Healthy Checkout Lines: A Study in Urban Supermarkets

Objective: To understand the impact of healthy checkouts in Bronx, New York City supermarkets. Design: Consumer purchasing behavior was observed for 2 weeks in 2015. Setting: Three supermarkets in the South Bronx. Participants: A total of 2,131 adult shoppers (aged >= 18 years) who paid for their groceries at 1 of the selected study checkout lines. Intervention: Two checkout lines were selected per store; 1 was converted to a healthy checkout and the other remained as it was (standard checkout). Data collectors observed consumer behavior at each line and recorded items purchased from checkout areas. Main Outcome Measures: Percentage of customers who purchase items from the checkout area; quantity and price of healthy and unhealthy items purchased from the healthy and standard checkout lines. Analysis: Measures were analyzed by study condition using chi-square and t tests; significance was determined at alpha = .05. Results: Only 4.0% of customers bought anything from the checkout area. A higher proportion of customers using the healthy vs standard checkout line bought healthy items (56.5% vs 20.5%; P < .001). Conclusions and Implications: When healthier products were available, the proportion of healthy purchases increased. Findings contribute to limited research on effectiveness of healthy checkouts in supermarkets. Similar interventions should expect an increase in healthy purchases from the checkout area, but limited overall impact.