Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jan 19, 2023
Date Accepted: Nov 27, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
SwapSHOP, a behaviourally-informed mobile app to improve the nutritional quality of the grocery shopping: results of a feasibility randomised controlled trial
ABSTRACT
Background:
Interventions targeting the nutritional quality of grocery shopping have the potential to help improve diet and health outcomes
Objective:
This study aimed to assess the feasibility and acceptability of receiving advice on healthier food purchases through SwapSHOP, a behaviourally-informed smartphone app that allows users to scan barcodes of grocery products from the United Kingdom, providing nutritional information and personalised swap suggestions to encourage healthier purchases
Methods:
We randomised adult volunteers in a 6-arm parallel-group controlled feasibility trial. Participants used the SwapSHOP app to record their grocery shopping during a 2-week run-in period and were individually randomised 3:1 to either intervention or control arms within three strata related to a nutrient of concern of their choice - saturated fat (SFA), sugar or salt. Participants randomised to the intervention received the SwapSHOP app with a healthier swap function, goal-setting and personalised feedback. The control group were asked to use the simpler version of the app to record all their food purchases with no advice. The primary outcome assessed the feasibility of progression to a full trial, including app use and follow up rates at 6-weeks. Secondary outcomes included other feasibility outcomes, process and qualitative measures and exploratory effectiveness outcomes to assess changes in the nutrient content of purchased foods
Results:
A total of 112 participants were randomised into three groups: SFA (n=38 intervention; n=13 control); sugar (n=40 intervention; n=15 control); and salt (n=5 intervention; n=1 control - not analysed). The two progression criteria were met for SFA and sugar: 81% and 87% of intervention participants in the SFA and sugar group respectively used the app to obtain healthier swaps; and 96% of intervention participants and 89% of control participants completed follow-up by scanning all purchases over the follow-up period. Process and qualitative outcomes suggested that the intervention was acceptable and has potential to influence shopping behaviours. There were reductions of -0.56 g/100g (95%CI -1.02, -0.19) in SFA and -1 g/100g (95%CI -1.97, -0.03) in total sugars across all food purchases in the intervention groups
Conclusions:
People are willing to use the SwapSHOP app to help reduce sugar and SFA (but not salt) in their grocery shopping. Adherence and follow up rates suggest a full trial is feasible. Together with suggestive evidence that the intervention led to reductions in sugars and SFA, a definitive trial is warranted aiming to improve health outcomes Clinical Trial: ISRCTN13022312. Registered 30 October 2020, https://doi.org/10.1186/ISRCTN13022312
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