Choice Architecture Interventions in Asian Retail Food Environments: A Meta-Synthesis of Equity Effects on Vulnerable Populations

Abstract

Public health strategies are using choice architecture interventions such as retail product allocation layouts and default swaps to change consumer food choices without constraining economic autonomy. However, how varied customer segments accept and manage these low-agency procedures in structurally complex Asian retail food landscapes is unclear. This study consolidated qualitative data on customer experiences, environmental realities, and subsequent equity implications in this fast-modernising setting. Methodology: Using PRISMA principles, signiHicant electronic datasets were reviewed up to 2026. We isolated nine empirical primary qualitative research studies (n = 9) that met tight inclusion criteria: direct participant interviews, focus group discussions, or ethnographic Hield observations. The Critical Appraisal Skills Programme (CASP) qualitative checklist assessed methodological quality. A continual comparative meta-ethnographic translation method gathered and synthesised primary narrative texts and interpretive codes. Results: CASP scores of 9 to 10 indicate good methodological quality. Four themes emerged from meta-ethnographic translation: (1) Intervention Modalities and Mechanisms of Action; (2) Consumer Experiences and Acceptability; (3) Equity Implications for Vulnerable Populations; and (4) Contextual Factors in Asian Retail Environments. In addition, the Hindings suggest that low-income consumers use conventional wet markets as an important equity buffer due to their easily accessible micro-quantities and informal credit networks. On the other hand, contemporary convenience stores outside of school raise the issue of persistent diets that are not supervised by parents. Discussion: These Hindings show that centralised choice architecture interventions often fail because they assume equal cognitive agency without considering socioeconomic constraints, household risks, and regional policy patterns. Therefore, multi-level structural strategies need to be used within a public health framework, rather than relying solely on micro-environmental impulses. To ensure equitable health outcomes, policies should actively protect informal food systems, address time poverty among the working class, and enforce stricter spatial zoning regulations on high-density commercial corporate chains near vulnerable communities.