How do defaults and framing influence food choice? An intervention aimed at promoting plant-based choice in online menus.

Nudging consumers towards plant-based foods by making these choices the default option is a promising strategy for effecting sustainable dietary change. In the hypothetical context of online food ordering in a Northern European country, we examined the underlying mechanisms and effectiveness of swapping the default in menus from meat to a plant-based meat alternative. Results showed that pre-selecting a plant-based option in the online setting was not enough to increase choice of plant-based meals alone. Rather, additionally framing the plant-based default as the more sustainable or tasty option was needed to significantly increase choice. While ease was unimportant and held constant in this online setting, endowment and implied endorsement were found to mediate default success such that the positive influence of endowment outweighed the (surprising) negative effect via endorsement. In contrast to general theoretical expectations of default nudges, an endorsement by an online food provider is unlikely to encourage plant-based choices.

That's not natural! Consumer response to disconfirmed expectations about 'natural' food.

Natural claims on food products create a large number of positive expectations. This research aims to reveal which potentially disconfirmed expectations about 'natural' food are problematic as they harm consumer attitudes and intentions. In a pre-study (N = 160), we show that consumers expect natural-claimed food to be organic, locally produced, minimally processed, fresh, to ensure better animal welfare, and to be free from GMO, artificial ingredients, antibiotics, and hormones. In our main study (N = 2152), we show that the natural claim increases purchase intention, mediated via brand trust and product attitude. However, when consumers learn that their expectations may be disconfirmed, their brand- and product-related attitudes decrease, which in turn leads to reduced purchase intentions. These findings imply that food marketers can profit from the natural claim, but that there is a large potential for irresponsible food marketing and consumer deception, which can result in negative expectation disconfirmation. We also inform policy makers which product expectations should be considered for consumer protection against halo effects induced by the natural claim. Regulation or education about the meaning of the claim can help consumers to make more informed decisions.

Vegan labeling for what is already vegan: Product perceptions and consumption intentions.

Given the increasing popularity of vegan labels, our study examines the effect of vegan labeling on product perceptions and consumption intentions. We focus on randomly-vegan products which are products that have neither undergone any special reformulation to be vegan nor explicitly aim to serve the market segment of vegans and vegetarians. Food marketers are often tempted to add a vegan label to their randomly-vegan products to capitalize on the growing popularity of vegan food. Our results show that labeling randomly-vegan products biases the perceived healthiness, expected taste, and perceived sustainability, but only if consumers do not expect such randomly-vegan products to be vegan by default. This translates into altered consumption intentions for these unexpected-vegan products with a vegan label (vs. no label). Importantly, this applies to both utilitarian and hedonic products. No effects attributed to the vegan label (vs. no label) were found for randomly-vegan products that consumers expected to be vegan by default.

What Patients Value in Physicians: Analyzing Drivers of Patient Satisfaction Using Physician-Rating Website Data.

BACKGROUND: Customer-oriented health care management and patient satisfaction have become important for physicians to attract patients in an increasingly competitive environment. Satisfaction influences patients' choice of physician and leads to higher patient retention and higher willingness to engage in positive word of mouth. In addition, higher satisfaction has positive effects on patients' willingness to follow the advice given by the physician. In recent years, physician-rating websites (PRWs) have emerged in the health care sector and are increasingly used by patients. Patients' usage includes either posting an evaluation to provide feedback to others about their own experience with a physician or reading evaluations of other patients before choosing a physician. The emergence of PRWs offers new avenues to analyze patient satisfaction and its key drivers. PRW data enable both satisfaction analyses and implications on the level of the individual physician as well as satisfaction analyses and implications on an overall level. OBJECTIVE: This study aimed to identify linear and nonlinear effects of patients' perceived quality of physician appointment service attributes on the overall evaluation measures that are published on PRWs. METHODS: We analyzed large-scale survey data from a German PRW containing 84,680 surveys of patients rating a total of 7038 physicians on 24 service attributes and 4 overall evaluation measures. Elasticities are estimated from regression models with perceived attribute quality as explanatory variables and overall evaluation measures as dependent variables. Depending on the magnitude of the elasticity, service attributes are classified into 3 categories: attributes with diminishing, constant, or increasing returns to overall evaluation. RESULTS: The proposed approach revealed new insights into what patients value when visiting physicians and what they take for granted. Improvements in the physicians' pleasantness and friendliness have increasing returns to the publicly available overall evaluation (b=1.26). The practices' cleanliness (b=1.05) and the communication behavior of a physician during a visit (b level between .97 and 1.03) have constant returns. Indiscretion in the waiting rooms, extended waiting times, and a lack of modernity of the medical equipment (b level between .46 and .59) have the strongest diminishing returns to overall evaluation. CONCLUSIONS: The categorization of the service attributes supports physicians in identifying potential for improvements and prioritizing resource allocation to improve the publicly available overall evaluation ratings on PRWs. Thus, the study contributes to patient-centered health care management and, furthermore, promotes the utility of PRWs through large-scale data analysis.

How category average reference points affect choice of sugary foods.

Improving diet quality is as important as it is difficult. Market-level information such as summary information in the form of an average (i.e., category average reference point [CARP]) discloses information otherwise difficult to obtain by comparing different products. The results of a choice-based conjoint experiment (N = 698) show that CARP affects food choice in multicue environments and interacts with source credibility in driving consumer acceptance of sugar content. In particular, the likelihood of choosing high amounts of sugar increases when a high CARP is provided by a credible source because of increased consumer acceptance of higher levels of that nutrient. Implications of the findings for research and public policy conclude the article.

Dual-process theory and consumer response to front-of-package nutrition label formats.

Nutrition labeling literature yields fragmented results about the effect of front-of-package (FOP) nutrition label formats on healthy food choice. Specifically, it is unclear which type of nutrition label format is effective across different shopping situations. To address this gap, the present review investigates the available nutrition labeling literature through the prism of dual-process theory, which posits that decisions are made either quickly and automatically (system 1) or slowly and deliberately (system 2). A systematically performed review of nutrition labeling literature returned 59 papers that provide findings that can be explained according to dual-process theory. The findings of these studies suggest that the effectiveness of nutrition label formats is influenced by the consumer's dominant processing system, which is a function of specific contexts and personal variables (eg, motivation, nutrition knowledge, time pressure, and depletion). Examination of reported findings through a situational processing perspective reveals that consumers might prefer different FOP nutrition label formats in different situations and can exhibit varying responses to the same label format across situations. This review offers several suggestions for policy makers and researchers to help improve current FOP nutrition label formats.