Buy 1 Get 1: Role of Grocery Coupons in Promoting Obesogenic Home Food Environments and Eating Behaviors

The prevalence of overweight and obesity among older adults has reached an all-time high, which puts this age group at high risk for associated comorbidities such as type 2 diabetes, cardiovascular disease, and certain forms of cancer. Confronted with declining incomes and economic uncertainty, many middle-aged and older Americans tried to save on their food purchases during the 2007-2009 recession. Grocery coupons, available through newspapers, mail, and increasingly online, are one of several promotional tools that supermarkets and warehouse clubs use to promote sales. It is estimated that nationally 27% of households are frequent grocery coupon users who shop at a variety of retailers. Despite the increasing popularity of grocery coupons, little is known about the extent to which they may promote obesogenic home food environments and eating behaviors. Many coupons advertise the purchase of large quantities of prepackaged and processed foods and often reward shoppers by adding 'free' products if they purchase certain quantities. Availability and easy accessibility of large portions of energy dense foods in the home has been shown to promote increased intake. The proposed study seeks to examine the effects of frequent grocery coupon usage on dietary intake, weight status, and home food availability among middle-aged and older adults. A second aim of this study is to test, in a randomized-controlled trial, the effects of incentivizing grocery coupon use for the purchase of healthy foods on 3-month changes in dietary intake, body mass index/waist circumference, home food availability, and grocery coupon use among frequent coupon users and non-coupon users.