At a glance
Behavioral design can be grouped into six categories, each with supporting scientific evidence and rationale.
Placement and layout
Approach and examples
Strategically place foods and beverages, and design the layout of food service venues to promote selecting healthier foods and beverages. This includes using equipment and serving ware to highlight healthy options. For example, you can:
- Make accessing healthy items easier.
- Create flow paths that emphasize healthy items.
- Make healthy items more visible.
- Organize products to influence choice such as putting healthy items first among two items or in the middle of three items.3
Evidence and rationale
Placement and layout strategies can make selecting healthy choices an automatic process by reducing physical and cognitive effort. The amount of working memory that a person needs to decide is called the cognitive load. Decreasing the cognitive load can increase reason-based choice-making and lead to healthier choices.5,6 These practices can influence dietary choices, including increasing the consumption of fruits and vegetables and decreasing the consumption of sugar-sweetened beverages.7-10
Product innovations and defaults
Approach and examples
Use product innovations and including healthier options as default choices at decision points to encourage healthier choices. For example, you can:
- Use a variety of culinary and presentation styles and different combinations of offerings.
- Balance expected or traditional offerings with more novel items to maintain current customers and attract new ones.
- Offer smaller portion size options and provide smaller serving ware.
- Normalize easy access to healthier items such as putting only healthy items by the cash register or checkout machine.
- Make healthy options the default choice in menus, lists, sales, and bundles.
Rationale and evidence
Providing customers with a high-quality product and experience is important to selling healthier foods. Product and service innovation is a key to this effort. In turn, satisfaction with worksite food quality increases the general well-being of employees.11
Offering healthier foods that are in demand, including those that follow market trends, is a safe way to introduce new products at low-financial risk. Evidence is mixed on the ideal number of offerings or the ideal ratio of healthy to less healthy offerings. However, people choose healthy options more often when a larger number and variety of healthy products is available.9,10,12
Smaller portions, servings, and tableware can lead customers to choose smaller options.13 However, food service operators must pay attention to outcomes when adjusting portion sizes because the largest and smallest sizes tend to be the least selected.14
Default or preset options simplify decision-making.15 In food service settings, this approach can include bundling meals with healthy sides and beverages. By reducing the need to make decisions, default options reduce cognitive burden and make healthy choices easier and more likely.16
Pricing and promotion
Approach and examples
Use price incentives and marketing strategies to highlight healthier food and beverage items. Examples include financial incentives such as discounts, vouchers, coupons, rebates, bundling, and price comparisons to encourage healthy food choices. The goal is to make healthier foods relatively more affordable.
Rationale and evidence
The price of food is a primary determinant of consumer purchasing decisions.17 Price reductions can increase consumer demand and consumption of healthier foods.18–23 For example, food pricing and consumption studies in cafeterias, vending machines, and supermarkets found that a price decrease of 10% would lead to an overall increased consumption of healthy foods by 12%.24 For fruits and vegetables, an average 10% decrease in price led to a 14% increase in consumption.24,25
Price increases may also reduce consumption of less healthy products, such as sugar-sweetened beverages.8 One study found that a 10% increase in the price of unhealthy foods lead to a 6% decrease in consumption of these items.24
Price discounts have also increased purchases of healthy foods in workplace environments.26 However, these incentives are not equally effective for all products or in all venues, and their effect may vary according to customer demographics.
Tableware
Approach and examples
Promote healthy portion sizes by optimizing the size of plates, bowls, glasses, other dishware, and serving ware. These strategies can increase the portion size of healthy foods or decrease the size of less healthy foods.
Rationale and evidence
Many studies have found that people eat and drink more when portion sizes are larger, which can lead to increased calorie intake.27 Portion size and the amount consumed are influenced by individual, cultural, and environmental variables. One example is the size and shape of the tableware and serving ware.13,28,29
The dominant mechanism through which tableware influences consumption is that the size of the tableware distorts perceived portion size, leading to larger servings being added to larger tableware.30 Perception of liquids is slightly different. People have more difficulty estimating the volume of liquids in glasses that are wider and shorter vs narrower and taller, which can increase the amount consumed from wider and shorter glasses.31
Many studies have explored how tableware and serving ware influence portion size and consumption. These studies have generally found a small but consistent effect when size and shape are modified, with larger tableware increasing the selection and intake of healthier foods and smaller tableware decreasing the selection and intake of less healthy foods.13,31,32 However, these strategies have been found to be most effective in self-service settings.31
Advantages of these strategies include that they can help create transferable normative behavior, and they are not invasive.33
Information
Approach and examples
Use information, displays, decorations, and signage to highlight healthier choices. These strategies focus primarily on where and how to display factual information designed to encourage or provide a rationale for healthier selections. This information can be displayed through menus, labels, advertising, demonstrations, or other types of messaging.
These strategies inherently include design elements, such as color, size, positioning, styling, sounds, and smells. These may influence a person's general experience (alone and in combination) and, in turn, their behavior. These design elements are classified in an additional behavioral design category called atmospherics, which will be addressed in future guidance documents.
Rationale and evidence
Information strategies influence dietary behaviors by communicating factual associations between dietary choices and health or performance outcomes. Behavioral outcomes are influenced by the content and context of messaging efforts. For example, food and nutrition information on menus, labels, or signs can influence customers' knowledge of portion size and nutritional quality and may influence food purchasing and consumption.8,34,35
These strategies may lead to healthier food and beverage selection and a better understanding of how food and food systems affect individual health and social and ecological outcomes.36,37 They include nutrition labeling, menu design, food and nutrition literacy, and signage.
Definitions
Nutrition labeling. Labeling foods with information about nutritional value, health potential, or how the product was sourced or produced can increase its selection.35,38–41 For example, labels that use traffic light colors (green, yellow, and red) to rate the healthiness of foods and beverages may help people choose healthier foods and drink fewer sugar-sweetened beverages.8,42 Several international health organizations recommend front-of-package (FOP) labels as a way to influence dietary behavior and provide product transparency.43
Food and nutrition literacy. Food and nutrition literacy strategies seek to increase skills and knowledge about foods, such as preparation, tasting, cultures, and systems. Food systems include how dietary choices influence social, economic, and ecologic outcomes.48–50
Signage. Signs can encourage people to select healthier food items by drawing attention to products, creating flow paths, communicating factual information, and showing inspirational images, such as nature scenes or people being physically active.51,52
Note that the U.S. Federal Drug Administration is currently taking steps to standardize front of package labelling for consumers. 53
Organizational policy
Approach and examples
Adopt policies, practices, and programs that support a culture of health in your organization and encourage using food service guidelines and behavioral design standards in all onsite food venues. These strategies use institutional authority and management processes—such as leadership, worksite wellness programs, and employee organizations—to create policies, practices, and programs that promote environments where healthy choices are the default option.
These strategies may take different approaches depending on your organization's goals, values, and demographics. For example, if your organization is overtly committed to health and wellness and has a top-down management structure, you can use directives, written policies, and intensive monitoring to achieve your goals. Alternatively, if your organization has a more relaxed management style and no overt commitment to health, you may simply provide education and guidance on food venue contracts, spaces, and informational materials, without directives or contractual requirements.
Two ways to use organizational policies to promote healthier outcomes are:
Agent- or individual-focused approach
This approach is designed to support intentional, rational decision-making. It relies on individuals to actively incorporate messages into their decision-making processes. Examples include FOP labeling, social marketing, and media campaigns.
Ecologic or environmental approach
This approach is designed to make it easier to make healthy choices or take healthy actions. It requires little or no effort from individuals. Instead, it requires societal commitment and cultural acceptance to change the shared environment. Examples include fluoridation of community water systems, fortification of grains,54 or Food Service Guidelines for Federal Facilities.
Rationale and evidence
Organizational policies have been used successfully to improve food and nutrition quality and influence the dining and food selection experience in many institutional settings. Examples are schools, universities, private and government worksites, hospitals, recreation facilities, and parks.55 Local, state, and federal governments and the World Health Organization use and recommend the use of food service guidelines as a public health policy approach.56
Policies that focus on improving health can have both direct and indirect benefits. For example, in addition to helping individuals eat a healthy diet, healthy food service options in the workplace can improve productivity and satisfaction among employees, especially when quality food is offered in a pleasant setting. It may also encourage people to make better dietary choices outside the workplace.11,57
To succeed, policies to improve health must include cognitive and behavioral approaches in their content, design, and focus.58,59 These approaches can help clarify expectations around how and when a policy will achieve its goal.
Toolkit links
