Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis

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Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis

Pechey, Rachel; Hollands, Gareth J; Reynolds, James P; Jebb, Susan A; Marteau, Theresa M; (2022) Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis. International Journal of Behavioral Nutrition and Physical Activity , 19 (1) , Article 88. 10.1186/s12966-022-01315-y. Green open access

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Abstract

Background: Availability interventions have been hypothesised to make limited demands on conscious processes and, as a result, to be less likely to generate health inequalities than cognitively-oriented interventions. Here we synthesise existing evidence to examine whether the impact of altering the availability of healthier vs. less-healthy options differs by socioeconomic position. / Methods: Individual-level data (21,360 observations from 7,375 participants) from six studies (conducted online (n = 4) and in laboratories (n = 2)) were pooled for mega-analysis. Multilevel logistic regressions analysed the impact of altering the availability of healthier options on selection of a healthier (rather than a less-healthy) option by socioeconomic position, assessed by (a) education and (b) income. / Results: Participants had over threefold higher odds of selecting a healthier option when the available range was predominantly healthier compared to selections when the range offered was predominantly less-healthy (odds ratio (OR): 3.8; 95%CIs: 3.5, 4.1). Less educated participants were less likely to select healthier options in each availability condition (ORs: 0.75–0.85; all p < 0.005), but there was no evidence of differences in healthier option selection by income. Compared to selections when the range offered was predominantly less-healthy, when predominantly healthier options were available there was a 31% increase in selecting healthier options for the most educated group vs 27% for the least educated. This modest degree of increased responsiveness in the most educated group appeared only to occur when healthier options were predominant. There was no evidence of any differential response to the intervention by income. / Conclusion: Increasing the proportion of healthier options available increases the selection of healthier options across socioeconomic positions. Availability interventions may have a slightly larger beneficial effect on those with the highest levels of education in settings when healthier options predominate.

Type:	Article
Title:	Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis
Location:	England
Open access status:	An open access version is available from UCL Discovery
DOI:	10.1186/s12966-022-01315-y
Publisher version:	https://doi.org/10.1186/s12966-022-01315-y
Language:	English
Additional information:	This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Keywords:	Availability, Intervention-generated inequalities, Health inequalities, Socioeconomic position, Food
UCL classification:	UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute UCL > Provost and Vice Provost Offices > School of Education UCL
URI:	https://discovery.ucl.ac.uk/id/eprint/10158588