UKSBM
4.12.2014
Public acceptability in the UK and USA of choice
architecture interventions to reduce obesity: the
example of reducing sugar-sweetened beverages
consumption
Dragos Petrescu, Gareth Hollands, Danice Ng, Theresa Marteau
Public Acceptability of Government
Interventions to Change Health-Related
Behaviour
Diepeveen et al. 2013: a systematic
review of 200 studies…
Key finding:
Acceptability varies with type of
intervention: most support for less
intrusive interventions
The problem:
The most effective ways of changing
behaviour can be the least
acceptable
Background
• Choice Architecture – modifying the
environment in which people make
choices - has the potential to change
behaviour in populations (e.g.
Hollands et al. 2013)
• Criticism from ethicists (e.g., White,
2013)
• Public acceptability unknown
Research Questions
1. How acceptable are different types of interventions?
Limiting the size
Changing the shape
Changing the
location
Choice architecture interventions
Increased taxation - high intrusion
Education campaign - low intrusion
Traditional interventions
2. What is the impact on acceptability of highlighting
conscious vs. non-conscious mechanisms?
Hypothesis: describing the mechanism via which
interventions are expected to work as “non-conscious”
decreases public acceptability
Study Design
Siz
e
Group 1 - Control
Shap
Locatio
e
n
Group 2 - Conscious
Taxatio
Educatio
n
n
Group 3 - Non-Conscious
This new policy would work like this:
This new policy would work like this:
This new policy would work like this:
•
• The size of sugary drinks containers
(e.g., bottles & cans) will be limited to
smaller versions
• Changing the size of containers for
sugary drinks means people will tend
to drink less
• People will be conscious (i.e. aware) of
how this change in container size
makes them drink less
• People will still be able to drink as
much as they like
• The size of sugary drinks containers
(e.g., bottles & cans) will be limited to
smaller versions
• Changing the size of containers for
sugary drinks means people will tend
to drink less
• People will not be conscious (i.e. not
aware) of how this change in container
size makes them drink less
• People will still be able to drink as
much as they like
•
•
The size of sugary drinks containers
(e.g., bottles & cans) will be limited
to smaller versions
Changing the size of containers for
sugary drinks means people will
tend to drink less
People will still be able to drink as
much as they like
Sample Characteristics
UK Sample (N = 1068)
Gender
Women
Men
Age
Mage
Recruitment
US Sample (N = 1082)
Gender
50.7%
49.3%
49.3
Agency, to allow analysis
of age, gender, and SES
effects
Women
Men
Age
Mage
Recruitmen
t
46.1%
53.9%
33.4
Amazon Mechanical Turk;
Younger and more
educated population
Research Question 1
How acceptable are different types of interventions?
US sample
100
100
90
90
80
80
70
70
Acceptable %
Acceptable %
UK sample
60
50
40
60
50
40
30
30
20
20
10
10
0
0
Size
Shape
Location
Taxation
Education
Size
Shape
Location
Taxation
Education
Research Question 2
What is the impact on acceptability of highlighting conscious
vs. non-conscious mechanisms?
US
Sample
UK
Sample
*
*
*
*
*
p = .052
Summary
1. How acceptable are different types of
interventions?
• Education: most acceptable
• Taxation: least acceptable
• Choice architecture: acceptable to most people
Results were similar in UK and US participants
2. What is the impact on acceptability of highlighting
conscious vs. non-conscious processes?
• Highlighting non-conscious processes does not
reduce acceptability
Implication
Concerns about acceptability should not be a barrier to
choice architecture interventions