Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis
Abstract 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 alte...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | International Journal of Behavioral Nutrition and Physical Activity |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12966-022-01315-y |
| _version_ | 1828784784905601024 |
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| author | Rachel Pechey Gareth J. Hollands James P. Reynolds Susan A. Jebb Theresa M. Marteau |
| author_facet | Rachel Pechey Gareth J. Hollands James P. Reynolds Susan A. Jebb Theresa M. Marteau |
| author_sort | Rachel Pechey |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-11T23:37:52Z |
| format | Article |
| id | doaj.art-8cbbbaf3e20a43b58fe96f68a4b6ec44 |
| institution | Directory Open Access Journal |
| issn | 1479-5868 |
| language | English |
| last_indexed | 2024-12-11T23:37:52Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Behavioral Nutrition and Physical Activity |
| spelling | doaj.art-8cbbbaf3e20a43b58fe96f68a4b6ec442022-12-22T00:45:49ZengBMCInternational Journal of Behavioral Nutrition and Physical Activity1479-58682022-07-0119111010.1186/s12966-022-01315-yIs altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysisRachel Pechey0Gareth J. Hollands1James P. Reynolds2Susan A. Jebb3Theresa M. Marteau4Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of OxfordDepartment of Public Health and Primary Care, University of CambridgeSchool of Psychology, Aston UniversityNuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of OxfordDepartment of Public Health and Primary Care, University of CambridgeAbstract 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.https://doi.org/10.1186/s12966-022-01315-yAvailabilityIntervention-generated inequalitiesHealth inequalitiesSocioeconomic positionFood |
| spellingShingle | Rachel Pechey Gareth J. Hollands James P. Reynolds Susan A. Jebb Theresa M. Marteau Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis International Journal of Behavioral Nutrition and Physical Activity Availability Intervention-generated inequalities Health inequalities Socioeconomic position Food |
| title | Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis |
| title_full | Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis |
| title_fullStr | Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis |
| title_full_unstemmed | Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis |
| title_short | Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis |
| title_sort | is altering the availability of healthier vs less healthy options effective across socioeconomic groups a mega analysis |
| topic | Availability Intervention-generated inequalities Health inequalities Socioeconomic position Food |
| url | https://doi.org/10.1186/s12966-022-01315-y |
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