Effectiveness of workplace choice architecture modification for healthy eating and daily physical activity

• Published in: BMC Public Health 2024, Vol.24 (1)
• Main Authors: Rantala, Eeva, Vanhatalo, Saara, Valtanen, Mikko, Lindström, Jaana, Pihlajamäki, Jussi, Poutanen, Kaisa, Absetz, Pilvikki, Karhunen, Leila
• Format: Report
• Language: English
• Subjects: Analysis; Environmental aspects; Exercise; Health aspects; Health behavior; Workplace accommodation
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-024-18482-1

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. 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). 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.