Choice architecture interventions promoting sustained healthier food choice and consumption by students in a secondary school setting: A systematic review of intervention studies

<jats:title>Abstract</jats:title> <jats:sec id="S1368980023001118_as1"> <jats:title>Objective:</jats:title> <jats:p>To systematically review the impact of choice architecture interventions (CAI) on the food choice of healthy adolescents in a secondary school setting. Factors potentially contributing to the effectiveness of CAI types and numbers implemented and its long-term success were examined.</jats:p> </jats:sec> <jats:sec id="S1368980023001118_as2"> <jats:title>Design:</jats:title> <jats:p>PUBMED and Web of Science were systematically searched in October 2021. Publications were included following predefined inclusion criteria and grouped according to number and duration of implemented interventions. Intervention impact was determined by systematic description of the reported quantitative changes in food choice and/or consumption. Intervention types were compared with regards to food selection and sustained effects either during or following the intervention.</jats:p> </jats:sec> <jats:sec id="S1368980023001118_as3"> <jats:title>Setting:</jats:title> <jats:p>CAI on food choice of healthy adolescents in secondary schools.</jats:p> </jats:sec> <jats:sec id="S1368980023001118_as4"> <jats:title>Participants:</jats:title> <jats:p>Not applicable</jats:p> </jats:sec> <jats:sec id="S1368980023001118_as5"> <jats:title>Results:</jats:title> <jats:p>Fourteen studies were included; four randomized controlled trials and five each of controlled or uncontrolled pre-post design, respectively. Four studies implemented a single CAI type, with ten implementing &gt; 1. Three studies investigated CAI effects over the course of a school year either by continuous or repeated data collection, while ten studies’ schools were visited on selected days during intervention. Twelve studies reported desired changes in overall food selection, yet effects were not always significant, and appeared less conclusive for longer term studies.</jats:p> </jats:sec> <jats:sec id="S1368980023001118_as6"> <jats:title>Conclusions:</jats:title> <jats:p>This review found promising evidence that CAI can be effective in encouraging favorable food choices in healthy adolescents in a secondary school setting. However, further studies designed to evaluate complex interventions are needed.</jats:p> </jats:sec>