Women intend to buy, and attend more to, healthy foods in supermarkets: attention to product placement observed in women in a 2-dimensional simulated supermarket environment

Background: Research in real supermarkets can be challenging due to competing health and business agendas. This study used a 2-dimensional (2D) simulated supermarket to investigate whether visual attention to, and intended purchase of, products in prominent store locations (checkout, end-of-aisle, store entrance) differed for healthy, unhealthy or non-food items. The study also explored if these findings were modified by participants’ level of educational attainment. Methods: Women from Wessex, UK, took part in one of two trials. Phase 1: 201 women completed an online questionnaire in which all participants viewed simulated supermarket journeys depicting healthy, unhealthy and non-food product routes, starting at the store entrance and ending at the checkout, in a random order. Participants clicked on items (i) that they were interested in and then (ii) that they wished to purchase. Phase 2: 71 women participated in an eye-tracking study in which all participants again viewed all journey types, followed by a series of side-by-side preferential looking scenes to allow comparison of attention between the three product types, presented in a random order. Twelve participants took part in semi-structured interviews to better understand their views on what influences product attention; data were analysed using thematic analysis. Results: Phase 1: Participants demonstrated higher attention to food items compared to non-food items but their intention to purchase was higher for healthy foods than both unhealthy and non-food items. Phase 2: there was no difference in attention across product types during the journey task. In the preferential looking task, participants spent more time viewing healthy products than unhealthy or non-food products. Participants also exhibited higher intention to purchase healthy products than unhealthy or non-food items. Interview participants used shopping lists and avoided certain aisles to prevent unhealthy purchases. They wanted to see healthy foods or essential non-food options at prominent store locations. Conclusions: Women intend to make more healthy purchases than unhealthy purchases when they shop but supermarket strategies to promote less healthy foods in prominent locations in stores may undermine this intent. These findings support the use of prominent positioning of healthier items in stores as a useful strategy to increase healthy sales and support current and planned food policies. Trial registration: This was a quasi-experimental study of participants’ attention in an online questionnaire (phase 1) and an eye-tracking study (phase 2) and trial registration was not required. Participants did not receive an intervention.