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Shopping for a healthy bargain


Some Wellington shoppers have had an added dimension to their supermarket shopping recently, thanks to a trial called SHOP.

The Supermarket Healthy Options Project (SHOP) feasibility study aims to pilot the design and processes for a large randomised controlled trial of the effectiveness of two strategies for promoting healthier food purchases in supermarkets:
1) Culturally appropriate nutrition education and
2) Price discounts

Funded by the Health Research Council and National Heart Foundation, with sponsorship from the Cancer Society and in partnership with Wellington School of Medicine, Te Hotu Manawa Maori, and the Pacific Islands Heartbeat Programme, the study is being led by Dr Cliona Ni Mhurchu. She is a public health nutritionist based in the Clinical Trials Research Unit, Faculty of Medicine and Health Sciences, at the University of Auckland.

The feasibility study consists of three phases:
1) Development and pre-testing of culturally appropriate nutrition resources
2) Ethnic-specific focus groups to provide feedback on the proposed study interventions and processes
3) A pilot trial where customers will be randomised to one of four intervention groups: education, discounts, education plus discounts, or a control group.

Effects on purchase of fruit and vegetables is to be measured over a 12-week period using individualised electronic shopping data (Shop 'N Go).

The pilot trial started in March 2005 and recruited 97 participants, but Cliona says unfortunately she was unable to sign up many Maori or Pacific Islanders. 72 percent of the recruits were female, 80 percent were European and 61 percent had a University or Polytechnic degree. Participants had to be the main shopper in the household; be over 18 and normally buy at least two-thirds of their fruit and vegetables from Pak 'N Save. The Pak 'N Save supermarket in Kilbirnie, Wellington is the supermarket used for the study and Cliona says its management (from Foodstuffs Wellington) have been "very receptive."

Once participants were registered for the trial, they use a hand-held barcode scanner with which they scan food as they move around the supermarket and put it in their trolley. They then show their scanner, which has tallied their grocery bill total, to the checkout person. Those monitoring the study get data on what people are buying through a computer link.

"It's a really objective survey of what people buy," Cliona says. "We want to see if people respond to interventions at supermarket level -- in other words, if healthy food is cheaper, would people buy more of it?"

Those who were given discounts on their food -- 12.5 percent off fruit and vegetables -- were sent a list of the eligible foods, such as canned fruit (but not in syrup), all fresh fruit and vegetables and most frozen and canned vegetables, and fruit juice containing 100 percent fruit. Feedback from focus groups had indicated that most people wanted larger discounts -- 20 to 50 percent -- off food. The figure of 12.5 percent that has been used for the study is significant, being the amount of GST we pay in New Zealand.

The key outcomes -- including the effect of the interventions on the purchase of fruit and vegetables and an assessment of supermarket food data as a measure of total food purchases -- should be known by August. The SHOP team plans to apply to the Health Research Council in November for further funding for the main trial. That would involve 1000 participants and start in 2006.

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