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Making good health insurance decisions is important for health outcomes and longevity, but consumers' errors are well documented. The authors examine whether targeted choice architecture interventions can reduce these mistakes. The article examines the interaction of two choice architecture tools on improved consumer insurance decisions in online health care exchanges: (1) ordering the options from best to worst based on a high-quality user model and (2) partitioning the total set of options. Although ordering and partitioning do not always improve choices separately, the authors use one field study and three experiments to identify the conditions that allow the combination to greatly improve health insurance decisions. Findings indicate that when options are ordered such that the best options appear at the beginning of the presented list, partitioning nudges consumers to focus on the best options. However, if the best options are not at the top of the list, partitioning discourages search and can impair consumers' discovery of the best options. Process data show that these effects are achieved by focusing consumers' limited attention on higher-quality options. These results suggest that wise choice architecture interventions need to consider the joint effect of choice architecture tools as well as the quality of the firm's user model. [ABSTRACT FROM AUTHOR]

To encourage farsighted behaviors, previous research suggests that marketers should invite consumers to precommit to adopting these behaviors "later." However, the authors propose that people will draw different inferences from different types of precommitment offers, and that these inferences can help explain when precommitment is (and is not) effective at increasing adoption of farsighted behaviors. Specifically, the authors theorize that simultaneously offering consumers the opportunity to adopt a farsighted behavior now or later (i.e., offering "simultaneous precommitment") may signal that the behavior is not urgently recommended; however, offering consumers the opportunity to adopt that behavior immediately and then, only if they decline, inviting them to adopt it later (i.e., offering "sequential precommitment") may signal just the opposite. In a multisite field experiment (N = 5,196), the authors find that simultaneously giving consumers the chance to increase their savings now or later reduced retirement savings. Two preregistered lab studies (N = 5,080) show that simultaneous precommitment leads people to infer that taking action is not urgently recommended, and such inferences predict less adoption of recommended behaviors. Importantly, offering sequential precommitment increases inferred urgency, predicting greater adoption. Together, this research advances knowledge about the limits and potential of precommitment. [ABSTRACT FROM AUTHOR]

Sustainable diets can achieve considerable reductions in greenhouse gas emissions and improvements in human health, but changing dietary behavior remains a challenge. We assessed the impacts of two behavioral insights strategies on bridging the intention-action gap related to sustainable and healthy food choices amongst hospital cafeteria patrons. In a pilot survey of hospital staff (N = 1,165), 56% identified limited awareness and availability of sustainable food as barriers to purchasing, although 46% were extremely willing to try sustainable dishes. We examined increasing salience (Study 1), varying availability (Study 2a), and decreasing availability (Study 2b) on sustainable and healthy dish purchases in three hospital cafeterias. Each study ran for seven weeks from March to April, 2023. In total, 10,616 dishes were purchased. In Study 1, increasing salience was associated with significant uptake of sustainable and healthy dishes, but the effect disappeared once the salience intervention was removed. In Study 2a, increasing availability of sustainable dishes corresponded to a significant increase in purchases of sustainable dishes, while decreasing availability in Study 2b followed a downward trend in purchases, suggesting that availability drove dietary choices. We recommend hospitals consider these choice architecture interventions to support the adoption of sustainable and healthy diets. [ABSTRACT FROM AUTHOR]

With the advent of the Internet of Things (IoT), it has become increasingly challenging for users to assess the privacy risks associated with consumer products and the continuous stream of user data needed to operate them. In this study, we propose and test three mechanisms with the potential to help users make more accurate assessments of privacy risks. We refer to these mechanisms as framing (i.e., presenting information on the collection and use of user data with or without direct reference to privacy risks), comparing (i.e., presenting a product and the associated information on data collection and use with or without reference to an alternative product), and educating (i.e., augmenting users' general privacy literacy). To assess these mechanisms in different IoT contexts, we conducted two scenario-based online experiments with reference to a telematics device (n = 317) and a fitness tracker (n = 356). In both studies, we find that actual privacy risks as manipulated in the experiment are only moderately related to the privacy risks perceived by users. However, comparing and educating each helped users make more accurate privacy risk assessments. In Study 2, framing and comparing jointly enabled especially users with low privacy literacy to assess privacy risks more accurately. These findings have meaningful implications for key actors in the IoT ecosystem and those regulating it. [ABSTRACT FROM AUTHOR]

Applying behavioral insights for climate-change mitigation has both potential and pitfalls. Drawing upon IPCC insights on the potential of demand-side mitigation of various sectors, actors, and regions, three arguments address the role of the behavioral sciences. First, behavioral insights have heterogeneous effects, rendering the question of their average contribution meaningless. Second, many effects from behavioral science are found outside of the academic literature, so these relevant indicators of effectiveness do not inform the debate. Third, mitigation impact depends on scaling, which provides unique challenges for behavioral science because the research and application settings are often markedly different. Due to these challenges, policymakers should proceed with caution and apply behavioral insights with a careful case-by-case analysis. [ABSTRACT FROM AUTHOR]

Regulators are increasingly concerned about deceptive, online choice architecture, including dark patterns and behavioral sludge. From a behavioral science perspective, fostering a regulatory environment which reduces the economic harm caused by deceptive designs, while safeguarding the benefits of well‐meaning behavioral insights, is essential. This article argues for a principles‐based approach and proposes behavioral audits as a tool to support this approach. [ABSTRACT FROM AUTHOR]

Abstract Sustainable diets can achieve considerable reductions in greenhouse gas emissions and improvements in human health, but changing dietary behavior remains a challenge. We assessed the impacts of two behavioral insights strategies on bridging the intention-action gap related to sustainable and healthy food choices amongst hospital cafeteria patrons. In a pilot survey of hospital staff (N = 1,165), 56% identified limited awareness and availability of sustainable food as barriers to purchasing, although 46% were extremely willing to try sustainable dishes. We examined increasing salience (Study 1), varying availability (Study 2a), and decreasing availability (Study 2b) on sustainable and healthy dish purchases in three hospital cafeterias. Each study ran for seven weeks from March to April, 2023. In total, 10,616 dishes were purchased. In Study 1, increasing salience was associated with significant uptake of sustainable and healthy dishes, but the effect disappeared once the salience intervention was removed. In Study 2a, increasing availability of sustainable dishes corresponded to a significant increase in purchases of sustainable dishes, while decreasing availability in Study 2b followed a downward trend in purchases, suggesting that availability drove dietary choices. We recommend hospitals consider these choice architecture interventions to support the adoption of sustainable and healthy diets.

How can firms encourage consumers to adopt smartphone apps? The authors show that several inexpensive choice architecture techniques can make users more likely to enable important app features and complete app onboarding. In six preregistered experiments (n = 5,968) and a field experiment (n = 594,997), choice architecture interventions manipulating choice sequence, color, and wording of app adoption decisions dramatically increased app adoption. Across experiments, integrating multiple feature decisions into a single choice increased adoption. This integration effect emerges because it decreases decision noise and reduces the prominence of individual features, consistent with support theory. Changing colors to match habitual patterns commonly found in current digital interfaces appears to increase adoption by accelerating consumers' decisions. Finally, wording options as if enabling the app is the default response (even without changing the actual default) also increases adoption. These "defaultless defaults" may be particularly relevant in heavily regulated consumer domains, such as finance or health care. The effects generalized across different types of apps and were robust across subsamples varying in demographics, attitudes toward the apps, and political affiliation. These results suggest simple tools that marketing managers and app developers can use to increase app adoption. [ABSTRACT FROM AUTHOR]

Abstract Background Typical adolescent diets do not meet current dietary recommendations. There is a need to address these dietary patterns to reduce the risk of obesity and other diet-related diseases. Schools provide an opportune setting to do so, as students consume a substantial proportion of their daily dietary intake whilst at school. There is a developing evidence base on the use of choice architecture (food choice cues) to promote healthy eating in school contexts. It is necessary to understand the acceptability and feasibility of implementing such interventions. We aimed to explore these factors from the perspectives of secondary school caterers. Methods We conducted qualitative interviews with caterers from secondary schools across the West Midlands, UK and national/regional catering representatives. A semi-structured topic guide and visual aid were used to guide interviews. Interviews were recorded and transcribed. Framework analysis was conducted in NVivo v12. Results Twelve participants took part. Seven themes were identified and grouped into three categories: Acceptability (Suitability; Salient cues; Student engagement), Barriers (Catering decision drivers; Limits of influence), and Enablers (Perceived role; Opportunities). Caterers considered healthy food cues to be suited to adolescents as they require minimal reflective motivation. Salient cues included enhancing the placement, presentation and portability of healthy items, improving the dining environment and focusing pricing/incentive strategies on increased quantity. Student engagement was considered important. Some catering decision drivers conflicted with healthy food cues, and many felt that their role in healthy eating was limited due to the overwhelming influence of external food environments, adolescent resistance, and features of the secondary school canteen setting e.g. short duration of lunchtime, lack of space. However, caterers appeared motivated to implement healthy food cues and identified key opportunities for implementation, including integration into whole-school approaches to healthy eating. Conclusions Interventions using healthy food cues appeared acceptable to secondary school caterers, key potential implementers of these strategies. Future interventions could incorporate strategies relating to placement, presentation and pricing to prompt healthy selections, and actions to engage the student body and improve the dining environment. Evaluations should consider potential impacts upon food purchasing, consumption and waste to address caterers’ concerns about these issues.

Abstract Background Changing the food environment is an important public health lever for encouraging sustainable food choices. Targeting the availability of vegetarian main meals served in cafeterias substantially affects food choice, but acceptability has never been assessed. We examined the effects of an availability intervention at a French university cafeteria on students’ main meal choices, meal offer satisfaction and liking. Methods A four-week controlled trial was conducted in a university cafeteria in Dijon, France. During the two-week control period, vegetarian main meals constituted 24% of the offer. In the subsequent two-week intervention period, this proportion increased to 48%, while all the other menu items remained unchanged. Students were not informed of the change. Student choices were tracked using production data, and daily paper ballots were used to assess student satisfaction with the meal offer and liking of the main meal they chose (score range [1;5]). Nutritional quality, environmental impact, and cost of production of meal choices were calculated for each lunchtime. Food waste was measured over 4 lunchtimes during control and intervention periods. An online questionnaire collected student feedback at the end of the study. Results Doubling availability of vegetarian main meals significantly increased the likelihood of choosing vegetarian options (OR = 2.57, 95% CI = [2.41; 2.74]). Responses of the paper ballots (n = 18,342) indicated slight improvements in meal offer satisfaction from 4.05 ± 0.92 to 4.07 ± 0.93 (p = 0.028) and in liking from 4.09 ± 0.90 to 4.13 ± 0.92 (p

Abstract Background Supermarket interventions are promising to promote healthier dietary patterns, but not all individuals may be equally susceptible. We explored whether the effectiveness of nudging and pricing strategies on diet quality differs by psychological and grocery shopping characteristics. Methods We used data of the 12-month Supreme Nudge parallel cluster-randomised controlled supermarket trial, testing nudging and pricing strategies to promote healthier diets. Participants were Dutch speaking adults aged 30–80 years and regular shoppers of participating supermarkets (n = 12) in socially disadvantaged neighbourhoods. Data on psychological characteristics (food-related behaviours; price sensitivity; food decision styles; social cognitive factors; self-control) and grocery shopping characteristics (time spent in the supermarket; moment of the day; average supermarket visits; shopping at other retailers; supermarket proximity) were self-reported at baseline. These characteristics were tested for their moderating effects of the intervention on diet quality (scored 0–150) in linear mixed models. Results We included 162 participants from intervention supermarkets and 199 from control supermarkets (73% female, 58 (± 10.8) years old, 42% highly educated). The interventions had no overall effect on diet quality. Only five out of 23 potential moderators were statistically significant. Yet, stratified analyses of these significant moderators showed no significant effects on diet quality for one of the subgroups and statistically non-significant negative effects for the other. Negative effects were suggested for individuals with lower baseline levels of meal planning (β − 2.6, 95% CI − 5.9; 0.8), healthy shopping convenience (β − 3.0, 95% CI − 7.2; 1.3), and healthy food attractiveness (β − 3.5, 95% CI − 8.3; 1.3), and with higher levels of price consciousness (β − 2.6, 95% CI − 6.2; 1.0) and weekly supermarket visits (β − 2.4, 95% CI − 6.8; 1.9). Conclusions Adults with varying psychological and grocery shopping characteristics largely seem equally (un)susceptible to nudging and pricing strategies. It might be that certain characteristics lead to adverse effects, but this is not plausible, and the observed negative effects were small and statistically non-significant and may be explained by chance findings. Verification of these findings is needed in real-world trials based on larger sample sizes and with the use of more comprehensive interventions. Trial registration Dutch Trial Register ID NL7064, 30th of May, 2018, https://onderzoekmetmensen.nl/en/trial/20990

Engineering design and construction teams commonly use decision tools, such as rating systems, to manage the complexity of infrastructure projects. However, these systems often focus predominantly on environmental dimensions, potentially overlooking the holistic economic and social aspects of sustainability. This can hinder decision-makers from recognizing the benefits, thereby inadvertently impeding optimal sustainability performance. This research explores a potential solution: reframing the goals of credits on rating systems to explicitly highlight the interconnectedness of environmental, social, and financial dimensions. The aim was to amplify engineers' motivation towards higher levels of sustainability performance. The study examined the effect of the goal-framed credits by comparing the sustainability scores between engineering professionals (n=42) who used the original Envision system and the reframed version when evaluating a case project. The control group participants averaged a score of 95.4 Envision points (37%), while the intervention group averaged 121.8 Envision points (48%). The reframed credits significantly increased engineering professionals' sustainability goal setting. Emphasizing financial and social objectives on credits from the Envision rating system, rather than solely focusing on the existing environmental goals, had a favorable influence on professionals' sustainable design choices. This reframing, by emphasizing the interconnectedness of environmental, social, and financial dimensions of each decision, appears to amplify the awareness, motivation, and selection of higher levels of sustainability achievement, thereby increasing their perceived value and leading to a shift in sustainability-oriented decision-making. The findings suggest that reframing rating systems to better emphasize the interconnectedness of the environmental, social, and financial dimensions of each decision can serve to help engineering teams set higher goals for sustainable performance. Practical Applications: For infrastructure project managers, architects, and designers, this research highlights the significance of considering economic and social aspects alongside environmental concerns. By doing so, it can further empower stakeholders to make more well-rounded and sustainable decisions that benefit both their projects and the communities they serve. Small changes in how decision tools are worded, or framed, can have a significant effect on project goal setting. A better understanding of how framing affects design cognition can also help inform how project managers, architects, and designers present information to their clients. Subtle changes in the decision tools and the way information about projects is expressed cost little compared to the actual cost of infrastructure, offering inexpensive and easy to implement strategies to influence and nudge project teams toward setting higher sustainability goals during the design and construction of infrastructure projects. [ABSTRACT FROM AUTHOR]

Background: Typical adolescent diets do not meet current dietary recommendations. There is a need to address these dietary patterns to reduce the risk of obesity and other diet-related diseases. Schools provide an opportune setting to do so, as students consume a substantial proportion of their daily dietary intake whilst at school. There is a developing evidence base on the use of choice architecture (food choice cues) to promote healthy eating in school contexts. It is necessary to understand the acceptability and feasibility of implementing such interventions. We aimed to explore these factors from the perspectives of secondary school caterers. Methods: We conducted qualitative interviews with caterers from secondary schools across the West Midlands, UK and national/regional catering representatives. A semi-structured topic guide and visual aid were used to guide interviews. Interviews were recorded and transcribed. Framework analysis was conducted in NVivo v12. Results: Twelve participants took part. Seven themes were identified and grouped into three categories: Acceptability (Suitability; Salient cues; Student engagement), Barriers (Catering decision drivers; Limits of influence), and Enablers (Perceived role; Opportunities). Caterers considered healthy food cues to be suited to adolescents as they require minimal reflective motivation. Salient cues included enhancing the placement, presentation and portability of healthy items, improving the dining environment and focusing pricing/incentive strategies on increased quantity. Student engagement was considered important. Some catering decision drivers conflicted with healthy food cues, and many felt that their role in healthy eating was limited due to the overwhelming influence of external food environments, adolescent resistance, and features of the secondary school canteen setting e.g. short duration of lunchtime, lack of space. However, caterers appeared motivated to implement healthy food cues and identified key opportunities for implementation, including integration into whole-school approaches to healthy eating. Conclusions: Interventions using healthy food cues appeared acceptable to secondary school caterers, key potential implementers of these strategies. Future interventions could incorporate strategies relating to placement, presentation and pricing to prompt healthy selections, and actions to engage the student body and improve the dining environment. Evaluations should consider potential impacts upon food purchasing, consumption and waste to address caterers' concerns about these issues. [ABSTRACT FROM AUTHOR]

Background: Changing the food environment is an important public health lever for encouraging sustainable food choices. Targeting the availability of vegetarian main meals served in cafeterias substantially affects food choice, but acceptability has never been assessed. We examined the effects of an availability intervention at a French university cafeteria on students' main meal choices, meal offer satisfaction and liking. Methods: A four-week controlled trial was conducted in a university cafeteria in Dijon, France. During the two-week control period, vegetarian main meals constituted 24% of the offer. In the subsequent two-week intervention period, this proportion increased to 48%, while all the other menu items remained unchanged. Students were not informed of the change. Student choices were tracked using production data, and daily paper ballots were used to assess student satisfaction with the meal offer and liking of the main meal they chose (score range [1;5]). Nutritional quality, environmental impact, and cost of production of meal choices were calculated for each lunchtime. Food waste was measured over 4 lunchtimes during control and intervention periods. An online questionnaire collected student feedback at the end of the study. Results: Doubling availability of vegetarian main meals significantly increased the likelihood of choosing vegetarian options (OR = 2.57, 95% CI = [2.41; 2.74]). Responses of the paper ballots (n = 18,342) indicated slight improvements in meal offer satisfaction from 4.05 ± 0.92 to 4.07 ± 0.93 (p = 0.028) and in liking from 4.09 ± 0.90 to 4.13 ± 0.92 (p < 0.001) during control and intervention periods, respectively. The end-of-study questionnaire (n = 510) revealed that only 6% of students noticed a change the availability of vegetarian main meals. The intervention led to a decrease in the environmental impact of the main meals chosen, a slight decrease in nutritional quality, a slight increase in meal costs and no change in food waste. Conclusions: Doubling availability of vegetarian main meals in a university cafeteria resulted in a twofold increase in their selection, with students reporting being more satisfied and liking the main meals more during the intervention period. These results suggest that serving an equal proportion of vegetarian and nonvegetarian main meals could be considered in French university cafeterias to tackle environmental issues. Trial registration: Study protocol and analysis plan were pre-registered on the Open Science Framework (https://osf.io/pf3x7/). [ABSTRACT FROM AUTHOR]

Interventions that tackle 'last mile' behaviors in the form of improved choice architecture are fundamental to Behavioral Public Policy (BPP), yet far less attention is typically paid to the nature and design of underlying system conditions and infrastructures that support these interventions. However, inattention to broader conditions that impact participant engagement and intervention functionality, such as barriers to access that deter participation or perverse structural disincentives that reward undesirable behaviors, may not only limit the effectiveness of behavioral solutions but also miss opportunities to deliberately design underlying 'plumbing' – the choice infrastructure – in a way that improves overall system efficacy and equity. Using the illustrative case of civic policy in food licensure, this article describes how using a 'SPACE' model to address Standards, Process mechanics and policies, Accountability, Culture within systems, and Evaluative and iterative feedback can support the development of improved choice infrastructure, contributing to BPP problem-solving efforts by helping practitioners create system conditions that are more conducive to the success of behavioral solutions. [ABSTRACT FROM AUTHOR]

Background: Supermarket interventions are promising to promote healthier dietary patterns, but not all individuals may be equally susceptible. We explored whether the effectiveness of nudging and pricing strategies on diet quality differs by psychological and grocery shopping characteristics. Methods: We used data of the 12-month Supreme Nudge parallel cluster-randomised controlled supermarket trial, testing nudging and pricing strategies to promote healthier diets. Participants were Dutch speaking adults aged 30–80 years and regular shoppers of participating supermarkets (n = 12) in socially disadvantaged neighbourhoods. Data on psychological characteristics (food-related behaviours; price sensitivity; food decision styles; social cognitive factors; self-control) and grocery shopping characteristics (time spent in the supermarket; moment of the day; average supermarket visits; shopping at other retailers; supermarket proximity) were self-reported at baseline. These characteristics were tested for their moderating effects of the intervention on diet quality (scored 0–150) in linear mixed models. Results: We included 162 participants from intervention supermarkets and 199 from control supermarkets (73% female, 58 (± 10.8) years old, 42% highly educated). The interventions had no overall effect on diet quality. Only five out of 23 potential moderators were statistically significant. Yet, stratified analyses of these significant moderators showed no significant effects on diet quality for one of the subgroups and statistically non-significant negative effects for the other. Negative effects were suggested for individuals with lower baseline levels of meal planning (β − 2.6, 95% CI − 5.9; 0.8), healthy shopping convenience (β − 3.0, 95% CI − 7.2; 1.3), and healthy food attractiveness (β − 3.5, 95% CI − 8.3; 1.3), and with higher levels of price consciousness (β − 2.6, 95% CI − 6.2; 1.0) and weekly supermarket visits (β − 2.4, 95% CI − 6.8; 1.9). Conclusions: Adults with varying psychological and grocery shopping characteristics largely seem equally (un)susceptible to nudging and pricing strategies. It might be that certain characteristics lead to adverse effects, but this is not plausible, and the observed negative effects were small and statistically non-significant and may be explained by chance findings. Verification of these findings is needed in real-world trials based on larger sample sizes and with the use of more comprehensive interventions. Trial registration: Dutch Trial Register ID NL7064, 30th of May, 2018, https://onderzoekmetmensen.nl/en/trial/20990 [ABSTRACT FROM AUTHOR]

Abstract Background Modifying the choice architecture of behavioural contexts can facilitate health behaviour change, but existing evidence builds mostly on small-scale interventions limited in duration, targets, strategies, and settings. We evaluated the effectiveness of a one-year hybrid type 2 implementation-effectiveness trial aimed at promoting healthy eating and daily physical activity with subtle modifications to the choice architecture of heterogeneous worksites. The intervention was contextualised to and integrated into the routine operations of each worksite. Effectiveness was evaluated in a quasi-experimental pre-post design. Methods Intervention sites (n = 21) implemented a median of two (range 1–9) intervention strategies for healthy eating and one (range 1–5) for physical activity. Questionnaires pre (n = 1126) and post (n = 943) intervention surveyed employees’ behavioural patterns at work (food consumption: vegetables/roots, fruit/berries, nuts/almonds/seeds, sweet treats, fast food, water; physical activity: restorative movement, exercise equipment use, stair use). The post-intervention questionnaire also measured employees’ perception of and response to three intervention strategies: a packed lunch recipe campaign, a fruit crew-strategy, and movement prompts. Multi- and single-level regression models evaluated effectiveness, treating intervention as a continuous predictor formed of the site-specific dose (n intervention strategies employed) and mean quality (three-point rating per strategy halfway and at the end of the intervention) of implementation relevant to each outcome. Results Multinomial logistic regression models found the intervention significantly associated with a favourable change in employees’ fruit and berry consumption (interaction effect of time and implementation p = 0.006) and with an unfavourable change in sweet treat consumption (p = 0.048). The evidence was strongest for the finding concerning fruit/berry consumption—an outcome that sites with greater dose and quality of implementation targeted by using strategies that reduced the physical effort required to have fruit/berries at work and by covering multiple eating-related contexts at the worksite. The quality of implementation was positively associated with the perception of (p = 0.044) and response to (p = 0.017) the packed lunch recipes, and with response to the fruit crew-strategy (p

Electronic health records (EHRs) offer decision support in the form of alerts, which are often though not always interruptive. These alerts, though sometimes effective, can come at the cost of high cognitive burden and workflow disruption. Less well studied is the design of the EHR itself-the ordering providers choice architecture-which nudges users toward alternatives, sometimes unintentionally toward waste and misuse, but ideally intentionally toward better practice. We studied 3 different workflows at our institution where the existing choice architecture was potentially nudging providers toward erroneous decisions, waste, and misuse in the form of inappropriate laboratory work, incorrectly specified computerized tomographic imaging, and excessive benzodiazepine dosing for imaging-related sedation. We changed the architecture to nudge providers toward better practice and found that the 3 nudges were successful to varying degrees in reducing erroneous decision-making and mitigating waste and misuse.

Willingness to vaccinate and test are critical in the COVID-19 pandemic. We study the effects of two measures to increase the support of vaccination and testing: defaults and monetary compensations. Some organizations, such as restaurants, fire departments, hospitals, or governments in some countries, have used these measures. Yet there is the concern that compensations could erode intrinsic motivation and decrease vaccination intentions. We show that, in the early stages of the pandemic, both approaches, compensations and defaults, significantly increased COVID-19 test demand and vaccine intentions. Compensations for vaccines, however, need to be large enough because low compensations can backfire. We estimate heterogeneous treatment effects to document which groups are more likely to respond to these measures. The results show that defaults and avoidance of small compensations are especially important for individuals who are more skeptical of the vaccine, measured by their trust in the vaccine and their political views. Hence, both measures could be used in a targeted manner to achieve stronger results. This paper was accepted by Yan Chen, behavioral economics and decision analysis. Supplemental Material: The online appendix and data are available at https://doi.org/10.1287/mnsc.2022.4405 .

Background: Modifying the choice architecture of behavioural contexts can facilitate health behaviour change, but existing evidence builds mostly on small-scale interventions limited in duration, targets, strategies, and settings. We evaluated the effectiveness of a one-year hybrid type 2 implementation-effectiveness trial aimed at promoting healthy eating and daily physical activity with subtle modifications to the choice architecture of heterogeneous worksites. The intervention was contextualised to and integrated into the routine operations of each worksite. Effectiveness was evaluated in a quasi-experimental pre-post design. Methods: Intervention sites (n = 21) implemented a median of two (range 1–9) intervention strategies for healthy eating and one (range 1–5) for physical activity. Questionnaires pre (n = 1126) and post (n = 943) intervention surveyed employees' behavioural patterns at work (food consumption: vegetables/roots, fruit/berries, nuts/almonds/seeds, sweet treats, fast food, water; physical activity: restorative movement, exercise equipment use, stair use). The post-intervention questionnaire also measured employees' perception of and response to three intervention strategies: a packed lunch recipe campaign, a fruit crew-strategy, and movement prompts. Multi- and single-level regression models evaluated effectiveness, treating intervention as a continuous predictor formed of the site-specific dose (n intervention strategies employed) and mean quality (three-point rating per strategy halfway and at the end of the intervention) of implementation relevant to each outcome. Results: Multinomial logistic regression models found the intervention significantly associated with a favourable change in employees' fruit and berry consumption (interaction effect of time and implementation p = 0.006) and with an unfavourable change in sweet treat consumption (p = 0.048). The evidence was strongest for the finding concerning fruit/berry consumption—an outcome that sites with greater dose and quality of implementation targeted by using strategies that reduced the physical effort required to have fruit/berries at work and by covering multiple eating-related contexts at the worksite. The quality of implementation was positively associated with the perception of (p = 0.044) and response to (p = 0.017) the packed lunch recipes, and with response to the fruit crew-strategy (p < 0.001). Conclusions: The results suggest that a contextualised, multicomponent choice architecture intervention can positively influence eating behaviour in diverse real-world settings over a one-year period, and that higher implementation quality can enhance intervention perception and response. However, outcomes may depend on the type of intervention strategies used and the extent of their delivery. [ABSTRACT FROM AUTHOR]

Choice architecture describes the environment in which choices are presented to decision-makers. In recent years, public and private actors have looked at choice architecture with great interest as they seek to influence human behaviour. These actors are typically called choice architects. Increasingly, however, this role of architecting choice is not performed by a human choice architect, but an algorithm or artificial intelligence, powered by a stream of Big Data and infused with an objective it has been programmed to maximise. We call this entity the autonomous choice architect. In this paper, we present an account of why artificial intelligence can fulfil the role of a choice architect and why this creates problems of transparency, responsibility and accountability for nudges. We argue that choice architects, be them autonomous computational systems or human-beings, at a most basic level select, from a range of designs, the design which is most likely to maximise a pre-determined objective. We then proceed to argue that, given the growing demand for targeted, personalised choice architecture and for faster, dynamic reconfigurations of choice architecture, as well as the ever-expanding pool of data from which feedback can be drawn, the role of the human choice architect is increasingly obscured behind algorithmic, artificially intelligent systems. We provide a discussion of the implications of autonomous choice architects, focusing on the importance of the humans who programme these systems, ultimately arguing that despite technological advances, the responsibility of choice architecture and influence remains firmly one human beings must bear. [ABSTRACT FROM AUTHOR]

With an eye on the future of global ethics, I argue that social-media technologies are not morally neutral tools but are, for all intents and purposes, a kind of agent. They nudge us to do things that are bad for us. Moreover, I argue that we have a duty to quit using social-media platforms, not just on account of possible duties to preserve our own well-being but because users are akin to test subjects on whom developers are testing new nudges, and we ought to deprive them of their test subjects. [ABSTRACT FROM AUTHOR]

Policymakers increasingly rely on behavioral science in response to global challenges, such as climate change or global health crises. But applications of behavioral science face an important problem: Interventions often exert substantially different effects across contexts and individuals. We examine this heterogeneity for different paradigms that underlie many behavioral interventions. We study the paradigms in a series of five preregistered studies across one in-person and 10 online panels, with over 11,000 respondents in total. We find substantial heterogeneity across settings and paradigms, apply techniques for modeling the heterogeneity, and introduce a framework that measures typically omitted moderators. The framework's factors (Fluid Intelligence, Attentiveness, Crystallized Intelligence, and Experience) affect the effectiveness of many text-based interventions, producing different observed effect sizes and explaining variations across samples. Moderators are associated with effect sizes through two paths, with the intensity of the manipulation and with the effect of the manipulation directly. Our results motivate observing these moderators and provide a theoretical and empirical framework for understanding and predicting varying effect sizes in the social sciences. [ABSTRACT FROM AUTHOR]

This research aims to investigate the relationship between prior spending and unplanned purchases based on an understanding of decision framing effects and compensatory psychology. We argue that the impact of prior buying on unplanned purchases is moderated by the decision frame (separate vs. integrated). We conducted a series of four sequential scenario-based experimental studies to support our theoretical predictions. Consequently, our study revealed that travelers within a separate decision frame exhibited a stronger compensatory motive, leading to a higher unplanned purchase when prior spending was low. In practice, this research has managerial implications using compensatory consumption marketing strategies. [ABSTRACT FROM AUTHOR]

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Purpose: Recent reviews of field experiments aiming to entice tourists to behave in more environmentally sustainable ways conclude that attitudes – while the primary target – do not perform as well as expected. The purpose of this study is to analyse in detail when attitudes have or have not been successful as behavioural change targets and propose a conceptual framework of possible explanations. In so doing, this study represents the first theoretical – rather than empirical – challenge to the currently dominant theoretical understanding of environmentally significant tourist behaviours and offers alternative theoretical constructs tourism researchers aiming to make tourists behave in more sustainable ways could investigate in future. Design/methodology/approach: The authors investigate in detail experiments where attitude-based behavioural change approaches failed. Based on the insights from this analysis, the authors propose a conceptual framework offering five potential explanations. This study also discusses alternative theoretical constructs that could be used for behavioural change interventions. Findings: The authors derive five potential explanations for why attitudes often fail to trigger behavioural change in the context of environmentally sustainable tourist behaviour: tourists do not notice messages attempting to change their attitudes; tourists are unwilling to cognitively process behavioural change messages; tourists develop reactance to behavioural change requests; attempts to alter attitudes do not influence habits; and attempts to alter attitudes do not reduce the effort associated with displaying the desired behaviour. Research limitations/implications: This study broadens research attention to alternative theoretical constructs that may be more effective in making tourists behave in more sustainable ways and opens opportunities for new measures tourism businesses and destinations can implement to influence tourist behaviour. Originality/value: To the best of the authors' knowledge, this is the first theoretical investigation of possible reasons why attitudes have performed poorly as targets of behavioural change interventions aiming to trigger environmentally sustainable tourist behaviours. [ABSTRACT FROM AUTHOR]

Abstract Background Context-specific interventions may contribute to sustained behaviour change and improved health outcomes. We evaluated the real-world effects of supermarket nudging and pricing strategies and mobile physical activity coaching on diet quality, food-purchasing behaviour, walking behaviour, and cardiometabolic risk markers. Methods This parallel cluster-randomised controlled trial included supermarkets in socially disadvantaged neighbourhoods across the Netherlands with regular shoppers aged 30–80 years. Supermarkets were randomised to receive co-created nudging and pricing strategies promoting healthier purchasing (N = 6) or not (N = 6). Nudges targeted 9% of supermarket products and pricing strategies 3%. Subsequently, participants were individually randomised to a control (step counter app) or intervention arm (step counter and mobile coaching app) to promote walking. The primary outcome was the average change in diet quality (low (0) to high (150)) over all follow-up time points measured with a validated 40-item food frequency questionnaire at baseline and 3, 6, and 12 months. Secondary outcomes included healthier food purchasing (loyalty card-derived), daily step count (step counter app), cardiometabolic risk markers (lipid profile and HbA1c via finger prick, and waist circumference via measuring tape), and supermarket customer satisfaction (questionnaire-based: very unsatisfied (1) to very satisfied (7)), evaluated using linear mixed-models. Healthy supermarket sales (an exploratory outcome) were analysed via controlled interrupted time series analyses. Results Of 361 participants (162 intervention, 199 control), 73% were female, the average age was 58 (SD 11) years, and 42% were highly educated. Compared to the control arm, the intervention arm showed no statistically significant average changes over time in diet quality (β − 1.1 (95% CI − 3.8 to 1.7)), percentage healthy purchasing (β 0.7 ( − 2.7 to 4.0)), step count (β − 124.0 ( − 723.1 to 475.1), or any of the cardiometabolic risk markers. Participants in the intervention arm scored 0.3 points (0.1 to 0.5) higher on customer satisfaction on average over time. Supermarket-level sales were unaffected (β − 0.0 (− 0.0 to 0.0)). Conclusions Co-created nudging and pricing strategies that predominantly targeted healthy products via nudges were unable to increase healthier food purchases and intake nor improve cardiometabolic health. The mobile coaching intervention did not affect step count. Governmental policy measures are needed to ensure more impactful supermarket modifications that promote healthier purchases. Trial registration Dutch Trial Register ID NL7064, 30 May 2018, https://www.onderzoekmetmensen.nl/en/trial/20990

Abstract Background Tuberculosis (TB) preventive treatment (TPT) substantially reduces the risk of developing active TB for people living with HIV (PLHIV). We utilized a novel implementation strategy based on choice architecture (CAT) which makes TPT prescribing the default option. Through CAT, health care workers (HCWs) need to “opt-out” when choosing not to prescribe TPT to PLHIV. We assessed the prospective, concurrent, and retrospective acceptability of TPT prescribing among HCWs in Malawi who worked in clinics participating in a cluster randomized trial of the CAT intervention. Methods 28 in-depth semi-structured interviews were conducted with HCWs from control (standard prescribing approach) and intervention (CAT approach) clinics. The CAT approach was facilitated in intervention clinics using a default prescribing module built into the point-of-care HIV Electronic Medical Record (EMR) system. An interview guide for the qualitative CAT assessment was developed based on the theoretical framework of acceptability and on the normalization process theory. Thematic analysis was used to code the data, using NVivo 12 software. Results We identified eight themes belonging to the three chronological constructs of acceptability. HCWs expressed no tension for changing the standard approach to TPT prescribing (prospective acceptability); however, those exposed to CAT described several advantages, including that it served as a reminder to prescribe TPT and routinized TPT prescribing (concurrent acceptability). Some felt that CAT may reduce HCW´s autonomy and might lead to inappropriate TPT prescribing (retrospective acceptability). Conclusions The default prescribing module for TPT has now been incorporated into the point-of-care EMR system nationally in Malawi. This seems to fit the acceptability of the HCWs. Moving forward, it is important to train HCWs on how the EMR can be leveraged to determine who is eligible for TPT and who is not, while acknowledging the autonomy of HCWs.

Abstract Background Altering the choice architecture of decision contexts can assist behaviour change, but the acceptability of this approach has sparked debate. Considering hypothetical interventions, people generally welcome the approach for promoting health, but little evidence exists on acceptance in the real world. Furthermore, research has yet to explore the implementers’ perspective, acknowledging the multidimensionality of the acceptability construct. Addressing these knowledge gaps, this study evaluated the acceptability of a quasi-experimental implementation-effectiveness trial that modified the worksite choice architecture for healthy eating and daily physical activity. Methods Fifty-three worksites participated in the 12-month intervention and implemented altogether 23 choice architecture strategies (Mdn 3/site), including point-of-choice prompts and changes to choice availability or accessibility. Retrospective acceptability evaluation built on deductive qualitative content analysis of implementer interviews (n = 65) and quantitative analysis of an employee questionnaire (n = 1124). Qualitative analysis examined implementers’ thoughts and observations of the intervention and its implementation, considering six domains of the Theoretical Framework of Acceptability: ethicality, affective attitude, burden, intervention coherence, opportunity costs, and perceived effectiveness. Quantitative analysis examined employees’ acceptance (7-point Likert scale) of eight specific intervention strategies using Friedman test and mixed-effects logistic regression. Results Implementers considered the choice architecture approach ethical for workplace health promotion, reported mostly positive affective attitudes to and little burden because of the intervention. Intervention coherence supported acceptance through increased interest in implementation, whereas low perceived utility and high intensity of implementation reduced cost acceptance. Perceived effectiveness was mixed and varied along factors related to the implementer, social/physical work environment, employer, and employee. Employees showed overall high acceptance of evaluated strategies (Mdn 7, IQR 6.4–7), though strategies replacing unhealthy foods with healthier alternatives appeared less supported than providing information or enhancing healthy option availability or accessibility (p-values

U.S. households currently hold $770 billion in credit card debt, often managing repayments across multiple accounts. The authors investigate how minimum payment requirements (i.e., the requirement to allocate at least some money to each account with a balance) alter consumers' allocation strategies across multiple accounts. Across four experiments, they find that minimum payment requirements cause consumers to increase dispersion (i.e., spread their repayments more evenly) across accounts. The authors term this change in strategy "the dispersion effect of minimum payments" and provide evidence that it can be costly for consumers. They find that the effect is partially driven by the tendency for consumers to interpret minimum payment requirements as recommendations to pay more than the minimum amount. While the presence of the minimum payment requirement is unlikely to change, the authors propose that marketers and policy makers can influence the effects of minimum payments on dispersion by altering the way that information is displayed to consumers. Specifically, they investigate five distinct information displays and find that choice of display can either exaggerate or minimize dispersion and corresponding costs. They discuss implications for consumers, policy makers, and firms, with a particular focus on ways to improve consumer financial well-being. [ABSTRACT FROM AUTHOR]

Background: The prison population presents complex health needs and is disproportionately affected by poor health, compared to the general population. Diet has a clear role in prisoner health, and the prison food environment within which food choices are made is relatively under–researched. The aim of this study was to examine whether food choices in a women's prison changed after the introduction of a new menu design by the catering team. Methods: The adjusted menu design incorporated an emoticon (a smiley face) placed next to designated 'Healthy Choice' foods on the menu sheets, which were used to preselect meals. Data comprised all women's (n = 865) food choices (more than 115,000 selections) for a period of 8 weeks (with the new menu) as well as 8 weeks prior (baseline period). The study design was a pre‐post intervention study, and food selection was examined using chi‐square tests and binary logistic regression models. Results: The selection of promoted foods overall significantly increased under the new menu design (with the emoticon nudge strategy) compared to baseline; the effect size, however, was small according to the usual guidelines (21.4% compared to 20% at baseline; χ2(1) = 32.6, p < 0.001, φ = 0.02). Individuals were 11% more likely (p < 0.001) to select the promoted 'Healthy Choice' foods under the adjusted food choice architecture. A significant effect was found for lunch and evening meal – but not for desserts. A minority of individual food items that were promoted had significant positive changes in selection, and were 1.3–4 times as likely to be selected when emoticons had been introduced, compared to baseline. Conclusions: Further research is needed to examine the potential added benefit of multiple complementary nudge strategies, and the relevance of the preselection of foods in advance of consumption. Key points: Food choice changed with the introduction of an emoticon to the menu sheets in a prison.The emoticon was placed next to 'Healthy Choice' foods, and overall selection of these foods increased, but with a small effect size.Future research should investigate the introduction of further changes to the menu and the effectiveness of multiple versus single nudge strategies to promote 'Healthy Choice' foods. [ABSTRACT FROM AUTHOR]

Background: Context-specific interventions may contribute to sustained behaviour change and improved health outcomes. We evaluated the real-world effects of supermarket nudging and pricing strategies and mobile physical activity coaching on diet quality, food-purchasing behaviour, walking behaviour, and cardiometabolic risk markers. Methods: This parallel cluster-randomised controlled trial included supermarkets in socially disadvantaged neighbourhoods across the Netherlands with regular shoppers aged 30–80 years. Supermarkets were randomised to receive co-created nudging and pricing strategies promoting healthier purchasing (N = 6) or not (N = 6). Nudges targeted 9% of supermarket products and pricing strategies 3%. Subsequently, participants were individually randomised to a control (step counter app) or intervention arm (step counter and mobile coaching app) to promote walking. The primary outcome was the average change in diet quality (low (0) to high (150)) over all follow-up time points measured with a validated 40-item food frequency questionnaire at baseline and 3, 6, and 12 months. Secondary outcomes included healthier food purchasing (loyalty card-derived), daily step count (step counter app), cardiometabolic risk markers (lipid profile and HbA1c via finger prick, and waist circumference via measuring tape), and supermarket customer satisfaction (questionnaire-based: very unsatisfied (1) to very satisfied (7)), evaluated using linear mixed-models. Healthy supermarket sales (an exploratory outcome) were analysed via controlled interrupted time series analyses. Results: Of 361 participants (162 intervention, 199 control), 73% were female, the average age was 58 (SD 11) years, and 42% were highly educated. Compared to the control arm, the intervention arm showed no statistically significant average changes over time in diet quality (β − 1.1 (95% CI − 3.8 to 1.7)), percentage healthy purchasing (β 0.7 (− 2.7 to 4.0)), step count (β − 124.0 (− 723.1 to 475.1), or any of the cardiometabolic risk markers. Participants in the intervention arm scored 0.3 points (0.1 to 0.5) higher on customer satisfaction on average over time. Supermarket-level sales were unaffected (β − 0.0 (− 0.0 to 0.0)). Conclusions: Co-created nudging and pricing strategies that predominantly targeted healthy products via nudges were unable to increase healthier food purchases and intake nor improve cardiometabolic health. The mobile coaching intervention did not affect step count. Governmental policy measures are needed to ensure more impactful supermarket modifications that promote healthier purchases. Trial registration: Dutch Trial Register ID NL7064, 30 May 2018, https://www.onderzoekmetmensen.nl/en/trial/20990 [ABSTRACT FROM AUTHOR]

The effects of adding choice architecture to a theory-based (Health Action Process Approach; HAPA) sedentary intervention remain unknown. To investigate whether choice architecture enhances a theory-based sedentary behaviour reduction intervention in home-based office workers. A 4-week HAPA-based intervention was conducted in London, Canada. Choice architecture was tested as an enhancement via a two (group: 'Choice of Intervention' vs. 'No Choice Intervention') by two (time: Baseline vs. Week 4) factorial repeated measure randomized comparison design. Sedentary behaviour reduction strategies focussed on obtaining a sedentary break frequency (BF) of every 30–45 min with break durations (BD) of 2–3 min. BF, BD, sitting, standing, and moving time were objectively measured (activPAL4™) at both time points. Participants (n = 148) were 44.9 ± 11.4 years old and 72.3% female. BF and total sitting time showed a time effect (P <.001), where both groups improved over the 4 weeks; there were no significant differences between groups across time. BD, standing, and moving time had a significant group by time effect where the 'No Choice' group showed significant increases in BD (P <.001), standing (P =.006), and moving time (P <.001) over the 4 weeks. Augmenting a theory-based intervention with choice architecture resulted in change in some sedentary behaviours in at home office workers. Specifically, while BF increased for all participants, the 'No Choice' group exhibited greater changes for BD, standing, and moving time compared with the 'Choice' group. Overall, these changes exceeded the intervention BF and BD goals. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) preventive treatment (TPT) substantially reduces the risk of developing active TB for people living with HIV (PLHIV). We utilized a novel implementation strategy based on choice architecture (CAT) which makes TPT prescribing the default option. Through CAT, health care workers (HCWs) need to "opt-out" when choosing not to prescribe TPT to PLHIV. We assessed the prospective, concurrent, and retrospective acceptability of TPT prescribing among HCWs in Malawi who worked in clinics participating in a cluster randomized trial of the CAT intervention. Methods: 28 in-depth semi-structured interviews were conducted with HCWs from control (standard prescribing approach) and intervention (CAT approach) clinics. The CAT approach was facilitated in intervention clinics using a default prescribing module built into the point-of-care HIV Electronic Medical Record (EMR) system. An interview guide for the qualitative CAT assessment was developed based on the theoretical framework of acceptability and on the normalization process theory. Thematic analysis was used to code the data, using NVivo 12 software. Results: We identified eight themes belonging to the three chronological constructs of acceptability. HCWs expressed no tension for changing the standard approach to TPT prescribing (prospective acceptability); however, those exposed to CAT described several advantages, including that it served as a reminder to prescribe TPT and routinized TPT prescribing (concurrent acceptability). Some felt that CAT may reduce HCW´s autonomy and might lead to inappropriate TPT prescribing (retrospective acceptability). Conclusions: The default prescribing module for TPT has now been incorporated into the point-of-care EMR system nationally in Malawi. This seems to fit the acceptability of the HCWs. Moving forward, it is important to train HCWs on how the EMR can be leveraged to determine who is eligible for TPT and who is not, while acknowledging the autonomy of HCWs. [ABSTRACT FROM AUTHOR]

This article explores the impact of default nudges on individuals' experiences of autonomy, choice satisfaction, perceived threat to freedom of choice, and objection to the choice architecture. The study conducted three experiments and found that participants who received a prosocial opt-out default nudge made more prosocial choices without reporting lower autonomy or choice satisfaction compared to participants in opt-in default or active-choice conditions. The study suggests that default nudges are less manipulative and autonomy-infringing than feared and recommends including measures of choice experiences when testing new interventions. The article discusses the results of two studies examining the effects of different choice formats on participants' choices, experienced autonomy, choice satisfaction, and perceived threat to freedom of choice. The studies found that the choice formats did not significantly impact participants' perceptions of autonomy, choice satisfaction, or perceived threat to freedom of choice. Additionally, participants' donation choices were influenced by the choice formats, but when participants received a disclosure and passed a comprehension check, the differences in donation choices between the choice formats were not significant. The studies suggest that the default nudge had a strong influence on choice without negatively affecting other outcomes. The experiments found that participants generally reported high levels of autonomy and satisfaction, and low levels of perceived threat, regardless of the choice format. The findings suggest that individuals were able to recognize the presence of the nudge but did not feel their autonomy or satisfaction were compromised. The article also discusses the implications of these findings for the debate on the ethicality of nudging and the [Extracted from the article]

Nudges may play an important role in improving infection prevention and control (IPC) in hospitals. However, despite the novelty of the framework, their objectives, strategies and implementation approaches are not new. This review aims to provide an overview of the methods typically used by nudge interventions in IPC in hospitals targeting healthcare workers (HCWs). The initial search in PubMed yielded nine hits. Consequently, the search criteria were broadened and a second search was conducted, introducing 'nudge sensu lato ' which incorporates insights from sources beyond the traditional nudge framework while maintaining the same objectives, strategies and approaches. During the second search, PubMed, Epistemonikos, Web of Science and PsycInfo were searched in accordance with the PRISMA guidelines. Abstracts were screened, and reviewers from an interdisciplinary team read the full text of selected papers. In total, 5706 unique primary studies were identified. Of these, 67 were included in the review, and only four were listed as nudge sensu stricto , focusing on changing HCWs' hand hygiene. All articles reported positive intervention outcomes. Of the 56 articles focused on improving hand hygiene compliance, 71.4% had positive outcomes. For healthcare equipment disinfection, 50% of studies showed significant results. Guideline adherence interventions had a 66.7% significant outcome rate. The concept of nudge sensu lato was introduced, encompassing interventions that employ strategies, methods and implementation approaches found in the nudge framework. The findings demonstrate that this concept can enhance the scientific development of more impactful nudges. This may help clinicians, researchers and policy makers to develop and implement effective nudging interventions. [ABSTRACT FROM AUTHOR]

Background: Altering the choice architecture of decision contexts can assist behaviour change, but the acceptability of this approach has sparked debate. Considering hypothetical interventions, people generally welcome the approach for promoting health, but little evidence exists on acceptance in the real world. Furthermore, research has yet to explore the implementers' perspective, acknowledging the multidimensionality of the acceptability construct. Addressing these knowledge gaps, this study evaluated the acceptability of a quasi-experimental implementation-effectiveness trial that modified the worksite choice architecture for healthy eating and daily physical activity. Methods: Fifty-three worksites participated in the 12-month intervention and implemented altogether 23 choice architecture strategies (Mdn 3/site), including point-of-choice prompts and changes to choice availability or accessibility. Retrospective acceptability evaluation built on deductive qualitative content analysis of implementer interviews (n = 65) and quantitative analysis of an employee questionnaire (n = 1124). Qualitative analysis examined implementers' thoughts and observations of the intervention and its implementation, considering six domains of the Theoretical Framework of Acceptability: ethicality, affective attitude, burden, intervention coherence, opportunity costs, and perceived effectiveness. Quantitative analysis examined employees' acceptance (7-point Likert scale) of eight specific intervention strategies using Friedman test and mixed-effects logistic regression. Results: Implementers considered the choice architecture approach ethical for workplace health promotion, reported mostly positive affective attitudes to and little burden because of the intervention. Intervention coherence supported acceptance through increased interest in implementation, whereas low perceived utility and high intensity of implementation reduced cost acceptance. Perceived effectiveness was mixed and varied along factors related to the implementer, social/physical work environment, employer, and employee. Employees showed overall high acceptance of evaluated strategies (Mdn 7, IQR 6.4–7), though strategies replacing unhealthy foods with healthier alternatives appeared less supported than providing information or enhancing healthy option availability or accessibility (p-values < 0.02). Greater proportion of male employees per site predicted lower overall acceptance (OR 4.4, 95% CI 1.2–16.5). Conclusions: Work communities appear to approve workplace choice architecture interventions for healthy eating and physical activity, but numerous factors influence acceptance and warrant consideration in future interventions. The study contributes with a theory-based, multidimensional evaluation that considered the perspectives of implementers and influenced individuals across heterogeneous real-world settings. [ABSTRACT FROM AUTHOR]

Global construction has been blighted by productivity inertia caused by behavioural bias for decades. While other industry sector productivity has grown more than fifteen-fold since 1960, construction has stagnated with no more than a seven to ten percent overall growth. McKinsey Global Institute's report Reinventing Construction: A Route to Higher Productivity, reported infrastructure construction amongst a small group of outperforming market sub-sectors at 15 to 20 percent. This paper, which charts the development of a unique procurement model designed for high productivity, builds on that performance using behavioural insights to counter damaging and habitual biases. The new model changes trading relationships using a nudged 'opt-out' contract structure creating a different responsibility dynamic between client and supplier. A recognisable but different infrastructure construction procurement model to improve productivity using recognised behavioural economics and construction economics. Highways England was set up to run England's strategic road network in 2015. The procurement model that resulted, Regional Delivery Partnerships can be refined for any infrastructure sector construction environment and sets up a key step forward in contracting based on integrated project delivery. Using a combination of counter bias strategies built from loss aversion and nudge theory this new construction procurement model uses 'opt-out' from lean construction to drive higher productivity. By setting up an integrator, to create an integrated project team, Regional Delivery Partnerships uses loss aversion as the motivational key to better innovation. It empowers the integrator to counter uniqueness bias and find and eradicate waste (process time and money) to enhance productivity. Reward is aligned to both optimised efficient design and high productivity working. As 100% of budget underspend can be kept rewarding the integrator, the potential of not achieving this triggers loss aversion and motivates change using the principles of escalation of commitment in favour of the client. Performance data is also used to motivate using reduced acquisition costs from secondary competition, long held as an inefficient market overhead. Using recognised pragmatic academic techniques, and constructionism; choice architectures were remodelled into a new outcome and value focused procurement model. Using applied research, the team used processes and techniques to develop, build, test, and deploy the model in open market competition. It can be used by any infrastructure sector construction client to replicate a sector specific version of Regional Delivery Partnerships that changes trading choice architecture towards higher productivity. [ABSTRACT FROM AUTHOR]

Aims: To estimate the impact on selection and actual purchasing of (a) health warning labels (text‐only and image‐and‐text) on alcoholic drinks and (b) calorie labels on alcoholic and non‐alcoholic drinks. Design: Parallel‐groups randomised controlled trial. Setting: Drinks were selected in a simulated online supermarket, before being purchased in an actual online supermarket. Participants: Adults in England and Wales who regularly consumed and purchased beer or wine online (n = 651). Six hundred and eight participants completed the study and were included in the primary analysis. Interventions: Participants were randomized to one of six groups in a between‐subjects three [health warning labels (HWLs) (i): image‐and‐text HWL; (ii) text‐only HWL; (iii) no HWL] × 2 (calorie labels: present versus absent) factorial design (n per group 103–113). Measurements: The primary outcome measure was the number of alcohol units selected (with intention to purchase); secondary outcomes included alcohol units purchased and calories selected and purchased. There was no time limit for selection. For purchasing, participants were directed to purchase their drinks immediately (although they were allowed up to 2 weeks to do so). Findings There was no evidence of main effects for either (a) HWLs or (b) calorie labels on the number of alcohol units selected (HWLs: F(2,599) = 0.406, P = 0.666; calorie labels: F(1,599) = 0.002, P = 0.961). There was also no evidence of an interaction between HWLs and calorie labels, and no evidence of an overall difference on any secondary outcomes. In pre‐specified subgroup analyses comparing the 'calorie label only' group (n = 101) with the 'no label' group (n = 104) there was no evidence that calorie labels reduced the number of calories selected (unadjusted means: 1913 calories versus 2203, P = 0.643). Among the 75% of participants who went on to purchase drinks, those in the 'calorie label only' group (n = 74) purchased fewer calories than those in the 'no label' group (n = 79) (unadjusted means: 1532 versus 2090, P = 0.028). Conclusions: There was no evidence that health warning labels reduced the number of alcohol units selected or purchased in an online retail context. There was some evidence suggesting that calorie labels on alcoholic and non‐alcoholic drinks may reduce calories purchased from both types of drinks. [ABSTRACT FROM AUTHOR]

Defaults are powerful tools for nudging individuals toward potentially beneficial options. However, defaults typically guide all decision-makers toward the same option and, consequently, may misguide individuals with minority interests. We test whether presenting defaults with information about heterogeneity can help individuals with minority interests select alternative options, and we dub this intervention a "reason default." Reason defaults preselect the option that is best for most individuals (like standard defaults) but also explain (a) why the default was selected and (b) who should opt for an alternative. In five preregistered studies using online convenience samples of adults (N = 4,210), we find that reason defaults can improve decision-makers' outcomes over standard defaults and forced choices by guiding most individuals toward the default option while helping individuals with minority interests select an alternative. Further, participants reported that reason defaults enhance transparency, decision ease, and understanding of the choice relative to standard defaults and forced choices. [ABSTRACT FROM AUTHOR]

This study demonstrates behavioral economic task sensitivity in the context of "green" consumerism, specifically carbon-neutral home energy enrollment. Task respondents reported their likelihood of enrolling with a hypothetical home energy supplier via a medium (i.e., simulated task) closely resembling an actual choice context (i.e., energy provider web portal). We described enrollment probability across prices and generated demand metrics using field-standard nonlinear modeling. Model outputs were consistent with extant behavioral economic literature in internal consistency (i.e., correlations among derived demand metrics) and data quality (i.e., the proportion of nonsystematic flagging). We then used hierarchical linear regression to assess the degree to which demand metrics predict ecological concern. Results revealed a predictive relation between the demand sensitivity metric α (alpha) and sum scores on the New Ecological Paradigm Scale such that those respondents most willing to continue paying for green energy at increasing prices were also those expressing greatest concern over human–environment relations. This preliminary predictive validation underscores the task's ability to contact relevant ecological decision-making contexts. Overall findings support task use as an evaluative instrument in prospective community intervention (as in evaluating contextual influences) and underscore the viable application of behavioral economic methods to better understand "green" consumer preferences. [ABSTRACT FROM AUTHOR]

Behavioral economics theories were used to evaluate Beyond Meat's success in changing consumer tastes and preferences for plant-based protein in North America--mainly through its retail presence and partnerships with fast-food restaurants. Conclusions were drawn through the analysis of Beyond Meat's corporate decisions and various secondary sources, such as research conducted by Cattlemen's Beef Promotion and Research Board, Kansas University, and Purdue. The study revealed that biases, including status quo, distinction, familiarity, anchoring, and confirmation, are extensive in consumer perceptions of plant-based meats, often requiring immense efforts in choice architecture and nudging to create changes in pre-established habits such as meat consumption. However, by leveraging theories such as advertised responsibility, framing, nudging, herd behavior, and FOMO, Beyond Meat has significantly impacted the industry and the acceptance of plant-based meats. Biases pose problems in our day-to-day lives as change is required for improvement. Through exploring the factors in decision-making that influence human stagnance, we could alter the environment and context in which choices are presented through choice architecture, "nudging" consumers in the right direction. This can lead to low-cost and wide-scale change, such as more sustainable diets and reducing the impacts of imminent issues such as climate change. [ABSTRACT FROM AUTHOR]

The purpose of the study is to identify opportunities for changes related to social initiatives in the field of environmental preservation and maintaining a healthy lifestyle, through the application of the achievements of behavioral economics. The article analyzes the features of the formation of the architecture of choice as an element of behavioral economics by the tools of nudging in the context of eco-solutions. It is shown that in the formation of the global goals of sustainable development, much attention is paid to the tasks of preserving the environment and saving resource consumption. In view of this, the development of programs and projects that will accelerate the achievement of these goals is extremely important both for Ukraine and for the world community in general. The expediency of applying such approaches to the formation of the architecture of choice, which can increase the level of intensity of the transition to ecological solutions, is substantiated: the option of «default» should include the element of «eco»; the importance of applying the principles of eco-design; access to eco-solutions should be at least no more difficult than traditional ones, and, speaking of an ideal, much easier; eco-solutions should be beneficial for the consumer, and the benefits are not limited to purely economic ones. The theoretical conclusions are justified by practical cases that have already been implemented and are demonstrating their effectiveness in Ukraine. The difficulties that become obstacles in the processes of environmental conservation and can be overcome by climate incentives are outlined. In general, it has been proved that behavioral economics is able to offer its tools for forming the habit of making eco-decisions in a balanced way, taking into account the need to preserve the environment. Promising directions of research are the analysis of the possibilities of implementing the principles of behavioral economics in decision-making processes in the field of education, personal development, finance, etc.

Abstract Objective: To systematically review the impact of choice architecture interventions (CAI) on the food choice of healthy adolescents in a secondary school setting. Factors potentially contributing to the effectiveness of CAI types and numbers implemented and its long-term success were examined. Design: PUBMED and Web of Science were systematically searched in October 2021. Publications were included following predefined inclusion criteria and grouped according to the number and duration of implemented interventions. Intervention impact was determined by a systematic description of the reported quantitative changes in food choice and/or consumption. Intervention types were compared with regard to food selection and sustained effects either during or following the intervention. Setting: CAI on food choice of healthy adolescents in secondary schools. Participants: Not applicable. Results: Fourteen studies were included; four randomised controlled trials and five each of controlled or uncontrolled pre–post design, respectively. Four studies implemented a single CAI type, with ten implementing > 1. Three studies investigated CAI effects over the course of a school year either by continuous or repeated data collection, while ten studies’ schools were visited on selected days during an intervention. Twelve studies reported desired changes in overall food selection, yet effects were not always significant and appeared less conclusive for longer-term studies. Conclusions: This review found promising evidence that CAI can be effective in encouraging favourable food choices in healthy adolescents in a secondary school setting. However, further studies designed to evaluate complex interventions are needed.

Research shows that women are less likely to enter competitions than men. This disparity may translate into a gender imbalance in holding leadership positions or ascending in organizations. We provide both laboratory and field experimental evidence that this difference can be attenuated with a default nudge-changing the choice to enter a competitive task from a default in which applicants must actively choose to compete to a default in which applicants are automatically enrolled in competition but can choose to opt out. Changing the default affects the perception of prevailing social norms about gender and competition as well as perceptions of the performance or ability threshold at which to apply. We do not find associated negative effects for performance or wellbeing. These results suggest that organizations could make use of opt-out promotion schemes to reduce the gender gap in competition and support the ascension of women to leadership positions.

In recent years, numerous countries have enacted legislation to halt fossil-fueled vehicle sales within five to 10 years. With shrinking global markets for these vehicles, manufacturers are increasingly motivated to redirect them towards nations with less stringent regulations, using attractive prices and other tactics. However, the sale of new fossil-fueled vehicles poses a public challenge as they will remain in use for years. Consequently, reducing the likelihood of consumers purchasing new fossil-fueled vehicles in favor of electric vehicles is crucial in all countries, particularly those with less stringent regulations, to meet emission goals. Efforts to promote electric vehicle adoption through policy measures fall short due to underestimated cognitive biases and consumer behavior impacts. We contribute to the literature by bridging the gap between human behavioral studies and environmental policy. We incorporate choice architecture into energy labels to determine which information architecture regarding energy costs is an effective nudge in increasing electric vehicle purchase intentions. Our experiment finds that labels framing energy costs as ‘expenditure,’ rather than ‘savings,’ are more effective in increasing the intent to purchase an electric vehicle. Additionally, we find that a graphical display of expenditure was not effective in influencing purchase intentions. Policymakers can use similar choice architecture tools to encourage electric vehicle adoption, expediting the transition to electric vehicles and achieving national environmental goals.