BACKGROUND Previous product placement trials in supermarkets are limited in scope and outcome data collected. This study assessed the effects on store-level sales, household-level purchasing, and dietary behaviours of a healthier supermarket layout. METHODS AND FINDINGS This is a prospective matched controlled cluster trial with 2 intervention components: (i) new fresh fruit and vegetable sections near store entrances (replacing smaller displays at the back) and frozen vegetables repositioned to the entrance aisle, plus (ii) the removal of confectionery from checkouts and aisle ends opposite. In this pilot study, the intervention was implemented for 6 months in 3 discount supermarkets in England. Three control stores were matched on store sales and customer profiles and neighbourhood deprivation. Women customers aged 18 to 45 years, with loyalty cards, were assigned to the intervention (n = 62) or control group (n = 88) of their primary store. The trial registration number is NCT03518151. Interrupted time series analysis showed that increases in store-level sales of fruits and vegetables were greater in intervention stores than predicted at 3 (1.71 standard deviations (SDs) (95% CI 0.45, 2.96), P = 0.01) and 6 months follow-up (2.42 SDs (0.22, 4.62), P = 0.03), equivalent to approximately 6,170 and approximately 9,820 extra portions per store, per week, respectively. The proportion of purchasing fruits and vegetables per week rose among intervention participants at 3 and 6 months compared to control participants (0.2% versus -3.0%, P = 0.22; 1.7% versus -3.5%, P = 0.05, respectively). Store sales of confectionery were lower in intervention stores than predicted at 3 (-1.05 SDs (-1.98, -0.12), P = 0.03) and 6 months (-1.37 SDs (-2.95, 0.22), P = 0.09), equivalent to approximately 1,359 and approximately 1,575 fewer portions per store, per week, respectively; no differences were observed for confectionery purchasing. Changes in dietary variables were predominantly in the expected direction for health benefit. Intervention implementation was not within control of the research team, and stores could not be randomised. It is a pilot study, and, therefore, not powered to detect an effect. CONCLUSIONS Healthier supermarket layouts can improve the nutrition profile of store sales and likely improve household purchasing and dietary quality. Placing fruits and vegetables near store entrances should be considered alongside policies to limit prominent placement of unhealthy foods. TRIAL REGISTRATION ClinicalTrials.gov NCT03518151 (pre-results).

中文翻译：

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改变产品布局以在超市中创造更健康的布局：前瞻性匹配对照集群研究中商店销售、顾客购买和饮食的结果。


背景技术以前在超市进行的产品植入试验在范围和收集的结果数据方面受到限制。这项研究评估了更健康的超市布局对商店销售、家庭购买和饮食行为的影响。方法和结果 这是一项前瞻性匹配对照集群试验，有 2 个干预组成部分：(i) 商店入口附近新的新鲜水果和蔬菜区（取代后面较小的展示架）和重新放置在入口过道的冷冻蔬菜，加上 (ii)将糖果从收银台和对面的过道末端移走。在这项试点研究中，干预措施在英国的 3 家折扣超市实施了 6 个月。三个对照商店在商店销售、客户资料和社区剥夺方面进行了匹配。持有会员卡、年龄在 18 至 45 岁之间的女性顾客被分配到其主要商店的干预组 (n = 62) 或对照组 (n = 88)。试用注册号为NCT03518151。间断时间序列分析显示，干预商店中水果和蔬菜的商店级销售额增幅高于 3 个月（1.71 标准差 (SD)（95% CI 0.45, 2.96），P = 0.01）和 6 个月后的预测。增加（2.42 SD (0.22, 4.62)，P = 0.03），分别相当于每家商店每周额外增加约 6,170 份和约 9,820 份。与对照组相比，干预参与者在第 3 个月和第 6 个月时每周购买水果和蔬菜的比例有所上升（分别为 0.2% 与 -3.0%，P = 0.22；1.7% 与 -3.5%，P = 0.05）。干预商店的糖果店销售额在 3 个月（-1.05 SD（-1.98，-0.12），P = 0.03）和 6 个月（-1.37 SD（-2.95，0.22），P = 0）时低于预测。09)，相当于每家商店每周分别减少约 1,359 份和约 1,575 份；糖果购买方面没有观察到差异。饮食变量的变化主要朝着健康益处的预期方向发展。干预措施的实施不在研究团队的控制范围内，商店也不能随机化。这是一项试点研究，因此无法检测效果。结论 更健康的超市布局可以改善商店销售的营养状况，并可能改善家庭购买和饮食质量。应考虑将水果和蔬菜放置在商店入口附近，同时制定限制不健康食品显着放置的政策。试验注册 ClinicalTrials.gov NCT03518151（预结果）。