Evidence map›Paper›PMID 23231863›Full record

Trial reportBMC public health2012

Healthy snacks at the checkout counter: a lab and field study on the impact of shelf arrangement and assortment structure on consumer choices.

Ellen van Kleef, Kai Otten, Hans C M van Trijp

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC public health, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02808910 (Nudging), which is not on this map. Cited by 58 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 5 pooled it
15.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02808910 nacompletednot on this mapstarted 2016, after this paper: background citation

Nudging: How Small Changes in the Cafeteria of the Feiring Heart Clinic Can Result in a Healthier Food Choice.

TypeinterventionalSponsorLHL HelseRan2016 to 2018Enrolled144ConditionsCardiovascular Disease, ObesityArmsNudged to eat less added salt and more other seasonings, Nudged to avoid foods high in salt content, and to choose foods low in salt content, Nudged to eat more vegetables, Nudged to eat smaller portions, Nudged to eat less calorie-dense food
3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 5 syntheses or guidelines pooled it, 180 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  5. Pooled it
  6. Cafeteria Online: Nudges for Healthier Food Choices in a University Cafeteria-A Randomized Online Experiment.International journal of environmental research and public health · 2021
    Trial
  7. Prompting consumers to make healthier food choices in hospitals: a cluster randomised controlled trial.The international journal of behavioral nutrition and physical activity · 2020
    Trial
  8. Trial
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  10. Trial
  11. Article
  12. Article
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  14. [Choice architecture in institutional food services: strategies to promote sustainable nutrition].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2025
    Review
  15. A Scoping Review of Choice Architecture to Promote Healthy Nutrition in Health and Care Settings.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025
    Article
  16. Article
  17. Article
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  19. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Ellen van KleefWageningen University, Marketing and Consumer Behaviour Group, Hollandseweg 1, Wageningen, The Netherlands. Ellen.vanKleef@wur.nl
Kai Otten
Hans C M van Trijp
Wageningen University & Research · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe essence of nudging is to adapt the environment in which consumers make decisions to help them make better choices, without forcing certain outcomes upon them. To determine how consumers can effectively be guided to select healthier snacks, we examine the effect of manipulating the assortment structure and shelf layout of an impulse display including both healthy and unhealthy snacks near the checkout counter of a canteen.

methodsBoth a lab and field study applied a two-factor experimental design manipulating snack offerings both in an on-screen choice environment and a natural environment (hospital staff restaurant). Shelf arrangement (i.e. accessibility) was altered by putting healthy snacks at higher shelves versus lower shelves. Assortment structure (i.e. availability) was altered by offering an assortment that either included 25% or 75% healthy snacks. Participants in the lab study (n = 158) made a choice from a shelf display. A brief survey following snack selection asked participants to evaluate the assortment and their choice. The field experiment took place in a hospital canteen. Daily sales data were collected for a period of four weeks. On completion of the field study, employees (n = 92) filled out a questionnaire about all four displays and rated their attractiveness, healthiness and perceived freedom of choice.

resultsThe lab study showed a higher probability of healthy snack choice when 75% of the assortment consisted of healthy snacks compared to conditions with 25% healthy snack assortments, even though choices were not rated less satisfying or more restrictive. Regarding shelf display location of healthy snacks, no significant differences were observed. There was also no significant shelf arrangement by assortment structure interactive effect. The field study replicated these findings, in that this assortment structure led to higher sales of healthy snacks. Sales of unhealthy and total snacks were not impacted by manipulations (no main or interaction effects). Employees preferred shelf displays including a larger healthy snack assortment located at top shelves. Employees also felt more freedom in choice when healthy snacks were displayed at top shelves compared to lower shelves.

conclusionsOverall, results suggest that increasing the prominence of healthy snacks by enlarging their availability, while permitting access to unhealthy snacks, is a promising strategy to promote sales. These results point to the importance of nudging strategies to encourage healthier snack patterns.

Indexed as

Choice BehaviorAdolescentAdultCommerceEnvironment DesignFemaleFood PreferencesFood Service, HospitalHumansMaleResearch DesignSnacksYoung Adult

Identifiers

PMID23231863
PMCPMC3575369
OpenAlexW2143855644

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.