부산대학교 도서관

Impulsivity is associated with unhealthy food choices. Nudge interventions in the food environment may be particularly helpful for individuals with high impulsivity. To examine if trait, choice, and action impulsivity were associated with the effectiveness of a workplace-based nudge intervention to improve diet and weight. This was a planned secondary analysis of 487 participants of ChooseWell 365, a randomized controlled trial that tested a 12-month nudge intervention to improve cafeteria purchases among hospital employees. Trait impulsivity was measured with the Barratt Impulsiveness Scale. Choice and action impulsivity were assessed with delay discounting and response inhibition tasks, respectively. Tertiles were generated for each measure. Multivariate regression models examined the association of impulsivity with cafeteria purchases [Healthy Purchasing Score (HPS)] over 12 months, dietary intake [Healthy Eating lndex-2015 (HEI) score], and body mass index (BMI) measured at 12 months. Interaction terms tested differences in intervention effect by level of impulsivity. Participants with higher trait (p = .02) and choice (p < .001) impulsivity had lower baseline HPS than those with lower impulsivity. Employees of all impulsivity levels increased healthy eating, but higher trait impulsivity was associated with smaller increase in HPS over 12 months (p = .03). In the highest action impulsivity tertile, 12-month BMI increased less for intervention vs. control participants (0.3 vs. 0.5 kg/[m.sup.2]; p-interaction = .04). There were no interaction effects for trait or choice impulsivity. A workplace nudge intervention improved food choices among employees of all impulsivity levels and attenuated weight gain in those with higher action impulsivity. Impulsivity is an individual trait characterized by the tendency to make quick or rash decisions. High impulsivity is associated with less healthy food choices and poorer health outcomes, including obesity. "Nudges" which are small interventions that steer people towards healthy choices without removing other options, may be particularly helpful for individuals with high impulsivity. Our study tested whether trait impulsivity (i.e., mpulsive personality tendencies), choice impulsivity (i.e., preference for immediate vs. later rewards), and action impulsivity (i.e., low behavioral nhibition) were associated with the effectiveness of a workplace nudge intervention to increase healthy food choices and slow weight gain among hospital employees. We found that higher trait and choice impulsivity were associated with less healthy food purchases in the study population at baseline, but employees of all levels of impulsivity improved their food purchases in response to the intervention. The intervention may have helped slow weight gain in individuals with high action impulsivity. Keywords Impulsivity, Dietary intake, Weight, Workplace, Employee health Implications Practice: A workplace nudge intervention delivered to hospital employees improved healthy eating in employees of all impulsivity levels. Policy: Policymakers who want to improve healthy eating to reduce risk for diet-related chronic diseases such as obesity should explore nudge interventions that can be implemented wide scale in health care systems and other workplaces. Research: Future research is needed to explore the mechanisms through which different domains of impulsivity influence food choices and weight.
INTRODUCTION Individuals with high impulsivity exhibit poor self-regulation, characterized by a tendency to react to internal or external stimuli in manner that is inconsistent with immediate well-being and long-term goals. [...]