@Article{info:doi/10.2196/45854,
author="Piernas, Carmen
and Lee, Charlotte
and Hobson, Alice
and Harmer, Georgina
and Payne Riches, Sarah
and Noreik, Michaela
and Jebb, Susan A",
title="A Behaviorally Informed Mobile App to Improve the Nutritional Quality of Grocery Shopping (SwapSHOP): Feasibility Randomized Controlled Trial",
journal="JMIR Mhealth Uhealth",
year="2024",
month="Jan",
day="11",
volume="12",
pages="e45854",
keywords="swaps; mobile app; supermarket; food purchases; diet; randomized controlled trial; mobile phone",
abstract="Background: Interventions targeting the nutritional quality of grocery shopping have the potential to help improve diet and health outcomes. Objective: This study aims to assess the feasibility and acceptability of receiving advice on healthier food purchases through SwapSHOP, a behaviorally informed smartphone app that allows users to scan barcodes of grocery products from the United Kingdom, providing nutritional information and personalized swap suggestions to encourage healthier purchases. Methods: We randomized adult volunteers in a 6-arm parallel-group controlled feasibility trial. Participants used the SwapSHOP app to record their grocery shopping during a 2-week run-in period and were individually randomized in a 3:1 ratio to either intervention or control arms within 3 strata related to a nutrient of concern of their choice: saturated fat (SFA), sugar, or salt. Participants randomized to the intervention received the SwapSHOP app with a healthier swap function, goal setting, and personalized feedback. Participants in the control group were instructed to use a simpler version of the app to log all their food purchases without receiving any guidance or advice. The primary outcome was the feasibility of progression to a full trial, including app use and follow-up rates at 6 weeks. The secondary outcomes included other feasibility outcomes, process and qualitative measures, and exploratory effectiveness outcomes to assess changes in the nutrient content of the purchased foods. Results: A total of 112 participants were randomized into 3 groups: SFA (n=38 intervention and n=13 control), sugar (n=40 intervention and n=15 control), and salt (n=5 intervention and n=1 control, not analyzed). The 2 progression criteria were met for SFA and sugar: 81{\%} (30/37) and 87{\%} (34/39) of intervention participants in the SFA and sugar groups, respectively, used the app to obtain healthier swaps, and 89{\%} (68/76) of intervention participants and 96{\%} (23/24) of control participants completed follow-up by scanning all purchases over the follow-up period. The process and qualitative outcomes suggested that the intervention was acceptable and has the potential to influence shopping behaviors. There were reductions of −0.56 g per 100 g (95{\%} CI −1.02 to −0.19) in SFA and −1 g per 100 g (95{\%} CI −1.97 to −0.03) in total sugars across all food purchases in the intervention groups. Conclusions: People were willing to use the SwapSHOP app to help reduce sugar and SFA (but not salt) in their grocery shopping. Adherence and follow-up rates suggest that a full trial is feasible. Given the suggestive evidence indicating that the intervention resulted in reductions in sugars and SFA, a definitive trial is necessary to target improvements in health outcomes. Trial Registration: International Standard Randomised Controlled Trial Number ISRCTN13022312; https://doi.org/10.1186/ISRCTN13022312 ",
issn="2291-5222",
doi="10.2196/45854",
url="https://mhealth.jmir.org/2024/1/e45854",
url="https://doi.org/10.2196/45854",
url="http://www.ncbi.nlm.nih.gov/pubmed/38206671"
}