Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Mar;102(3):527-33.
doi: 10.2105/AJPH.2011.300391. Epub 2012 Jan 19.

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

Affiliations
Free PMC article

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

Anne N Thorndike et al. Am J Public Health. .
Free PMC article

Erratum in

  • Am J Public Health. 2012 Apr;102(4):584

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.

Figures

FIGURE 1—
FIGURE 1—
Location of bottled water for sale in the cafeteria during (a) baseline and phase 1, and (b) phase 2: a 2-phase labeling and choice architecture intervention; Massachusetts General Hospital, Boston; December 1, 2009–September 1, 2010.
FIGURE 2—
FIGURE 2—
Proportion of red, yellow, and green items sold during baseline, phase 1 (labeling), and phase 2 (labeling + choice architecture): a 2-phase labeling and choice architecture intervention; Massachusetts General Hospital, Boston; December 1, 2009–September 1, 2010. Note. CA = choice architecture; RYG = red, yellow, green.

Similar articles

See all similar articles

Cited by 69 articles

See all "Cited by" articles

Publication types

Feedback