Choice Architecture Research Articles

Using a human-centered design framework and behavioral economic interventions to increase fruit and vegetable purchases in an online grocery store: Study design and methodologies.

Using a human-centered design framework and behavioral economic interventions to increase fruit and vegetable purchases in an online grocery store: Study design and methodologies.

Empowering change: A self-control perspective on how choice architecture interventions can promote sustainable behavior change.

Empowering change: A self-control perspective on how choice architecture interventions can promote sustainable behavior change.

The Elastic Electronic Health Record: A Five-Tiered Framework for Applying Artificial Intelligence to Electronic Health Record Maintenance, Configuration, and Use

Abstract Properly configuring modern electronic health records (EHRs) has become increasingly challenging for human operators, failing to fully meet the efficiency and cost-saving potential seen with the digitization of other sectors. The integration of artificial intelligence (AI) offers a promising solution, particularly through a comprehensive governance approach that moves beyond front-end enhancements such as user- and patient-facing copilots. These copilots, although useful, are limited by the underlying EHR configuration, leading to inefficiencies and high maintenance costs. To address this, we propose the concept of an “Elastic EHR,” which proactively suggests and validates optimal content and configuration changes, significantly reducing governance costs and enhancing user experience, as well as reducing many of the common frustrations including the documentation burden, alert fatigue, system responsiveness, outdated content, and unintuitive design. Our five-tiered model details a structured approach to AI integration within EHRs. Tier I focuses on autonomous database reconfiguration, akin to Oracle Autonomous Database functionalities, to ensure continuous system improvements without direct edits to the production environment. Tier II empowers EHR clients to shape system performance according to predefined strategies and standards, ensuring coordinated and efficient EHR solution builds. Tier III optimizes EHR choice architecture by analyzing user behaviors and suggesting content and configuration changes that minimize clicks and keystrokes, thereby enhancing workflow efficiency. Tier IV maintains the currency of EHR clinical content and decision support by linking content and configuration to updated guidelines and literature, ensuring the EHR remains evidence-based and compliant with evolving standards. Finally, Tier V incorporates context-dependent AI copilots to enhance care efficiency, quality, and user experience. Despite the potential benefits, major limitations exist. The market dominance of a few major EHR vendors—Epic Systems, Oracle Health, and MEDITECH—poses a challenge, as any enhancements require their cooperation and financial motivation. Furthermore, the diverse and complex nature of health care environments demands a flexible yet robust AI system that can adapt to various institutional needs that has not yet been developed, researched, or tested. The Elastic EHR model proposes a five-tiered framework for optimizing EHR systems and user experience with AI. By overcoming the identified limitations through vendor-led, collaborative efforts, AI-enabled EHRs could improve the efficiency, quality, and user experience of health care delivery, fully delivering on the promises of digitization within health care.

Children's agency in England's primary schools: A case for structured freedom

AbstractThis paper examines how children's agency operates within primary education in England through an in‐depth qualitative study of three contrasting schools over two years. While children's right to participate in decisions affecting their education is increasingly recognised internationally, its practical implementation within formal education systems remains challenging. Drawing on critical realism and extensive empirical evidence, including classroom observations, interviews with school leadership and teachers, and innovative participatory methods capturing children's own voices, this study reveals how different institutional approaches create varying opportunities for children's agency. Through analysing structural conditions, daily practices, and children's experiences across two academic years, the research demonstrates how agency emerges through complex interactions between educational structures and children's lived experiences. The findings reveal that supporting children's agency does not require choosing between agency and structure; rather, thoughtfully designed structures can enable meaningful participation while maintaining educational standards. The paper presents the concept of ‘structured freedom’—a practical framework for systematically supporting children's agency through four key principles: three‐domain integration, choice architecture, systematic mechanisms for agency, and experiential development. This study offers both theoretical insights into how children's agency operates within educational structures and practical guidance for schools navigating the tensions between enabling children's agency and meeting standardised requirements.

Can behavioural nudges promote reduced-salt dish orders on meal delivery apps?

Can behavioural nudges promote reduced-salt dish orders on meal delivery apps?

Digital Nudging for Green Consumption: Leveraging Social Media Micro-Influencers to Reshape Sustainable Purchase Intentions through Normative Feedback Algorithms

This research investigates the efficacy of digital nudging mechanisms implemented through social media micro-influencers to reshape sustainable purchase intentions. Environmental degradation and climate change necessitate transformed consumption patterns, yet significant barriers impede the translation of environmental awareness into sustainable purchasing behaviors. Digital nudging, conceptualized as behavioral economics-informed modifications to choice architecture that preserve decision autonomy while facilitating environmentally responsible choices, presents a promising intervention strategy. The study employs a mixed-methods sequential explanatory design integrating a controlled experiment with qualitative insights from interviews and content analysis. Through a between-subjects factorial design, the research systematically manipulates influencer credibility and normative feedback type across four product categories: fashion, food, household goods, and personal care. Results demonstrate significant main effects for both influencer credibility and normative feedback type, with a notable interaction effect indicating contextual dependencies in intervention effectiveness. High-credibility micro-influencers employing injunctive normative feedback generate the strongest sustainable purchase intentions, with normative perceptions functioning as a significant mediating mechanism. Qualitative analysis discloses four main mechanisms—authenticity signaling, normative alignment, contextual resonance, and category-specific response patterns—that are involved in siting the quantitative findings. Product visibility is found to be an important moderating variable, with fashion products showing higher levels of responsiveness to norms compared with personal care products. This study adds to theoretical foundations of digital nudging in sustainability design by specifying contextual boundaries and psychological determinants that influence intervention efficacy. Recommendations regarding micro-influencer campaigns on the basis of these findings involve proposing that intentionally normative feedback levels be included as a means to promote sustainability consumption habits in increasingly digital-marketplace environments.

In-hospital nudging intervention increases patients’ healthy dietary choices: a quasi-experimental study

AimsMost hospitals still lag behind in their policies to stimulate healthier dietary choices by their patients. This study investigates whether a multicomponent nudging intervention, designed to prompt healthy food choices,...

Retirement and health plan choice.

Many consumers exhibit choice persistence, often sticking with suboptimal or dominated health plans. We analyze the effect of retirement on health plan choice using a fuzzy regression discontinuity design that exploits Switzerland's old-age pension legislation. Drawing on insurance claims data from 84,731 individuals aged 61 to 68 over the years 2006-2014, we find that retirement significantly increases switching from the standard model to managed care plans, which offer lower premiums but restrict access to specialist care. However, deductible choices remain largely unaffected, as retirees are no more likely to select the cost-minimizing deductible than their non-retired counterparts. We conclude that while retirement may encourage plan switching, many consumers still choose dominated options, underscoring the need for a richer policy framework that provides consumer guidance incorporating measures such as personalized information interventions and simplified choice architectures to promote better health plan choices.

〈오징어 게임〉의 자본주의 병리성 형상화 : 시즌 2 딱지맨의 왜곡된 인정 투쟁과 선택 설계

This study examines how the pathological structure of modern capitalism is dramatically embodied through struggles for recognition and choice architecture in the first episode of Squid Game Season 2, focusing on the newly emphasized character “Ddakji-man.” By analyzing three key games- “Ddakji,” “Bread and Lottery,” and “Russian Roulette”-the research reveals how capitalist competition and violence are symbolically represented, particularly through Ddakji-man’s paradoxical role as both the designer and participant. Drawing on Hegel’s theory of the struggle for recognition and behavioral economics’ concept of choice architecture, this study demonstrates that the distortion of one’s desire for recognition can lead to self-destructive outcomes. Furthermore, it highlights how global survival dramas on OTT platforms extend beyond mere entertainment, offering critical reflections on deep-seated inequality and violence in contemporary capitalist society while suggesting the possibility of alternative futures.

Behavioral Economics in Health: Nudging Better Choices

Behavioral economics examines the psychological and cognitive influences on decision-making, particularly how individuals often deviate from rational choice theory. These insights are instrumental in designing interventions that encourage healthier behaviors through strategic “nudges” and optimized choice architecture in the healthcare sector. This paper examines the core principles of behavioral economics, including bounded rationality, heuristics, and cognitive biases, and their application in public health. It highlights real-world cases of nudges such as modifying food placement in cafeterias, default enrollment in health programs, and social norm-based interventions that have effectively improved health outcomes. While nudging holds promise as a non-coercive strategy for behavior change, ethical considerations regarding autonomy and paternalism must be addressed. Future research should explore how these interventions can be scaled and personalized to cater to diverse populations. By leveraging behavioral insights, policymakers and healthcare providers can implement innovative strategies to promote healthier choices and bridge health disparities. Keywords: Behavioral economics, nudging, choice architecture, health decision-making, cognitive biases, bounded rationality.

Individual autonomy and public deliberation in behavioral public policy

The most successful concept in behavioral public policy (BPP) is nudging, which involves altering choice architecture to leverage people’s biases and heuristics to promote welfare-improving behaviors. However, in recent years, nudging has faced criticism. This article addresses a specific critique: while nudges may enhance welfare, they often fail to promote autonomy. Several authors have raised this concern, yet there is no unified definition of autonomy in BPP. This article delves into the various meanings of autonomy in the BPP literature: freedom of choice, agency, and self-constitution. It focuses on autonomy as self-constitution, which acknowledges instrumental rationality but also considers substantive rationality, i.e., people’s ability to reason about their goals, aspirations, and identities. The article explores epistemic, normative, and psychological challenges of autonomy as self-constitution and suggests that public deliberation in mini-publics could mitigate some of these challenges. Moreover, it emphasizes that an autonomy-centric BPP should shift its focus from reframing individual choice situations (i-frame interventions) to enabling public deliberation about institutional choices (s-frame interventions).

The effect of an electronic health record choice architecture intervention on efficient diuretic use: A research report

AbstractIntroductionOral metolazone and intravenous (IV) chlorothiazide have comparable diuretic efficacy and safety, although IV chlorothiazide is significantly more expensive. The use of electronic health record (EHR)‐based choice architecture interventions on the efficient use of diuretics remains unexplored.ObjectivesWe aimed to evaluate the impact of an EHR‐based choice architecture intervention on efficient chlorothiazide utilization at two United States institutions and highlight potential annual cost savings.MethodsInstitution 1 implemented an educational intervention on August 1, 2020, followed by an EHR‐based intervention on January 1, 2021. Institution 2 implemented the EHR intervention alone on March 8, 2023. The EHR intervention prompted clinicians to consider switching to oral metolazone, emphasizing cost differences and similar efficacy. We compared mean weekly administrations and estimated rate ratios (RRs) and 95% confidence intervals (CIs) for the use of IV chlorothiazide for pre‐ versus post‐EHR intervention using interrupted time series analyses at each institution.ResultsAt Institution 1, mean weekly IV chlorothiazide administrations decreased from 42.3 ± 21.9 at baseline to 16.4 ± 13.7 post‐EHR intervention (p < 0.001), with an estimated annual cost savings of $175 000. At Institution 2, mean weekly administrations decreased from 20.3 ± 21.9 to 10.7 ± 5.7 (p = 0.04), with an estimated annual cost savings of $65 000. Interrupted time series analyses showed a significant reduction in IV chlorothiazide use associated with the EHR intervention (Institution 1: RR 0.56; 95% CI 0.33, 0.91; Institution 2: RR 0.45; 95% CI 0.31, 0.65).ConclusionThe EHR‐based interventions demonstrated significant reductions in IV chlorothiazide use and potentially substantial cost savings at two separate institutions, highlighting their potential as a scalable strategy to improve efficient diuretic utilization.

Trading is a losing game: an audit of deceptive choice architecture in demo-mode Contract for Difference (CFD) trading apps

Trading is a losing game: an audit of deceptive choice architecture in demo-mode Contract for Difference (CFD) trading apps

Behavioural theory and regional development: nurturing cultures of possibility

ABSTRACT This paper explores how regions can catalyse behavioural change and nurture cultures of possibility. ‘Possibility’ refers to emergent patterns of human behaviour resulting in alternative and improved outcomes for citizens and their regions. Drawing on concepts from behavioural economics, complexity economics and behavioural economic geography, the paper provides a comprehensive understanding of the behavioural factors underpinning regional development. Utilising these concepts, it develops a behavioural theoretical framework to explain the important role played by possibility for regional development. In particular, it is proposed that the nature of the decision-making capabilities of citizens, and the choice architectures shaping these decisions, are crucial to regional development. It is concluded that policies focused on improving decision-making and choice architectures will promote innovation, creativity and entrepreneurship within and across regions.

The inevitability argument for choice architecture and the evidence-based view

The inevitability argument for choice architecture and the evidence-based view

Choice Architecture, Privacy Valuations, and Selection Bias in Consumer Data

Choice Architecture, Privacy Valuations, and Selection Bias in Consumer Data

Poly(hydrazinophosphine diazide)s (PHPDs): Hybrid Organic-Inorganic Polymers via Polycondensation between PN Cages and Organic Diazides.

Organic polymers generally feature 1-dimensional chains or 2-dimensional rings in their backbones since synthetic challenges limit the availability of 3-dimensional monomers. Inorganic cages are less strained and more accessible, offering an alternative route to explore this parameter space. However, only two families─carboranes and polyhedral oligomeric silsesquioxanes (POSS)─have been well-studied, revealing materials with valuable mechanical and thermal properties. Further exploration of this frontier requires the development of new inorganic cages that are accessible, stable, and polymerizable. Here we report that an easily assembled, bench-stable PN cage, P(NMeNMe)3P, undergoes Staudinger polycondensation with organic diazides to yield robust, solution-processable, and film-forming linear poly(trihydrazino-diphosphine diazide)s─PHPDs─as a new family of hybrid organic-inorganic polymers. Their solubility can be controlled by diazide choice and backbone architecture, which we rationally modify to access alternating or multiblock copolymers. We also show how a tetraphosphorus cage, P4(NMe)6, can be used to cross-link PHPDs. The Tg values for PHPDs are comparable to those of rigid π-conjugated polymers (>150 °C), and, despite a high nitrogen content (up to 32%) and three N-N σ-bonds per repeat unit, they show decomposition temperatures >200 °C with char yields up to 60%. These data support hypotheses of high stability arising from the presence of 3-dimensional backbone units. We further show that PHPDs may be leveraged for halogen-free flame retardancy. Collectively, the results debut new low-carbon polymers with an unusual backbone topology, reveal the design rules for controlling their microstructures and properties, and lay the foundation for future applied studies.

Nutrition Interventions to Improve the Military Nutrition Environment Positively Impact Service Members.

Nutrition Interventions to Improve the Military Nutrition Environment Positively Impact Service Members.

Nudging Perceived Credibility: The Impact of AIGC Labeling on User Distinction of AI-Generated Content

The rapid advancement of generative artificial intelligence (AI) has made AI-generated content (AIGC) increasingly prevalent. However, misinformation created by AI has also gained significant traction in online consumption, while individuals often lack the skills and attribues needed to distinguish AIGC from traditional content. In response, current media practices have introduced AIGC labels as a potential intervention. This study investigates whether AIGC labels influence users’ perceptions of credibility, accounting for differences in prior experience and content categories. An online experiment was conducted to simulate a realistic media environment, involving 236 valid participants. The findings reveal that the main effect of AIGC labels on perceived credibility is not significant. However, both prior experience and content category show significant main effects ( P < .001), with participants who have greater prior experience perceiving nonprofit content as more credible. Two significant interaction effects were also identified: between content category and prior experience, and between AIGC labels and prior experience ( P < .001). Specifically, participants with limited prior experience exhibited notable differences in trust depending on the content category ( P < .001), while those with extensive prior experience showed no significant differences in trust across content categories ( P = .06). This study offers several key insights. First, AIGC labels serve as a viable and replicable intervention that does not significantly alter perceptions of credibility for AIGC. Second, by reshaping the choice architecture, AIGC labels can help address digital inequalities. Third, AIGC labeling extends alignment theory from implicit value alignment to explicit human–machine interaction alignment. Fourth, the long-term effects of AIGC labels, such as the potential for implicit truth effects with prolonged use, warrant further attention. Lastly, this study provides practical implications for media platforms, users, and policymakers.

Behavioral Economics in Action: Analyzing the Role of Choice Architecture and Incentives in Indian Welfare Schemes

The study explores how behavioural principles, such as framing, nudges, and structured decision-making environments, have been embedded mainly in three flagship programmers viz. PM-Jan Dhan Yojana, PM-KISAN, and MGNREGS. The qualitative analysis highlights examples of choice architecture—such as the default enrolment in zero-balance bank accounts under Jan Dhan Yojana—and the use of financial incentives in PM-KISAN to provide income support to farmers. Similarly, MGNREGS employs guaranteed wages as an incentive to encourage rural employment and reduce poverty. These examples underscore the importance of aligning program design with the cognitive and socio-economic realities of beneficiaries. The paper also critically evaluates the limitations and challenges of applying behavioural economics in large-scale policy interventions, such as the potential for unintended consequences and the need for cultural sensitivity. By synthesising theoretical frameworks with practical applications, the study demonstrates how integrating choice architecture and well-structured incentives can improve program uptake, compliance, and overall impact. This research contributes to the growing discourse on innovative and inclusive policy design, offering valuable lessons for policymakers, development practitioners, and academics. It underscores the potential of behavioural economics to reshape welfare strategies, paving the way for more effective, sustainable, and equitable outcomes in addressing poverty and inequality