Encouraging Healthful Dietary Behavior in a Hospital Cafeteria: A Field Study Using Theories from Social Psychology and Behavioral Economics

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Encouraging Healthful Dietary Behavior in a Hospital Cafeteria: A Field Study Using Theories from Social Psychology and Behavioral Economics

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Title: Encouraging Healthful Dietary Behavior in a Hospital Cafeteria: A Field Study Using Theories from Social Psychology and Behavioral Economics
Author: Mazza, Mary Carol
Citation: Mazza, Mary Carol. 2013. Encouraging Healthful Dietary Behavior in a Hospital Cafeteria: A Field Study Using Theories from Social Psychology and Behavioral Economics. Doctoral dissertation, Harvard University.
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Abstract: Public policy efforts to curb obesity often adhere to a rational actor model of human behavior, asserting that consumer behavior will change provided proper economic incentives, nutritional information, and health education. However, rigorous academic research related to such questions remains limited in scope and appears inconclusive as to the success of such economic and cognitive interventions. In contrast, research in social psychology and behavioral economics suggests that decision making is partially based on heuristics, or rules of thumb, and susceptible to powerful cognitive biases. External cues can subtly influence decision making in powerful ways. In this paper, after discussing existing policy efforts and their limitations, we use concepts from behavioral decision theory to design interventions related to different psychological domains in hopes of providing a more complete understanding of consumer dietary decision making. We move beyond traditional cognitive methods, namely the provision of nutritional information and economic incentives, to suggest the value of other cognitive, affective, social, and environmental influences in shaping food choices. Over a 21-month period, we tested 9 interventions in a point-of-purchase field study at a hospital cafeteria, focusing on the healthfulness of beverage purchases and chip purchases. Information, in the form of novel, reinforcing health messages, had the most consistently beneficial effect on the healthfulness of purchases. Traffic light colored-nutritional labeling, affect-based cues (smiley faces and frowny faces), and environmental changes including grouping items together based on level of healthfulness ("grouping by healthfulness") and pairing an unhealthy item with a healthier alternative ("healthy substitute pairing") also affected choices. Messages related to social norms had no effect on purchases. Our work adds to existing consumer behavior research and helps to inform health policy of additional cognitive factors and biases that must be taken into account when designing interventions and which can, indeed, be leveraged to influence dietary behavior. This is the first study of which we know to test the relative effects of this number and variety (economic, cognitive, affective, social, and environmental) of theory-based behavioral nudges on food choice in one setting.
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Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:11125990
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