Using a computational model to quantify the potential impact of changing the placement of healthy beverages in stores as an intervention to Nudge adolescent behavior choice

Background: Product placement influences consumer choices in retail stores. While sugar sweetened beverage (SSB) manufacturers expend considerable effort and resources to determine how product placement may increase SSB purchases, the information is proprietary and not available to the public health and research community. This study aims to quantify the effect of non-SSB product placement in corner stores on adolescent beverage purchasing behavior. Corner stores are small privately owned retail stores that are important beverage providers in low-income neighborhoods - where adolescents have higher rates of obesity. Methods: Using data from a community-based survey in Baltimore and parameters from the marketing literature, we developed a decision-analytic model to simulate and quantify how placement of healthy beverage (placement in beverage cooler closest to entrance, distance from back of the store, and vertical placement within each cooler) affects the probability of adolescents purchasing non-SSBs. Results: In our simulation, non-SSB purchases were 2.8 times higher when placed in the optimal location - on the second or third shelves of the front cooler - compared to the worst location on the bottom shelf of the cooler farthest from the entrance. Based on our model results and survey data, we project that moving non-SSBs from the worst to the optional location would result in approximately 5.2 million more non-SSBs purchased by Baltimore adolescents annually. Conclusions: Our study is the first to quantify the potential impact of changing placement of beverages in corner stores. Our findings suggest that this could be a low-cost, yet impactful strategy to nudge this population-highly susceptible to obesity-towards healthier beverage decisions.