Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis.
Availability
Food
Health inequalities
Intervention-generated inequalities
Socioeconomic position
Journal
The international journal of behavioral nutrition and physical activity
ISSN: 1479-5868
Titre abrégé: Int J Behav Nutr Phys Act
Pays: England
ID NLM: 101217089
Informations de publication
Date de publication:
20 07 2022
20 07 2022
Historique:
received:
28
01
2022
accepted:
13
06
2022
entrez:
19
7
2022
pubmed:
20
7
2022
medline:
22
7
2022
Statut:
epublish
Résumé
Availability interventions have been hypothesised to make limited demands on conscious processes and, as a result, to be less likely to generate health inequalities than cognitively-oriented interventions. Here we synthesise existing evidence to examine whether the impact of altering the availability of healthier vs. less-healthy options differs by socioeconomic position. Individual-level data (21,360 observations from 7,375 participants) from six studies (conducted online (n = 4) and in laboratories (n = 2)) were pooled for mega-analysis. Multilevel logistic regressions analysed the impact of altering the availability of healthier options on selection of a healthier (rather than a less-healthy) option by socioeconomic position, assessed by (a) education and (b) income. Participants had over threefold higher odds of selecting a healthier option when the available range was predominantly healthier compared to selections when the range offered was predominantly less-healthy (odds ratio (OR): 3.8; 95%CIs: 3.5, 4.1). Less educated participants were less likely to select healthier options in each availability condition (ORs: 0.75-0.85; all p < 0.005), but there was no evidence of differences in healthier option selection by income. Compared to selections when the range offered was predominantly less-healthy, when predominantly healthier options were available there was a 31% increase in selecting healthier options for the most educated group vs 27% for the least educated. This modest degree of increased responsiveness in the most educated group appeared only to occur when healthier options were predominant. There was no evidence of any differential response to the intervention by income. Increasing the proportion of healthier options available increases the selection of healthier options across socioeconomic positions. Availability interventions may have a slightly larger beneficial effect on those with the highest levels of education in settings when healthier options predominate.
Sections du résumé
BACKGROUND
Availability interventions have been hypothesised to make limited demands on conscious processes and, as a result, to be less likely to generate health inequalities than cognitively-oriented interventions. Here we synthesise existing evidence to examine whether the impact of altering the availability of healthier vs. less-healthy options differs by socioeconomic position.
METHODS
Individual-level data (21,360 observations from 7,375 participants) from six studies (conducted online (n = 4) and in laboratories (n = 2)) were pooled for mega-analysis. Multilevel logistic regressions analysed the impact of altering the availability of healthier options on selection of a healthier (rather than a less-healthy) option by socioeconomic position, assessed by (a) education and (b) income.
RESULTS
Participants had over threefold higher odds of selecting a healthier option when the available range was predominantly healthier compared to selections when the range offered was predominantly less-healthy (odds ratio (OR): 3.8; 95%CIs: 3.5, 4.1). Less educated participants were less likely to select healthier options in each availability condition (ORs: 0.75-0.85; all p < 0.005), but there was no evidence of differences in healthier option selection by income. Compared to selections when the range offered was predominantly less-healthy, when predominantly healthier options were available there was a 31% increase in selecting healthier options for the most educated group vs 27% for the least educated. This modest degree of increased responsiveness in the most educated group appeared only to occur when healthier options were predominant. There was no evidence of any differential response to the intervention by income.
CONCLUSION
Increasing the proportion of healthier options available increases the selection of healthier options across socioeconomic positions. Availability interventions may have a slightly larger beneficial effect on those with the highest levels of education in settings when healthier options predominate.
Identifiants
pubmed: 35854353
doi: 10.1186/s12966-022-01315-y
pii: 10.1186/s12966-022-01315-y
pmc: PMC9297538
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
88Subventions
Organisme : Wellcome Trust
ID : 222566/Z/21/Z
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 206853/Z/17/Z
Pays : United Kingdom
Informations de copyright
© 2022. The Author(s).
Références
Public Health Nutr. 2021 Feb;24(2):203-214
pubmed: 32792022
PLoS Med. 2016 Apr 05;13(4):e1001990
pubmed: 27046234
Health Psychol Rev. 2016 Dec;10(4):381-394
pubmed: 26745243
BMC Public Health. 2015 May 02;15:457
pubmed: 25934496
Curr Opin Psychol. 2017 Dec;18:131-136
pubmed: 28923664
Int J Behav Nutr Phys Act. 2018 Jul 24;15(1):71
pubmed: 30041671
Int J Behav Nutr Phys Act. 2020 Jan 31;17(1):10
pubmed: 32005255
Am J Public Health. 2014 Nov;104(11):2170-8
pubmed: 25211721
Nutr J. 2020 Sep 17;19(1):103
pubmed: 32943071
J R Soc Med. 2010 Jul;103(7):266-72
pubmed: 20558547
Cochrane Database Syst Rev. 2019 Sep 04;9:CD012573
pubmed: 31482606
Appetite. 2016 Jan 1;96:25-31
pubmed: 26321417
Br J Nutr. 2015 Jan 14;113(1):181-9
pubmed: 25399952
Comput Stat Data Anal. 2009 Jan 15;53(3):603-608
pubmed: 20084090
Soc Sci Med. 2013 Sep;92:22-6
pubmed: 23849275
BMJ. 2022 Apr 13;377:e069848
pubmed: 35418445
IARC Sci Publ. 1997;(138):51-64
pubmed: 9353663
Appetite. 2021 Sep 1;164:105245
pubmed: 33836216
PLoS One. 2013 Apr 09;8(4):e60650
pubmed: 23585842
BMC Public Health. 2021 Feb 1;21(1):132
pubmed: 33517908
PLoS Med. 2010 Aug 24;7(8):e1000320
pubmed: 20811492
J Health Soc Behav. 2007 Sep;48(3):223-38
pubmed: 17982865
Public Health Nutr. 2003 Apr;6(2):191-200
pubmed: 12675962
N Engl J Med. 2008 Jun 5;358(23):2468-81
pubmed: 18525043
BMJ. 2011 Jan 25;342:d228
pubmed: 21266441
Front Public Health. 2021 Jul 23;9:668998
pubmed: 34368049
Pers Soc Psychol Bull. 2020 Dec;46(12):1702-1711
pubmed: 32208875
Int J Epidemiol. 2001 Apr;30(2):334-40
pubmed: 11369739
BMC Public Health. 2020 Jun 29;20(1):986
pubmed: 32594907
BMC Public Health. 2018 Nov 29;18(1):1296
pubmed: 30486801
BMC Public Health. 2022 Apr 30;22(1):868
pubmed: 35501746