Evidence map›Paper›PMID 38502177›Full record

Trial reportJournal of medical Internet research2024

Long-Term Effectiveness of a Multi-Strategy Choice Architecture Intervention in Increasing Healthy Food Choices of High-School Students From Online Canteens (Click & Crunch High Schools): Cluster Randomized Controlled Trial.

Tessa Delaney, Jacklyn Jackson, Christophe Lecathelinais, Tara Clinton-McHarg, Hannah Lamont, Sze Lin Yoong, Luke Wolfenden, Rachel Sutherland, Rebecca Wyse

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of medical Internet research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Tessa DelaneySchool of Medicine and Public Health, University of Newcastle, Wallsend, Australia.ORCID 0000-0002-2756-4821
Jacklyn JacksonSchool of Medicine and Public Health, University of Newcastle, Wallsend, Australia.ORCID 0000-0001-7633-0418
Christophe LecathelinaisSchool of Medicine and Public Health, University of Newcastle, Wallsend, Australia.ORCID 0000-0002-8931-473X
Tara Clinton-McHargMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.ORCID 0000-0001-5833-7376
Hannah LamontSchool of Medicine and Public Health, University of Newcastle, Wallsend, Australia.ORCID 0000-0002-3688-566X
Sze Lin YoongFaculty of Health, School of Health and Social Development, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Melbourne, Australia.ORCID 0000-0002-0836-017X
Luke WolfendenSchool of Medicine and Public Health, University of Newcastle, Wallsend, Australia.ORCID 0000-0002-6178-3868
Rachel SutherlandSchool of Medicine and Public Health, University of Newcastle, Wallsend, Australia.ORCID 0000-0003-0470-7663
Rebecca WyseSchool of Medicine and Public Health, University of Newcastle, Wallsend, Australia.ORCID 0000-0002-4872-2112
Hunter Medical Research Institute · AUDeakin University · AUThe University of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSchool canteens are a recommended setting to influence adolescent nutrition due to their scope to improve student food choices. Online lunch ordering systems ("online canteens") are increasingly used and represent attractive infrastructure to implement choice architecture interventions that nudge users toward healthier food choices. A recent cluster randomized controlled trial demonstrated the short-term effectiveness (2-month follow-up) of a choice architecture intervention to increase the healthiness of foods purchased by high school students from online canteens. However, there is little evidence regarding the long-term effectiveness of choice architecture interventions targeting adolescent food purchases, particularly those delivered online.

objectiveThis study aimed to determine the long-term effectiveness of a multi-strategy choice architecture intervention embedded within online canteen infrastructure in high schools at a 15-month follow-up.

methodsA cluster randomized controlled trial was undertaken with 1331 students (from 9 high schools) in New South Wales, Australia. Schools were randomized to receive the automated choice architecture intervention (including menu labeling, positioning, feedback, and prompting strategies) or the control (standard online ordering). The foods purchased were classified according to the New South Wales Healthy Canteen strategy as either "everyday," "occasional," or "should not be sold." Primary outcomes were the average proportion of "everyday," "occasional," and "should not be sold" items purchased per student. Secondary outcomes were the mean energy, saturated fat, sugar, and sodium content of purchases. Outcomes were assessed using routine data collected by the online canteen.

resultsFrom baseline to 15-month follow-up, on average, students in the intervention group ordered significantly more "everyday" items (+11.5%, 95% CI 7.3% to 15.6%; P<.001), and significantly fewer "occasional" (-5.4%, 95% CI -9.4% to -1.5%; P=.007) and "should not be sold" items (-6%, 95% CI -9.1% to -2.9%; P<.001), relative to controls. There were no between-group differences over time in the mean energy, saturated fat, sugar, or sodium content of lunch orders.

conclusionsGiven their longer-term effectiveness, choice architecture interventions delivered via online canteens may represent a promising option for policy makers to support healthy eating among high school students.

trial registrationAustralian Clinical Trials ACTRN12620001338954, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380546 ; Open Science Framework osf.io/h8zfr, https://osf.io/h8zfr/.

Indexed as

Administrative PersonnelFoodAdolescentAustraliaHumansSodiumSugarsSodiumSugarsarchitecturebehavioral economicsbehavior changebehaviour changecanteencanteenschoicechoicescontrolled trialcontrolled trialsdietdigital interventioneatingfoodlunchmealmeal delivery appsmealsmenumenu labellingmenusnudgenudgesnutritionnutritionalorderingpromptpromptingpromptspublic health nutritionpurchasepurchasingrandomizedrandomized controlled trialRCTschoolschoolssecondary schoolstudentstudentsweb-based ordering systems

Identifiers

PMID38502177
PMCPMC10988364
OpenAlexW4391368035

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.