Behavioral Design Strategies Improve Healthy Food Sales in a Military Cafeteria

• Published in: American journal of health promotion Vol. 39; no. 2; pp. 234 - 243
• Main Authors: Kimmons, Joel, Nugent, Nadine Budd, Harris, Diane, Lee, Seung Hee, Kompaniyets, Lyudmyla, Onufrak, Stephen
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.02.2025; American Journal of Health Promotion
• Subjects: Adult; Armed forces; Behavior change; Cafeteria; Commerce - statistics & numerical data; Diet, Healthy; Dogs; Female; Fidelity; Food; Food Services - statistics & numerical data; Health Behavior; Health Promotion - methods; Health Promotion - organization & administration; Healthy food; Humans; Intervention; Layout; Male; Meals; Military bases; Military Facilities; Military Personnel - psychology; Military Personnel - statistics & numerical data; Military service; Positioning; Quasi-experimental methods; Retirees; Sales; Servicemen; Snacks; United States; Vegetables; United States; United States > US; nutrition; food service guidelines; federal government; health behavior; diet; military facilities; behavioral design; military personnel
• ISSN: 0890-1171; 2168-6602; 2168-6602
• DOI: 10.1177/08901171241293369

Purpose This study examined the use of behavioral design strategies to improve healthier food sales. Design A quasi-experimental, one-group, repeated measures design examined changes in food sales following behavioral design adjustments. Setting United States military base hospital dining facility. Subjects U.S. military service members, retirees, and civilian employees. Intervention Behavioral design changes included placement, layout, messaging, default healthy bundling, a stoplight rating system, strategic positioning of healthy items on menu boards, and an increase in healthier snacks. Measures Food sales were assessed by point-of-sales data. Analysis T-tests examined total sales of each food adjusted weekly between baseline and intervention and intervention and post-intervention. 16 food items targeted by the intervention were examined. Weekly food sales were calculated for the 18-week baseline, 18-week intervention, and 9-week post-intervention. Further, analysis estimated negative binomial models for food item sales. Results The hospital dining facility served 600 to 900 meals per day. Weekly foods sales decreased during the intervention for desserts, cooked starches, hummus, and yogurt (P < 0.01). Sales increased during the intervention for fruit cups, cooked vegetables, vegetable and turkey burgers, grilled chicken, packaged salads, French fries, hamburgers, and hot dogs (P < 0.02). Conclusion This study demonstrates that a mixture of behavioral design strategies can be operationalized with reasonable fidelity and can lead to increases in the sales of some healthy foods in military worksites.