An evaluation of a point of purchase labeling intervention to improve health literacy and healthy eating choices

Obesity related employer healthcare costs increased 8% from 2010 to 2011 (PwC, 2012; Durden, 2008), which has spurred an increase in worksite weight management programs. Due to minimal success of individually focused programs (Anderson, 2009; Mhurchu, 2010), efforts have shifted to the potential impact of environmental interventions. The purpose of this study was to evaluate the influence of a red, yellow, and green (R/Y/G) point of purchase (POP) labeling system on perceived health literacy and purchasing behaviors at three on-campus eateries frequented by university faculty and staff. Foods were rated as red, yellow, or green based on the Nutrient Rich Food Index. All foods were labeled with stickers that looked like miniature traffic lights with the appropriate color light lit up through menu boards and nametags. Posters, emails and table tents were also used to communicate about the intervention. In order to provide various levels of exposure, the first eatery had the intervention for six weeks, the second for four weeks, and the last for two weeks. Eatery patrons (N=191 across the three locations) completed a paper and pencil pre-intervention survey assessing healthy eating intentions, knowledge, and behaviors. Post-intervention data collection was conducted via online survey (N=89), and consisted of the pre-test items and additional questions about label awareness and utilization. While the intervention did not appear to influence healthy eating intentions or knowledge, 41.6% of the patrons reported that the labels influenced their food choices. Patrons also reported being aware of, understanding, and using the labels. The average food sales for the six weeks prior to the intervention were compared to the average food sales during the intervention. Food sales data were compared by location and food category (R/Y/G). There was a significant increase in green food sales and a significant decrease in red food sales (r=-.375, p=.044). However, there were no significant differences between locations. These findings suggest that future research with the traffic light labeling is warranted.