section at the back of the store
• Women and children also reported eating more healthily if they shopped at stores that removed unhealthy foods from checkouts and end of aisles opposite and had fresh fruit and vegetables near the store entrance

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003729

Women’s perceptions of factors influencing their food shopping choices and how supermarkets can support them to make healthier choices

• Study findings suggest that in-store environment can prompt unhealthy food choices even if participants adopted more conscious approaches to food shopping
• The responsibility for healthy food choices is seen to belong to individuals but the supermarket environment is not designed to facilitate this
• Creating healthier supermarket environments could reduce the burden of personal responsibility for healthy eating, by making healthier choices easier

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-11112-0

Resources in women’s social networks for food shopping are more strongly associated with better dietary quality than people: a cross-sectional study

• The research findings suggests that resources which promote healthy eating and healthy food shopping have a stronger association with dietary quality than social support from people.
• Interventions to improve food shopping and dietary behaviours may be particularly effective if resources, such as advertising and media, promoted healthy foods and diets more frequently

https://www.sciencedirect.com/science/article/pii/S0277953621005608

Evaluation of preparations for UK Government High Fat Salt Sugar Food legislation (Promotion and Placement) 2021

The WRAPPED study team are conducting interviews (individual and group) with key stakeholder to understand their views on the upcoming Food (Promotion and Placement) (England) Legislation 2021. Using rapid qualitative analysis, we aim to provide regular reports on our findings regarding the perceived impact, concerns, and support needs for stakeholders and we are holding a conference on 10th May 2022 to bring stakeholders together. See here for further information about this sub-study.

WRAPPED COVID-19 Sub study

The impact of the COVID-19 pandemic on shopping and eating behaviours is significant and has affected most of the population. We are undertaking a qualitative study with women participants from the WRAPPED study. A random sample of women (n= 40) were invited to take part in semi-structured interviews. These interviews covered issues such as stockpiling, altered grocery shopping habits and experiences, adjustment to food outlet closure, needing to cook more meals at home and adopting healthier or less healthy eating behaviours. Demographic information will be used to examine differences in dietary-related reactions to the pandemic according to level of educational attainment.

Principal investigator- Dr Christina Vogel cv@mrc.soton.ac.uk

Co-Principal investigator- Prof Janis Baird jb@mrc.soton.ac.uk

Study manager- Mrs Preeti Dhuria pd@mrc.soton.ac.uk

For more information, you can contact us at:

Email: wrapped@soton.ac.uk Freephone: 08001692042 Text WRAPPED to 66777