Cited by 406Consumer Attitudes and Food LabelingNutrition, Health and Food BehaviorBehavioral Health and Interventions

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A 2-Phase Labeling and Choice Architecture Intervention to Improve Healthy Food and Beverage Choices

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Thorndike, Anne N., Sonnenberg, Lillian, Riis, Jason, Barraclough, Susan, Levy, Douglas E.·2012·American Journal of Public Health

DOI 10.2105/ajph.2011.300391PMC PMC3329221

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Abstract

Objectives. We assessed whether a 2-phase labeling and choice architecture intervention would increase sales of healthy food and beverages in a large hospital cafeteria. Methods. Phase 1 was a 3-month color-coded labeling intervention (red = unhealthy, yellow = less healthy, green = healthy). Phase 2 added a 3-month choice architecture intervention that increased the visibility and convenience of some green items. We compared relative changes in 3-month sales from baseline to phase 1 and from phase 1 to phase 2. Results. At baseline (977 793 items, including 199 513 beverages), 24.9% of sales were red and 42.2% were green. Sales of red items decreased in both phases (P < .001), and green items increased in phase 1 (P < .001). The largest changes occurred among beverages. Red beverages decreased 16.5% during phase 1 (P < .001) and further decreased 11.4% in phase 2 (P < .001). Green beverages increased 9.6% in phase 1 (P < .001) and further increased 4.0% in phase 2 (P < .001). Bottled water increased 25.8% during phase 2 (P < .001) but did not increase at 2 on-site comparison cafeterias (P < .001). Conclusions. A color-coded labeling intervention improved sales of healthy items and was enhanced by a choice architecture intervention.

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Authors: Thorndike, A. N., Sonnenberg, L., Riis, J., Barraclough, S., & Levy, D. E.
Affiliations: Harvard University (US)
ORCID: Thorndike, Anne N.
Levy, Douglas E.
Venue: American Journal of Public Health
Publisher: American Public Health Association
Published: 2012-03
Volume: 102
Issue: 3
Pages: 527-533
ISSN: 0090-0036 (ISSN-L)
1541-0048
DOI: 10.2105/ajph.2011.300391
PMC: PMC3329221
OpenAlex: W2118495149
Cited by: 405
References: 26
Citations by year: 2026: 6 · 2025: 16 · 2024: 18 · 2023: 15 · 2022: 19 · 2021: 28 · 2020: 76 · 2019: 42 · 2018: 22 · 2017: 30 · 2016: 35 · 2015: 40 · 2014: 25 · 2013: 22 · 2012: 9
FWCI: 29.67
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: American Journal of Public Health (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
RePEc: Research Papers in Economics (submittedVersion)
Funders: American Heart Association
Massachusetts General Hospital
Harvard Catalyst
National Institutes of Health
National Heart, Lung, and Blood Institute (K23HL093221, 1 K23HL93221)
National Center for Research Resources (UL1RR025758)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Consumer Attitudes and Food Labeling
Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Keywords: choice architecture, hospital cafeterias, bottled water consumption, food environment
MeSH terms: Beverages, Boston, Choice Behavior, Color, Food, Food Service, Hospital, Hospitals, General, Humans, Male, Product Labeling

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A 2-Phase Labeling and Choice Architecture Intervention to Improve Healthy Food and Beverage Choices

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