Improving Healthy Eating and the Bottom Line

PURPOSE: To evaluate the impact of a health-promoting price intervention on food sales and profit. DESIGN: Nonrandomized evaluation study. SETTING: Two hospital cafeterias. PARTICIPANTS: Hospital employees (2800) were the priority population. INTERVENTION: During baseline phase, healthy versions of existing unhealthy items were introduced. The intervention phase included marketing and price incentives/disincentives for healthy and unhealthy items, with a 35% price differential. MEASURES: Average and proportional change in sales and impact on financial outcomes were assessed. ANALYSIS: Two-way factorial analyses of variance and two-proportion Z-score tests were run to assess change in sales. Independent samples t tests were used to test for changes in profit. RESULTS: Significant impact was demonstrated on all burger sales in the desired direction during intervention (P < .001). Most notably, the average weekly turkey burger sales at Penrose Hospital (PH) increased 13-fold (10.85-145.59) and became the majority of the market share (51.8%, P < .001). For salads, significant interaction between phase and food type was found at St. Francis Medical Center (SFMC) (P = .002) but not at PH (P = .304). Healthy PH salads were popular at baseline and intervention, comprising the majority of the market share throughout the entire study (68.4%-70.2%, respectively, P = .238). Cafeteria gross sales and burger profit (P < .001) increased at both cafeterias. CONCLUSION: Incentivizing consumers through price interventions changed hospital cafeteria food sales in the desired direction while improving the bottom line.