Changing Physical Environments

Our work on changing physical environments:

Here at the BHRU, we study ways in which we can alter the characteristics of the physical environments around us (or choice architecture) to shape our behaviour in a healthier direction.


Why is this important?

These kinds of interventions share some common features suggesting untapped potential for changing population health behaviour:

  • They can influence many people at once because they involve changing environments that many people are exposed to.
  • They do not typically rely on educational or persuasive messages that need to be thought about and so can influence people who do not have the time or inclination to engage with such messages.

Click on the images below to find out more about the work we have been doing in this area:

Key studies:

  • The TIPPME intervention typology for changing environments to change behaviour

    Reflecting interest in concepts of ‘nudging’ and ‘choice architecture’, there is increasing research and policy attention on altering aspects of the small-scale physical environment, such as portion sizes or product positioning, to change health-related behaviour. In a new paper, published in Nature Human Behaviour, we introduce a new framework we have developed: the Typology of Interventions in Proximal Physical Micro-Environments (TIPPME).

    This provides a way to classify and describe an important class of interventions to change selection, purchase and consumption of food, alcohol and tobacco. This has the potential to benefit both researchers and policymakers through facilitating both the synthesis of cumulative evidence about the effects of interventions (including clearer reporting), and the identification and discussion of a broader range of interventions to be developed and evaluated.

    The TIPPME intervention typology for changing environments to change behaviour. Hollands GJ, Bignardi G, Johnston M, Kelly MP, Ogilvie D, Petticrew M, Prestwich A, Shemilt I, Sutton S, Marteau TM

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  • Understanding interventions that change behaviour outside of conscious awareness

    Figure 1 for HPR BMP

    In a paper published in Health Psychology Review, we have proposed a framework for describing or categorising interventions to change behaviour by the degree to which their effects may be considered non-conscious. This is important because unhealthy behaviours often occur directly in response to environmental cues outside of conscious awareness, meaning that interventions that target non-conscious rather than conscious processes may have significant potential to shape healthier behaviours and improve health. However, examining this key premise requires a practicable conceptual framework that can be used to better describe and assess these interventions. This paper builds on a previous analysis by the same authors highlighting the importance of targeting automatic processes to change behaviour, published in Science in 2012.

    Non-conscious processes in changing health-related behaviour: a conceptual analysis and framework. Hollands, Marteau, & Fletcher.

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  • Can portion, package and tableware size increase consumption?

    shutterstock_41447758.jpgOur systematic review has produced the most conclusive evidence to date that people consistently consume more food and drink when offered larger-sized portions, packages or tableware than when offered smaller-sized versions.


    The size of this effect, based on combining data from 61 randomised controlled trials (6,711 participants), suggests that if sustained reductions in exposure to large sizes could be achieved across the whole diet, this could reduce average daily energy consumed from food by up to 16% (279 kcals) among UK adults.


    Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco. Hollands, Shemilt, Marteau, Jebb, Lewis, Wei, Higgins & Ogilvie. 2015.

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    • To view Cochrane UK coverage of this Cochrane review in the ‘Evidently Cochrane’ blog (from 15/09), click here.
    • To join the Twitter conversation about this Cochrane review, follow: @BHRUCambridge and #PortionSize



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  • What are the ways we can change the physical environments around us to change behaviour?

    PrintWe conducted a large-scale systematic scoping review of evidence for the effects on diet, physical activity, alcohol and tobacco use of a wide range of physical environment (choice architecture) interventions, in settings such as restaurants, shops and workplaces. We were then able to map the existing evidence and identify important gaps in what we know to inform future research.

    Altering micro-environments to change population health behaviour: towards an evidence base for choice architecture interventions. Hollands, Shemilt, Marteau, Jebb, Kelly, Nakamura, Suhrcke & Ogilvie. 2013.

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  • Do supermarket end-of-aisle displays affect sales of drinks?

    white wine in bottles in wine shopEnd-of-aisle displays are often used by supermarkets to promote sales. We found from our study that:

    • Putting drinks on end-of-aisle displays increases sales of both alcoholic and non-alcoholic drinks. For alcohol, this sales increase was similar to 4–9% decrease in price.
    • Limiting the use of aisle ends for alcohol and other less healthy products could be an effective way of increasing the healthiness of our weekly shopping.


    Sales impact of displaying alcoholic and non-alcoholic beverages in end-of-aisle locations: An observational study. Nakamura, Pechey, Suhrcke, Jebb & Marteau, 2014.

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Publications related to physical environment interventions (choice architecture):