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Erin Hobin Public Health Ontario May 29, 2014

Changes in consumer awareness, understanding, trust, and use of an on-shelf nutrition labelling program in supermarkets in Ontario. Erin Hobin Public Health Ontario May 29, 2014. Chronic Disease and Un healthy Eating.

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Erin Hobin Public Health Ontario May 29, 2014

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  1. Changes in consumer awareness, understanding, trust, and use of an on-shelf nutrition labelling program in supermarkets in Ontario. Erin Hobin Public Health Ontario May 29, 2014

  2. Chronic Disease and Unhealthy Eating • In Canada, deaths due to chronic disease account for  approximately 75% of all deaths each year (Public Health Agency of Canada, 2009) • The most recent Global Burden of Disease Study (2010) ranks unhealthy diet as the leading risk factor for chronic disease and premature death in Canada(Institute for Health Metrics and Evaluation, 2012)

  3. Promoting Healthy Food Choices • Supermarkets are a critically important environment for influencing food choices(Government of Canada, 2013) • Approximately 70 – 80% of food purchases are made at the supermarket (Carlson et al., 2002; Ransley et al., 2004)

  4. Nutrition Labels in Canada • Nutrition labels are the main source of nutrition information for Canadians (Goodman et al., 2008) • 71% of Canadians report reading the Nutrition Facts table on a regular basis to compare and select foods when making purchase decisions (Health Canada, 2011)

  5. Barriers to using NFts Information on Nutrition Facts tables can be difficult to interpret and apply because of: • the complexity of the information, • the time and effort required to process the information, and • the positioning of the information on the back or side of food packages. (Health Canada, 2011; Campos et al., 2011; Sinclair et al., 2013)

  6. Ordinal Standardized, Simple, Interpretive

  7. Supported by a Promotional Campaign

  8. Overall Research Objective To investigate the impact of an on-shelf nutrition labelling system on the nutritional quality of consumer food purchases in supermarkets in Canada. • Pre-post quasi-experimental design with a control group • 3 data sources: • Supermarket transaction data • Cardholder data • Exit surveys with supermarket customers

  9. Intervention Implementation in Loblaws Supermarkets in Ontario Loblaws supermarkets August 2012

  10. Wave 1: Loblaws and Zehrs Supermarket Sites in Ontario Loblaws supermarkets February 2013 Wave 1 n=882 August 2012

  11. Intervention Implementation in Zehrs Supermarkets in Ontario Loblaws supermarkets Zehrs supermarkets February 2013 Wave 1 n=882 August 2012 March 2013

  12. Wave 2: Loblaws and Zehrs Supermarket Sites in Ontario Loblaws supermarkets Zehrs supermarkets February 2013 February 2014 Wave 1 n=882 Wave 2 n=792 August 2012 March 2013

  13. Study Design Preliminary results from Loblaws supermarkets indicate differences between Wave 1 and Wave 2 after 1-year implementation. Preliminary results from Zehrs supermarkets indicate differences between Wave 1 and Wave 2, before and after the intervention was implemented.

  14. Regression models to examine the change in Zehrs supermarkets (intervention) compared to Loblaws supermarkets (active control) from Wave 1 to Wave 2 controlling for covariates. • Four key outcomes: • Unprompted Awareness • Understanding • Trust • Self-reported Use

  15. Sample Description Wave 1 Participants (n=882) • 72% female • Mean Age = 51.5 years • 24% with high school or less • 85% White • 78% primary shopper • 67% main supermarket • 56% doing a large shop Wave 2 Participants (n=792) • 69% female • Mean Age = 50.2 years • 22% with high school or less • 83% White • 76% primary shopper • 65% main supermarket • 57% doing a large shop

  16. Unprompted Awarenessof Stars on Shelf Tag (n=792) Loblaws Supermarkets (n=882) Zehrs Supermarkets (X2 = 0.45, p=0.50) (X2 = 17.55, p<.0001)

  17. Understand the Starsindicate Nutritional Quality • Overall, 9% of participants in Loblaws Supermarkets in Wave 1 and Wave 2 understood the stars symbol indicate nutritional quality of food (X2=0.78, p=0.38) Among those who noticed the stars symbol Loblaws Supermarkets (n=84)

  18. Understand the Stars indicate Nutritional Quality • Overall, 0% and 4.6% of participants understood the stars symbol indicate the nutritional quality of food in Wave 1 and Wave 2 (X2=35.50, p<.0001) Among those who noticed the stars symbol Zehrs Supermarkets (n=41)

  19. Self-Reported Useof Stars • Overall, 2% and 1.5% of participants in Loblaws Supermarkets reported using the stars symbol when choosing foods in the supermarket in Wave 1 and Wave 2 (X2=1.23, p=0.27) Among those who noticed and understood the stars symbol Loblaws Supermarkets (n=78)

  20. Self-Reported Useof Stars • Overall, 0% and 3% of participants reported using the stars symbol when choosing foods in Zehrs Supermarkets in Wave 1 and Wave 2 (X2=8.57, p=0.01) Among those who noticed and understood the stars symbol Zehrs Supermarkets (n=36)

  21. Trust in Guiding Stars symbol for providing food and nutrition information

  22. Support for displaying symbolson shelf tags to indicate the nutritional quality of foods Loblaws Supermarkets ((n=882) Zehrs Supermarkets (n=792) X2=2.54, p=0.11 X2=9.06, p=0.003

  23. Summary • Overall, relatively low levels of consumer awareness, understanding, and self-reported use of Guiding Stars labelling system • No differencesin levels of awareness, understanding, and self-reported use of Guiding Stars labelling system in Loblaws Supermarkets 1-year after implementation • Small but statistically significant differences in consumer awareness, understanding, and self-reported use of the Guiding Stars labelling system in Zehrs Supermarkets

  24. Summary • Moderatelevels of trust in the Guiding Stars labelling system • Highlevels of support for on-shelf nutrition labelling systems

  25. Next Steps • Analyze the supermarket and cardholder transaction data to examine the actual impact of the Guiding Stars labelling system on the nutritional quality of food purchases over time • Conduct Wave 3 Exit Surveys in Ontario and comparison provincesto examine changes in consumer awareness, understanding, trust, and self-reported use of the Guiding Stars labelling system over time

  26. Acknowledgements • Dr. David Hammond, University of Waterloo • Lana Vanderlee, University of Waterloo • Dr. Laura Rosella, Public Health Ontario • Dr. Heather Manson, Public Health Ontario • Dr. Mary L’Abbe, University of Toronto • Dr. Bryan Bollinger, New York University • Alexis Williams, RD, Loblaw Corp. Ltd. Funding for this study was provided by Propel Centre for Population Health Impact as well as a CIHR Operating Research Grant

  27. Thank You for Listening!E: Erin.Hobin@oahpp.caT: 647-260-7198

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