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Point-of-decision prompts: healthy food choices

Health Factors: Diet & Exercise
Decision Makers: Businesses & Employers, Healthcare Organizations, Schools
Evidence Rating: Some Evidence
Population Reach: 100% of WI's population
Impact on Disparities: No impact on disparities likely

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Description

Point-of-decision prompts are motivational messages such as signs and power point presentations placed near fruits, vegetables and other items to encourage individuals to purchase these healthier food options. 

Expected Beneficial Outcomes

Increased fruit & vegetable consumption

Evidence of Effectiveness

There is some evidence that point-of-decision/purchase prompts increase fruit and vegetable consumption (Buscher 2001, Freedman 2010, Reed 2011, Story 2008). However, additional evidence is needed to confirm effects.

Fruit and vegetable consumption and fat intake can be positively affected through environmental strategies such as point-of-decision prompts; effects are more consistent in worksites than grocery store settings (Story 2008). As part of a multicomponent worksite intervention, point-of-decision prompts may lower saturated fat and dietary cholesterol intake (Brehm 2011). Point-of-purchase signage can also influence children's food selections (CDC MMWR-School health 2011) and has been shown to positively affect food choices in university students (Buscher 2001, Freedman 2010, Reed 2011). 

Implementation Examples

United States

Colorado's Smart Meal Seal program works with restaurants to provide point-of-decision prompts indicating healthier options (CDC-OOC). Over 30 communities across the country implemented point-of-decision/purchase prompts through CDC Communities Putting Prevention to Work grants (Bunnell 2012).

Wisconsin

Point-of-decision prompts are used throughout Wisconsin. One example is the Healthy People Portage County Team's use of prompts on vending machines at Stevens Point Area Senior High School (HWLI).

Citations - Evidence

Brehm 2011* - Brehm BJ, Gates DM, Singler M, Succop PA, D’Alessio DA. Environmental changes to control obesity: A randomized controlled trial in manufacturing companies. American Journal of Health Promotion. 2011;25(5):334–40. Accessed on April 5, 2013
Webpage: http://ajhpcontents.org/doi/abs/10.4278/ajhp.090128-QUAN-37
Buscher 2001* - Buscher L, Martin K, Crocker S. Point-of-purchase messages framed in terms of cost, convenience, taste, and energy improve healthful snack selection in a college foodservice setting. Journal of the American Dietetic Association. 2001;101(8):909-13. Accessed on June 20, 2012
Webpage: http://www.journals.elsevierhealth.com/periodicals/yjada/article/S0002-8223(01)00223-1/abstract
CDC MMWR-School health 2011 - Centers for Disease Control and Prevention (CDC). School health guidelines to promote healthy eating and physical activity. Morbidity and Mortality Weekly Report (MMWR). 2011:60(RR05):1-71. Accessed on June 19, 2012
Webpage: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6005a1.htm
Freedman 2010* - Freedman MR, Connors R. Point-of-purchase nutrition information influences food-purchasing behaviors of college students: A pilot study. Journal of the American Dietetic Association. 2010;110(8):1222-26. Accessed on June 20, 2012
Webpage: http://www.journals.elsevierhealth.com/periodicals/yjada/article/S0002-8223(10)00522-5/abstract
Reed 2011* - Reed JA, Powers A, Greenwood M, Smith W, Underwood R. Using “point of decision” messages to intervene on college students’ eating behaviors. American Journal of Health Promotion. 2011;25(5):298-300. Accessed on June 15, 2012
Webpage: http://ajhpcontents.org/doi/abs/10.4278/ajhp.090511-ARB-162
Story 2008* - Story M, Kaphingst KM, Robinson-O’Brien R, Glanz K. Creating healthy food and eating environments: Policy and environmental approaches. Annual Review of Public Health. 2008;29:253-72. Accessed on June 19, 2012
Webpage: http://www.annualreviews.org/doi/abs/10.1146/annurev.publhealth.29.020907.090926

Citations - Implementation Examples

Bunnell 2012* - Bunnell R, O’Neil D, Soler R, et al. Fifty communities putting prevention to work: Accelerating chronic disease prevention through policy, systems and environmental change. Journal of Community Health. 2012;37(5):1081–90. Accessed on April 5, 2013
Webpage: http://link.springer.com/article/10.1007/s10900-012-9542-3/fulltext.html#Sec5
CDC-OOC - Centers for Disease Control and Prevention (CDC). Colorado: State nutrition, physical activity, and obesity profile. Accessed on June 20, 2012
Webpage: http://www.cdc.gov/obesity/stateprograms/fundedstates/colorado.html
HWLI - Healthy Wisconsin Leadership Institute (HWLI). Community teams program: Alumni. Accessed on June 19, 2012
Webpage: http://hwli.org/community-teams-program/alumni/

* Journal subscription may be required for access.

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Health Factors

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Decision Makers

Businesses & Employers
Community Organizations
Government - Local
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Individuals
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Evidence Rating

Level of effectiveness based on a scan of academic literature and key recommendations of leading organizations.

  • Scientifically Supported Numerous studies or systematic review(s) with positive results
  • Some Evidence Research suggests positive impacts; further study may be warranted
  • Expert Opinion Recommended by credible groups*; research evidence limited
  • Insufficient Evidence Evidence limited or unavailable; further study warranted
  • Mixed Evidence Evidence mixed; further study warranted
  • Evidence of Ineffectiveness Research consistently shows program is detrimental or has no effect

Although many policies and programs are recommended by credible groups, we apply the rating ‘expert opinion’ only when policies are recommended but limited scientific evidence of effectiveness is available.

* The American Heritage Dictionary defines credible as 'capable of being believed; plausible.' and 'worthy of confidence; reliable.' To be considered an 'expert recommendation,' policies and programs must be recommended by one or more organizations that are recognized for their impartial expertise in the area of interest and have limited evidence available.

Potential Population Reach

Portion of Wisconsin's population likely to be reached by a policy or program if implemented statewide, based on its characteristics (e.g., target population(s), geographic limitations, and potential implementers).

<1%   20-49%
1-9%   50-99%
10-19%   100%

Potential Population Reach

Portion of Wisconsin's population likely to be reached by a policy or program if implemented statewide, based on its characteristics (e.g., target population(s), geographic limitations, and potential implementers).

<1%   20-49%
1-9%   50-99%
10-19%   100%

Potential Impact on Health Disparities

Likely impact of a given policy or program on racial/ethnic, socioeconomic, geographic or other disparities in Wisconsin based on its characteristics (e.g., target audience, mode of delivery, etc.) and best available evidence related to disparities.

  • Likely to decrease disparities
  • No impact on disparities likely
  • Likely to increase disparities