Jason Riis

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

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.

Traffic-Light Labels and Choice Architecture Promoting Healthy Food Choices

BACKGROUND Preventing obesity requires maintenance of healthy eating behaviors over time. Food labels and strategies that increase visibility and convenience of healthy foods (choice architecture) promote healthier choices, but long-term effectiveness is unknown. PURPOSE Assess effectiveness of traffic-light labeling and choice architecture cafeteria intervention over 24 months. DESIGN Longitudinal pre-post cohort follow-up study between December 2009 and February 2012. Data were analyzed in 2012. SETTING/PARTICIPANTS Large hospital cafeteria with a mean of 6511 transactions daily. Cafeteria sales were analyzed for (1) all cafeteria customers and (2) a longitudinal cohort of 2285 hospital employees who used the cafeteria regularly. INTERVENTION After a 3-month baseline period, cafeteria items were labeled green (healthy); yellow (less healthy); or red (unhealthy) and rearranged to make healthy items more accessible. MAIN OUTCOME MEASURES Proportion of cafeteria sales that were green or red during each 3-month period from baseline to 24 months. Changes in 12- and 24-month sales were compared to baseline for all transactions and transactions by the employee cohort. RESULTS The proportion of sales of red items decreased from 24% at baseline to 20% at 24 months (p<0.001), and green sales increased from 41% to 46% (p<0.001). Red beverages decreased from 26% of beverage sales at baseline to 17% at 24 months (p<0.001); green beverages increased from 52% to 60% (p<0.001). Similar patterns were observed for the cohort of employees, with the largest change for red beverages (23%-14%, p<0.001). CONCLUSIONS A traffic-light and choice architecture cafeteria intervention resulted in sustained healthier choices over 2 years, suggesting that food environment interventions can promote long-term changes in population eating behaviors.

The Fresh Start Effect: Temporal Landmarks Motivate Aspirational Behavior

The popularity of New Year’s resolutions suggests that people are more likely to tackle their goals immediately following salient temporal landmarks. If true, this little-researched phenomenon has the potential to help people overcome important willpower problems that often limit goal attainment. Across three archival field studies, we provide evidence of a “fresh start effect.” We show that Google searches for the term “diet” (Study 1), gym visits (Study 2), and commitments to pursue goals (Study 3) all increase following temporal landmarks (e.g., the outset of a new week, month, year, or semester; a birthday; a holiday). We propose that these landmarks demarcate the passage of time, creating many new mental accounting periods each year, which relegate past imperfections to a previous period, induce people to take a big-picture view of their lives, and thus motivate aspirational behaviors. Data, as supplemental material, are available at http://dx.doi.org/10.1287/mnsc.2014.1901.

Getting the Most Out of Financial Incentives for Weight Loss

Incentive-based programs for weight loss are increasingly popular. In this issue, Kullgren and colleagues compared 2 such incentive schemes. The editorialist discusses the study and its findings an...