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The Behavioralist as Dietician: Leveraging Behavioral Economics to Improve Child Food Choice and Consumption John A. List and Anya C. (Savikhin) Samak.

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Presentation on theme: "The Behavioralist as Dietician: Leveraging Behavioral Economics to Improve Child Food Choice and Consumption John A. List and Anya C. (Savikhin) Samak."— Presentation transcript:

1 The Behavioralist as Dietician: Leveraging Behavioral Economics to Improve Child Food Choice and Consumption John A. List and Anya C. (Savikhin) Samak November, 2012 Thanks to the Greater Chicago Food Depository and the Kenneth and Anne Griffin Foundation for generous funding of this research. The views expressed in this paper do not represent the views of our funding sources.

2 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Need to Address Decision-Making by Children and Adolescents Tendency to consume an unhealthy diet is learned at a young age (Smith and Tasnadi, 2007) Lack of proper nourishment, such as not meeting RDA for F/V, affects health and hampers growth, can result in poor school performance (Whitaker et al., 2006) 17% of nations youth have BMI at or above recommended 95 th percentile (NIH, 1998) Children from low income families are at higher risk! Teachable moment: children consume food outside of the home on a regular basis – Lunch – USDA sponsored food programs (low income) MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

3 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Role of Behavioral Approach Incentives can Motivate Behavior Change – Agents value even small incentives to shift health behavior – weight loss, smoking cessation (Volpp et al., 2008; 2009) – Value of incentives for child food choice (Just and Price, 2011) Gain and Loss Framing – According to Kahneman and Tverskys (1991) model of loss aversion, incentives framed as losses are more effective than incentives framed as gains Long-term impact – Negative rebound effect (Lepper et al., 1973) – Habit formation (Gneezy et al., 2011) Educational Messages – Long-term, in-depth educational interventions have some effect – Simple verbal prompts have effect (Schwartz, 2007; Perry, 2004) MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

4 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Field Experiment Kids Cafe program – after school program in low- income areas of Chicago, including suburbs – Majority of children in these areas eligible for the Free or Reduced School Lunch Program – Sites are at schools, community centers, churches 1,616 separate participants ages 6 to 18 across 24 different sites – Kids visit daily, several times a week, or sporadically Two phases: February-March, 2011; April-May, 2011 Experimenters (3-6 per site) visited 2x per week and asked children to choose between 1 cookie or 1 dried fruit cup MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

5 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Meeting Daily Fruit Requirements MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS Daily Fruit Intake (24-Hour Recall)

6 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. On-Site Procedures Framed field experiment in the sense that participants know they are in an experiment (Harrison and List, 2004) Choice is made after the meal is served and children have ID stickers on Experimenter reads the standard message – At least one of each is always available – Can only choose one – Cannot share it – Should eat it on site (cant take it with) – Site cant keep the remaining desserts to serve on other days Experimenter reads treatment-specific message (if any) Experimenters record childs ID, choice, and consumption MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

7 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Field Experiment Design Summary of Treatments MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS Short Study SessionLong Study Session BaselineX116 participants Gain Incentive Only428 participantsX Loss Incentive Only216 participants107 participants Education Only141 participants341 participants Loss Incentive + Education 55 participants170 participants 2x per week – 5 times total B, T, B, B, B 2x per week – 9 times total B, T, T, T, T, T, B, B, B Choice of Fruit Cup or Cookie Get a prize for eating Fruit Educational message Combination Treatment

8 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Incentives – Gain Frame If you choose the dried fruit cup, and eat all of it today, you will also get to pick a gift immediately after you finish eating it! You can choose ONE of these gifts. MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

9 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Loss Frame But before you choose a dessert, you should come up and pick a gift. You can choose ONE of these gifts. Well put the gift in a closed box for you with your name on it, and you get to take it back to your table. If you eat the fruit cup, well open the box for you and you will keep the gift you picked up. If you dont finish eating all of it, you will have to give the box back to us and you will not keep the gift you picked… MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

10 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Short Education Message Based on USDA Requirements …the Food Pyramid…reminds us to make healthy food choices. Do you notice that some of the stripes are wider than others? The different sizes remind you to choose foods from the widest stripes… Eating just one new, good thing everyday will make a big difference! The fruits group has a pretty wide stripe… What about cookies? Cookies arent on the pyramid… MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

11 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Result Summary – Short Sessions MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

12 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Result Summary – Long Sessions MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

13 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Period 1 versus Period 2 Comparing a baseline visit to a treated visit Compare both between subject and within subject to test for treatment effects MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

14 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Baseline and Treatment Comparison Result 1: Incentives significantly increase the proportion of children selecting fruit MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

15 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Comparing the Incentives Result 2: The gain and loss treatment are equally effective at moving children to choose the healthy option Result 3: Education alone does not have a significant effect, but education paired with incentive is more effective than education alone MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

16 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Consumption Direct link between choice of food to consumption cannot be taken for granted Example: Just et al. (2011) find that in the lunchroom, over 44% of items taken by students are wasted We provide a link between selection and consumption We have detailed consumption data for 73% of choices on average – level of 1/4s MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

17 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Proportion Consumed Result 4: The loss treatments result in increased consumption of fruit more than the gain incentive, but the education treatment results in a decreased consumption of fruit relative to baseline MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

18 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Summary of Findings Incentives are very effective in the short-term (immediate) in increasing both fruit choice and consumption – Incentives provide a reduction in food waste compared to education alone – Gain and loss frame incentives similar in value Incentives combined with education most effective – No rebound effect; could be implemented at relatively low cost in practice MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

19 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. White Milk vs. Chocolate Utility-maximizing individual makes tradeoff between Expected enjoyment of food eaten in the present Expected future potential health consequences Present and future Individuals generally discount the future Health consequences take time to appear Facing uncertainty May be unsure about taste (if havent tasted recently) May be unsure about health benefits/consequences Health consequences not tied directly to one consumption

20 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Summary of Treatments Effect of different prompts in the school lunch-line healthy – changes belief about future benefit tasty – changes belief about current benefit Incentive – changes current benefit directly MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS

21 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Stats Number of Schools: 9 Separate Kids: 2,200 Milk Consumed: 690 gallons Total Trays Weighed: 19,000

22 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. K-3 rd versus 4 th -8 th

23 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Summary of Preliminary Results All prompts significantly increase white milk choice in round 1 Incentives more effective than prompts Health and Taste prompts work for younger children Taste and Prompt, but not Health, works for older children Prompt effectiveness decreases over time (as expected – children form greater beliefs)

24 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Future Work Effect of incentivizing parents vs. children to improve child food choice Effect of coupons and pre-commitment at grocery stores in food deserts Changing the incentives in the a la carte line

25 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Thank you! Anya C. Samak

26 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Timeline of Implementation MORE INFORMATION

27 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Fruits and Cookies Served MORE INFORMATION

28 BEHAVIORALIST AS DIETICIAN: LEVERAGING BEHAVIORAL ECONOMICS TO IMPROVE CHILD FOOD CHOICE | SAMAK, A. Demographics & Food Security Have data on 280 children across all sites Food security, Child age Low Income AgeProportion 4-833% 9 to 1356% % MOTIVATION | FIELD EXPERIMENT | RESULTS | CONCLUSIONS & IMPLICATIONS | RELATED WORK


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