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

The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index.

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

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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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Metadata

Authors
Thorndike, A. N., Sonnenberg, L., Riis, J., Barraclough, S., & Levy, D. E.
Affiliations
Harvard University (US)
Venue
American Journal of Public Health
Published
2012-03
Volume
102
Issue
3
Pages
527-533
ISSN
  • 0090-0036 (ISSN-L)
  • 1541-0048
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
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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