Physical micro-environment interventions for healthier eating in the workplace: protocol for a stepped wedge randomised controlled pilot trial.


Type
Article
Change log
Authors
Cartwright, Emma 
Hollands, Gareth J 
Couturier, Dominique-Laurent 
Abstract

BACKGROUND: An estimated one third of energy is consumed in the workplace. The workplace is therefore an important context in which to reduce energy consumption to tackle the high rates of overweight and obesity in the general population. Altering environmental cues for food selection and consumption-physical micro-environment or 'choice architecture' interventions-has the potential to reduce energy intake. The first aim of this pilot trial is to estimate the potential impact upon energy purchased of three such environmental cues (size of portions, packages and tableware; availability of healthier vs. less healthy options; and energy labelling) in workplace cafeterias. A second aim of this pilot trial is to examine the feasibility of recruiting eligible worksites, and identify barriers to the feasibility and acceptability of implementing the interventions in preparation for a larger trial. METHODS: Eighteen worksite cafeterias in England will be assigned to one of three intervention groups to assess the impact on energy purchased of altering (a) portion, package and tableware size (n = 6); (b) availability of healthier options (n = 6); and (c) energy (calorie) labelling (n = 6). Using a stepped wedge design, sites will implement allocated interventions at different time periods, as randomised. DISCUSSION: This pilot trial will examine the feasibility of recruiting eligible worksites, and the feasibility and acceptability of implementing the interventions in preparation for a larger trial. In addition, a series of linear mixed models will be used to estimate the impact of each intervention on total energy (calories) purchased per time frame of analysis (daily or weekly) controlling for the total sales/transactions adjusted for calendar time and with random effects for worksite. These analyses will allow an estimate of an effect size of each of the three proposed interventions, which will form the basis of the sample size calculations necessary for a larger trial. TRIAL REGISTRATION: ISRCTN52923504.

Description
Keywords
Availability, Choice architecture, Healthier eating, Labelling, Nudging, Physical micro-environment interventions, Randomised controlled trial, Size, Stepped wedge trial, Workplace interventions
Journal Title
Pilot Feasibility Stud
Conference Name
Journal ISSN
2055-5784
2055-5784
Volume Title
Publisher
Springer Science and Business Media LLC
Sponsorship
Department of Health (PRP number 107001)
Wellcome Trust (106679/Z/14/Z)
Institute of Grocery Distribution (IGD) (03HP)
The study is funded by the Department of Health Policy Research Programme (Policy Research Unit in Behaviour and Health [PR-UN-0409- 10109] and the Institute for Grocery Distribution [RG83425]). RP is supported by a Wellcome Trust Research Fellowship in Society and Ethics [106679/Z/ 14/Z].