International Journal of Hospitality Management 48 (2015) 12–21

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International Journal of Hospitality Management

journal homepage: www.elsevier.com/locate/ijhosman

Understanding customers’ healthy food choices at casual dining

restaurants: Using the Value–Attitude–Behavior model
Juhee Kang a,∗ , Jinhyun Jun b , Susan W. Arendt c
a
Rosen College of Hospitality Management, University of Central Florida, 9907 Universal Boulevard, Orlando, FL 32819, United States
b
School of Travel Industry Management, University of Hawaii at Manoa, 2560 Campus Road Honolulu, HI 96822, United States
c
Department of Apparel, Events, and Hospitality Management at Iowa State University, 9E MacKay Hall, Ames, IA 50011, United States

a r t i c l e i n f o a b s t r a c t

Keywords: This study examined how individual health values influence interest in healthy foods, positive outcome
Value–Attitude–Behavior model expectations, hedonic expectations, and behavior intentions. A total of 1188 valid questionnaires were
Healthy foods collected from customers who had consumed healthy menu items at casual dining restaurants. The results
Healthy eating
indicated that health value was the key element that inspired customer interest in healthy eating and
Restaurants
aroused hedonic and positive outcome expectations, which in turn enhanced intentions to purchase
Expectations
Health value healthy food items. Restaurant managers are advised to establish creative marketing strategies to moti-
vate customer interest in healthy menu items and emphasize benefits of their healthy food items. Future
studies can extend the scope of research by examining differences in geographical areas or demographic
profiles.
© 2015 Elsevier Ltd. All rights reserved.

1. Introduction
Frequent and consistent eating out of certain meals may cause
health problems such as obesity (Ma et al., 2003). Restaurant
foods are perceived, in popular press, as contributors to obesity
rates because of the calorie and fat content, which increase cus-
tomers’ total calorie consumption (American Cancer Society, 2014).
To avoid potential health-related problems, customer interest in
healthy eating has increased, especially when consuming foods
away from home (Jones, 2009). The U.S. National Restaurant Asso-
ciation reported that customers tend to select healthier menu
items (Kelso, 2012), control portion size, and prefer to visit restau-
rants that offer such choices (e.g., brown rice, vegetarian dishes)
(Anderson et al., 2007; Kim et al., 2013).
With the increased concern about healthy eating behavior,
researchers have focused on nutritional information on restaurant
menus (Hwang and Lorenzen, 2008; Sharma et al., 2011), qual-
ity of healthy food at restaurants (Kim et al., 2013), nutritional
labeling (Carange et al., 2004), and visual icons for healthy items
(Jones, 2009). However, what drives the customer’s desire to look
for healthy options on restaurant menus has been overlooked. The
present study focuses on the psychological aspect of customers’
∗ Corresponding author. Tel.: +1 407 903 8138.
E-mail addresses: juhee.kang@ucf.edu (J. Kang), jjh2505@gmail.com (J. Jun),
sarendt@iastate.edu (S.W. Arendt).
food choice process beyond the functional elements of food choices,
such as nutritional information and menu labeling. Value has been
considered predictive of customers’ satisfaction and their inten-
tions to revisit a restaurant (e.g., Hutchinson et al., 2009; Petrick,
2004). To the best of our knowledge, Kim et al. (2013) were the
first to examine customer value in determining healthy food items
in a restaurant context. Although Kim et al. (2013) attempted to
connect value to health, value was conceptualized as the com-
parison between price and quality, rather than the psychological
aspects of value related to consumer health. The fundamental cus-
tomer motivations to make healthy choices at restaurants remain
in question.
Despite efforts to make healthy food choices at restaurants, cus-
tomers are still hesitant to choose healthy menu items if they need
to sacrifice taste (Harnack and French, 2008; Mills and Thomas,
2008; Raghunathan et al., 2006). Therefore, the availability of nutri-
tional information does not directly explain customers’ healthy
choices at restaurants. For this reason, it is necessary to explore
which customers are likely to choose healthy menu items and
understand what motivates customers to make healthy choices.
To better understand customers’ healthy food choices, this study
employed the Value–Attitude–Behavior hierarchy (VAB) model,
which explains the influence of value on customer attitudes and
behaviors toward a certain object (e.g., Hansen, 2008; Honkanen
et al., 2006). Tudoran et al. (2009) employed this approach to eval-
uate the process of decision making on fish product purchases. In
their study, hedonic expectations and perceptions of fish products

http://dx.doi.org/10.1016/j.ijhm.2015.04.005
0278-4319/© 2015 Elsevier Ltd. All rights reserved.
 J. Kang et al. / International Journal of Hospitality Management 48 (2015) 12–21
were used as a set of attitudes that influences customer intention
to purchase fish. Thus, this study employed these two variables as
secondary predictors of consumer behavior.
In summary, this study addresses the lack of research regarding
the role of customers’ health values in food choices in order to
delineate why customers make healthier food choices when dining
out. It examines the relationships between health values, customer
expectations toward healthy food consumption, interest in healthy
food, and behavior intentions. This study suggests a novel approach
to understanding current trends of healthy food consumption. It
also provides practical implications for restaurants by offering ways
to segment target markets and strategies to address the expecta-
tions of customers regarding healthy menu items.
2. Literature review
2.1. Values, attitudes, and behaviors
In social psychology studies, the VAB model has been widely
used to understand behavior (e.g. Honkanen et al., 2006; Vaske
and Donnelly, 1999). Values are organized in a cognitive hierar-
chy, in which values influence behavior indirectly through attitudes
(Tudoran et al., 2009). Homer and Kahle (1988) apply the VAB
model to the context of natural food shopping behaviors and find
the causal sequence from abstract cognitions (i.e., values) to mid-
range cognitions (i.e., attitudes) to specific behaviors. Moreover,
they find internal values exert power on one’s decision in life
such as what food to eat and where to shop. Internally oriented
customers are more concerned about nutrition than externally ori-
ented customers and thus, resulting in more careful choices when
purchasing food items.
Although researchers have proven the principle of the VAB
approach, that is the hierarchical flow from individuals’ values to
their subsequent behaviors toward objects such as food (e.g., Björk,
1998; Grunert and Juhl, 1995), others have modified this approach
by adding or excluding constructs. For example, Honkanen et al.
(2006) employ ethical food choice motives instead of ethnic values
and examined their relationships with attitudes and intention to
consume organic food. Williams (1979) points out the importance
of values as criteria for judgment, however, ignored attitudes when
anticipating choices. Tudoran et al. (2009) include hedonic expec-
tations toward functional foods and perceptions of healthiness as
a part of domain-specific attitude in the VAB approach. These two
constructs are tested to examine the necessity of functional foods
focusing on how valuable and how good these foods are for con-
sumers. Therefore, this study chose expectations as intervening
variables because the purpose was to examine who was likely to
choose healthy food items at restaurants. Not all consumers who
value their health will purchase healthy menu items, but the prob-
ability of consumption may increase as consumer expectations
increase.
2.2. Customers’ health values
Health value is a broad concept that includes customers’ views
on the importance of, or concerns about, health (Tudoran et al.,
2009). Researchers use health value to explore the extent to which
customers want to achieve goals in their lives, especially related
to health (Nejad et al., 2005). Tromp et al. (2005) indicate that
health value significantly influences customers’ lifestyles and the
way people decide to improve their health. Customers who eat
low-calorie foods place a high value on personal health and have
significant interest in a healthy lifestyle (Gallicano et al., 2012;
Steptoe et al., 1995). Previous research on customers’ concerns
about health found that health-conscious customers consider the
13
nutritional content of restaurant foods and try to eat healthier
(Hwang and Lorenzen, 2008; Jones, 2009; Sharma et al., 2011;
Sualakamala and Huffman, 2010).
According to the Keystone Forum Report (2006), individuals
who eat out frequently consume more calories and fewer fruits and
vegetables than those who eat out less frequently. An increased
incidence of health problems contributes to developing public
interest in healthy eating and increasing the demand for healthy
foods (World Health Organization, 2004). Although there is more
public interest, the definition of healthy foods has not acquired
consent in research and the industry because people perceive it
differently. For example, some define healthy food as foods low in
sugar or low sodium, whereas others may be referring to low-fat or
low-calorie foods. Because customers are mainly concerned about
fat and calories in menu items (Chen et al., 2006), the present study
defines healthy foods as those that are low fat or low in calories.
2.3. Effect of health value on hedonic expectations
Customers usually have certain expectations of a food item
before they taste it (Villegas et al., 2008). Hedonic expectations of a
food product are defined as a perceived belief about the food, specif-
ically related to its pleasurable attributes (Tarancón et al., 2014).
Tuorila et al. (1994) emphasize the importance of hedonic expec-
tations when customers make decisions whether they will like or
dislike the food item. In that regard, hedonic expectations are asso-
ciated with affective evaluation, which refers to the acceptance of,
or the preference for, a food product (Cardello, 1994).
To remain healthy, some customers are likely to give up foods
they find tasty if these foods are high in fat or calories (Higgins et al.,
2003). Customers who value a healthy lifestyle are more likely to eat
a healthy diet (Sualakamala and Huffman, 2010) and find the foods
in these diets enjoyable, which may directly influence their accep-
tance of these foods (Kähkönen, 2000). As a result, these customers
develop positive hedonic expectations (i.e., the expectation of lik-
ing foods) toward healthy menu options while other customers do
not develop positive hedonic expectations (Tudoran et al., 2009).
It seems that customers are likely to induce positive emotional
responses as customers increase their experiences with food items
(Behrens et al., 2007). Wardle et al. (2000) note that health value
is an influential component for customers’ food acceptance. There-
fore, the present study suggests the following hypothesis:
H1. Health value has a positive influence on hedonic expectations.
2.4. Effect of health value on positive outcome expectations
Positive outcome expectations are defined as “a person’s esti-
mate that a given behavior will lead to certain outcomes” (Bandura,
1977, p. 193). In social cognitive theory, physical and self-evaluative
outcomes promote customers’ specific actions (Prodaniuk et al.,
2004). Physical outcomes reflect physical appearance and a desire
to look better (e.g., better fit of clothing, losing weight, and health-
ier appearance) (Anderson et al., 2000). Self-evaluative outcomes
include living a healthy life (i.e., feeling better, living longer, and
having better health) (Anderson et al., 2007). If these positive phys-
ical outcomes are confirmed, customers may be further encouraged
to eat healthy foods.
Health value plays a significant role in motivating customers to
maintain a desired health state (Tudoran et al., 2012) and influences
their decisions to perform specific actions to maintain or improve
their health (Tromp et al., 2005). Seeking nutritional information
on restaurant menus is one way to eat healthily (Josiam and Foster,
2009), as well as choosing foods with reduced portion sizes. Cus-
tomers, who are aware that being overweight is a contributor to
chronic illnesses (e.g., diabetes and high blood pressure), expect to
14 J. Kang et al. / International Journal of Hospitality Management 48 (2015) 12–21
achieve their goal of being healthy (through healthy diet or by con-
suming healthy foods) (Higgins et al., 2003). As a result, health value
is likely to lead to positive outcome expectations in one’s health,
a positive appearance, and a healthy lifestyle. Based on the above
discussion, the following hypothesis is suggested:
H2. Health value has a positive influence on positive outcome
expectations.
2.5. Interest in healthy food
Interest in healthy food is defined as an interest in eating foods
that are considered reduced-energy products, such as low-fat, low-
calorie, or unsweetened foods (Roininen et al., 1999). Non-fat milk
and reduced-fat cheeses are considered healthier foods (Zandstra
et al., 2001). Because customers perceive that these foods posi-
tively affect their health, they feel less guilty when consuming these
foods, thereby increasing interest in eating healthy foods (Roininen,
2001). According to Tudoran et al. (2012), how highly people value
their health is the key element that determines whether they make
healthy food choices. The more highly they value health, the more
likely they are to choose healthy foods (Kim et al., 2013). Customers
who want to live a healthy lifestyle are more likely to be inter-
ested in continuously eating healthy foods (Vazquez et al., 2009).
Thus, increased concerns about health value intensify the need for
healthy food on the market (Tudoran et al., 2012). Based on the
above discussion, the following hypothesis is proposed:
H3. Health value has a positive influence on interest in healthy
food.
Interest in healthy food relates to the benefits of eating healthy
foods, for example, enjoying the natural flavor of foods and being
healthy (Roininen, 2001). Because hedonic expectation relates to
taste aspects of a food, good taste plays a significant role in accept-
ing healthy food items (Roininen et al., 1999). When a healthy menu
item seems to be attractive in terms of its smell, texture, or taste,
customers may expect the menu item to taste flavorful. Moreover,
Radder and Roux (2005) argue that the acceptance of unfamiliar
foods is influenced by previous exposure. Pliner (1982) reports
that previous exposure to an unfamiliar food item (e.g. tropical
fruit juice) increased individuals’ preference for that food. Along
the same line, frequent exposure to healthy foods can increase the
acceptability of the food item. If healthy foods are tasty and deli-
cious, customers are likely to be attracted to the foods; thereby
leading to positive emotions such as pleasure and excitement when
anticipating appetizing foods. At the same time, customers can be
assured that they will like the food (Kähkönen, 2000).
In addition to a hedonic expectation, interest in healthy food
contributes to customers’ beliefs that healthy eating is beneficial to
their health. Customers eat healthy foods as a way to generate posi-
tive outcomes, such as losing weight, feeling better in their clothes,
and living longer (Anderson et al., 2007). Customers are likely to
look for health benefits of foods and have sufficient knowledge
about these benefits of healthy foods (Roininen, 2001). These cus-
tomers recognize health risks associated with eating habits and the
importance of controlling fat intake. Customers already know what
they eat influences their health (Steptoe et al., 1995; Wardle et al.,
2000). Therefore, eating healthy foods may be directly linked to
perceived state of well-being such as maintaining good health and
quality of life (Roininen, 2001). Consequently, such benefits may
help generate positive outcome expectations about healthy foods.
Therefore, the present study proposes the following hypotheses:
H4. Interest in healthy food has a positive influence on hedonic
expectations.
H5. Interest in healthy food has a positive influence on positive
outcome expectations.
2.6. Behavioral intention to make healthy food choices
Because of increasing health concerns, customers are willing to
give up foods that are high in fat or calories, even if they find them
tasty, in favor of healthy choices, which they expect to have a natu-
ral or light taste (Sualakamala and Huffman, 2010). Customers are
likely to choose healthy menu options, if they find healthy foods
to be tasty or enjoyable. Previous studies have shown that hedonic
expectations determine the likelihood of consuming healthy food
(e.g., Saba et al., 2010; Steptoe et al., 1995). Tuorila et al. (1994)
find repeat consumption or rejection of the food can be deter-
mined by the level of enjoyment, thereby influencing choices in
the future. Having awareness of the benefits of consuming healthy
foods motivates customers to seek out nutritional information
and further, persists in making healthy choices. Customers make
healthy choices because of the positive outcomes (e.g., maintaining
their health and looking good) obtained from previously consum-
ing healthy foods and/or the knowledge they have about healthy
foods (Trudeau et al., 1998; Varela et al., 2010). For example, the
amount of fat customers eat relates to positive outcome expecta-
tions (Anderson et al., 2007). Customer intentions to choose low-fat
food items are strengthened when they believe eating healthy food
is a way to achieve their health goals (e.g., maintaining or reducing
their weight), thereby continuing healthy eating behaviors (Chen
et al., 2006). Based on the discussion above, the following hypothe-
ses are proposed:
H6. Hedonic expectations have a positive influence on healthy
food choice intentions.
H7. Positive outcome expectations have a positive influence on
healthy food choice intentions.
Based on the proposed hypotheses above, the relationships
between constructs (i.e., health value, interest in healthy food,
hedonic expectations, positive outcome expectations, and food
choice intentions) are represented in Fig. 1.
3. Methodology
3.1. Survey instrument
An Internet-based survey was developed based on a thor-
ough literature review. The questionnaire consisted of six sections:
five sections were for health value, positive outcome expectation,
hedonic expectation, interest in healthy food, and healthy food
choice intention; and the other section was for respondents’ demo-
graphic information. All items except hedonic expectation were
measured using a seven-point Likert-type scale ranging from 1
(strongly disagree) to 7 (strongly agree).
At the beginning of the questionnaire, a screening question was
asked to determine whether respondents had ever chosen healthy
menu items when dining out. Respondents who chose “yes” to
this question were given an opportunity to complete the question-
naire. Those who had not eaten healthy menu items at restaurants
were excluded from this study. In the first part of the question-
naire, respondents were asked to rate the extent of their agreement
with the three statements on health value: (a) “Having good health
means a lot to me,” (b) “I often think about my health,” and (c) “I
think of myself as a person who is interested in healthful food.”
These items were adopted from Tudoran et al. (2009).
The other four sections consisted of questions related to healthy
menu items. In order to help respondents’ understanding, brief
 J. Kang et al. / International Journal of Hospitality Management 48 (2015) 12–21
Hedonic
Expectation
H1
H4
H3
Health Interest in
Value healthy food
H5
H2
Positive
outcome
expectation
Fig. 1. Conceptual model of healthy menu choice behavioral intention.
information about healthy menu items at restaurants was given
as below:
Take a moment to think about the restaurants listed on the pre-
vious page and recall their healthful menus. These restaurants
may use health symbols to promote healthful foods. The fol-
lowing symbols are used at some restaurants to indicate low fat
or low calorie foods among their healthful menu options. This
questionnaire will focus on the healthful foods indicated as low
fat or low calorie foods at casual dining restaurants.
After reading this information, respondents were asked to rate
three contrasting adjective semantic differential items on hedonic
expectation (see Appendix A). The anchors for these items were (a)
unappetizing/appetizing, (b) boring/exciting, and (c) expect to dis-
like/like (Tudoran et al., 2009). The third part of the survey asked
about respondents’ interests in healthy food items at restaurants.
Three items were measured by asking about the consumption of
low fat or low calorie menu items: (a) helps to keep the body in
shape, (b) keeps cholesterol level under control, and (c) improves
health. These items were adapted from Roininen et al. (1999) and
modified to fit the context of casual dining restaurants. In the fourth
part of the survey, positive outcome expectation was measured
with four items from Anderson et al. (2007): (a) lose weight, (b)
live longer, (c) feel better in clothes, and (d) improve health. The
fifth part of the survey measured three items to examine behav-
ioral intention to make healthier food choices. Three items were
adopted from Zeithaml et al. (1996): (a) repurchasing healthy menu
items, (b) recommending healthy menus to others, and (c) spread-
ing positive word of mouth about the healthy menu items. The
last part of the survey included questions related to respondents’
demographic information (e.g., age, gender, education, and income)
and their dining-out behaviors (e.g., frequency of eating low-fat or
low-calorie foods at casual dining restaurants).
3.2. Data collection
A pilot test was conducted with 18 graduate students and 7
faculty and staff in the hospitality management department in a
Midwestern university. Based on their feedback, the questionnaire
was revised in order to improve clarity for the final questionnaire.
During three months period from May to August, 2012, an invita-
tion e-mail that included the questionnaire URL was sent to 35,300
potential participants: 26,128 students, 6171 faculty and staff, and
3001 alumni at the same university. This study only included
15
H6
Healthy
food choice
intention
H7
people who had eaten out and selected healthy menu items at a
casual dining restaurant. They were identified by asking previous
experience of eating healthy foods at casual dining restaurants. A
total of 2155 responses were received, indicating a response rate
of 6.1%. After deleting 967 incomplete responses, 1188 complete
responses were used for further analysis.
3.3. Data analysis
This study employed a two-step approach suggested by
Anderson and Gerbing (1988). First, confirmatory factor analy-
sis (CFA) examines the measurement model, which validate the
pattern and reliability of observed variables representing specific
constructs in the proposed model. Second, structural equation
modeling analysis was utilized to assess the validity of the research
model and examine hypotheses. AMOS 13.0 software was used to
test the hypothesized model.
The present study used Barons and Kenny’s (1986) approach to
examine the mediating effect of interest in healthy food on two
relationships proposed in the research model: (1) the relationship
between health value and hedonic expectations, and (2) the rela-
tionship between health value and positive outcome expectations.
In addition, a median was used to classify subjects into two groups
(a high or low for income and an older or younger for age) based
on the results from descriptive analysis (Mangleburg et al., 1998).
Responses were recorded as group 1 if they were below than the
median value, whereas those which either equaled or were higher
than the median value were identified as group 2. Chi-square differ-
ence with one degree of freedom was used to test the moderating
effect on each path by comparing the constrained model against
the unconstrained model (Anderson and Gerbing, 1988).
4. Results
4.1. Descriptive statistics
The demographic profile of the respondents is described in
Table 1. More than half of respondents were female (68.8%),
whereas 31.2% of respondents were male. More than half of respon-
dents (53.2%) were young adults, specifically between the ages of
18 and 34. With regard to the highest education level respondents
achieved, 66.7% of respondents earned either bachelor’s or graduate
degree, while the rest (33.3%) accomplished a high school diploma,
some college, or other type of degree/certificate. Caucasians were
16 J. Kang et al. / International Journal of Hospitality Management 48 (2015) 12–21

Table 1 Table 2
Demographic information. Item measurement properties.

Characteristics Frequency Percentage Construct Standardized Composite Cronbach’s

factor loadings reliabilities alpha
Gender
Male 363 31.2% Health value .815 .807
Female 799 68.8% HV1 .702
Age HV2 .919
18–24 years 390 33.1% HV3 .678
25–34 years 237 20.1% Interest in healthy food .890 .890
35–44 years 136 11.5% LFI1 .864
45–54 years 189 16.0% LFI2 .847
55–64 years 193 16.4% LFI3 .851
Older than 64 years 34 2.9% Hedonic expectation .847 .843
Ethnicity HE1 .858
African American 18 1.5% HE2 .738
Asian 55 4.7% HE3 .816
Caucasian 1038 89.2% Positive outcome expectation .886 .883
Hispanic 23 2.0% PoE1 .771
Native Hawaiian or other Pacific Islander 3 .3% PoE2 .858
Other 27 2.3% PoE3 .853
Household income PoE4 .763
Less than $20,000 423 37.6% Healthy food choice intention .922 .919
$20,000 to $39,999 125 11.1% HFC1 .842
$40,000 to $79,999 332 29.5% HFC2 .912
$80,000 to $119,000 155 13.8% HFC3 .923
$120,000 to $149,000 47 4.2%
Over $150,000 43 3.8%
Education
Less than high school diploma 1 .1%
(Fornell and Larcker, 1981). Discriminant validity was evaluated by
High school diploma 42 3.6% comparing AVE values and the squared correlations between con-
Some college, but no degree 294 24.9% structs (Fornell and Larcker, 1981). As shown in Table 3, all of the
Associate degree 43 3.6% squared correlations (R2 ) between pairs of constructs were lower
Bachelor’s degree 318 26.9%
than the AVE for each construct, indicating acceptable discriminant
Graduate degree 470 39.8%
Other 14 1.2% validity.

4.3. Structural equation modeling (SEM)

the largest group in the sample (89.2%). In addition, 80.9% of the A structural equation modeling was estimated to empirically
respondents stated that they had eaten out at a restaurant in the validate the conceptual model in Fig. 1. The SEM results showed sat-
past two weeks prior to taking the survey. isfactory model fit with Chi-square (2 ) = 635.669 [df = 97, p < .001],
NFI = .957, TLI = .963, CFI = .963, RMSEA = .062. Fig. 2 shows the the-
4.2. Confirmatory factor analysis oretical hypotheses with each standardized coefficient.
Based on the SEM results, six of the seven hypotheses were
Confirmatory factor analysis (CFA) was employed (a) to evalu- supported, with the exception of H2, which predicted a positive
ate whether the underlying structure was a rational measurement relationship between health value and positive outcome expecta-
model for the construct and (b) to validate the overall measurement tion and which was not supported (t = 1.21, p = .227).
model. The CFA results revealed that the overall fit of the con- H1, which predicted a positive relationship between health
ceptual model was acceptable at 2 = 516.876 [degrees of freedom value and hedonic expectation, was supported (ˇ = .402, t = 13.49,
(df) = 94, p < .001], Normed Fit Index (NFI) = .965, Tucker Lewis Index p < .001). H3, which predicted a positive relationship between
(TLI) = .958, Comparative Fit Index (CFI) = .971, Root Mean Square health value and interest in healthy food, was supported (ˇ = .119,
Error of Approximation (RMSEA) = .055. The values for NFI, TLI, and t = 4.02, p < .001). H4, which predicted a positive relationship
CFI were higher than the suggested standard of .90 (Byrne, 1998). between interest in healthy food and hedonic expectation, was sup-
The RMSEA value between .04 and .07 supported an acceptable ported (ˇ = .267, t = 9.68, p < .001). H5, which predicted a positive
model fit (Turner and Reisinger, 2001). Table 2 shows the specific relationship between interest in healthy food and positive outcome
measurement items with standardized factor loadings, compos- expectation, was supported (ˇ = .668, t = 22.565, p < .001). H6, which
ite reliabilities, and Cronbach’s alpha estimates for each construct. predicted a positive relationship between hedonic expectation and
The factor loadings were equal to or higher than .678 at a signifi- healthy food choice intention, was supported (ˇ = .642, t = 23.63,
cant p < .001. Cronbach’s alpha estimates and composite reliability p < .001). H7, which predicted a positive relationship between
were greater than .70, indicating a satisfactory level of internal con-
sistency (Nunnally, 1978) and a high reliability for assessing each Table 3
construct (Hair et al., 1998). Latent variable correlation matrix.
Construct validity was proven based on the results of convergent
1 2 3 4 5
and discriminant validity (Shuttleworth, 2009). For convergent
validity, the average variance extracted (AVE) and latent construct 1. Healthy value .599a .014c .166 .011 .179
2. Interest in healthy food .119b .729 .088 .442 .240
correlations are reported in Table 3. The AVEs of all constructs
3. Hedonic expectation .407 .296 .649 .030 .454
ranged from .599 to .768, which is greater than the .50 thresh- 4. Positive outcome expectation .105 .665 .173 .660 .131
old (Bagozzi and Yi, 1988). With the high factor loadings on the 5. Healthy food choice intention .423 .490 .674 .362 .798
intended constructs (Table 2), this result indicates that a large a
Entries on the diagonal is AVE.
portion of variance was explained by the constructs. Thus, con- b
Correlations are below the diagonal.
c
vergent validity for the measurement-scale items was achieved Squared correlations are above the diagonal.
 J. Kang et al. / International Journal of Hospitality Management 48 (2015) 12–21 17

Fig. 2. Structural model of healthy menu choice behavioral intention.

positive expectation and healthy food choice intention, was sup-
ported (ˇ = .259, t = 11.20, p < .001).
In summary, our empirical data confirmed that health value
is the foundation of healthy food choices. Moreover, interest
in healthy food plays a significant role in increasing customer
expectations of having healthy foods, which in turn increases cus-
tomer intention to choose healthy menu options at restaurants.
In short, health value and interest in healthy foods are prerequi-
sites that influence customers’ intentions to choose healthy menu
items.
effect = .023, t-value = 9.54, p-value = .000). The results verified that
“interest in healthy food” has a significant partial mediating role in
the relationship between “health value” and “hedonic expectation.”
When the path from “interest in healthy food” to “positive
outcome expectation” (H5) was constrained to zero, the effect of
“health value” on “positive outcome expectation” (H2) was signif-
icant at p < .05 (ˇ = .118, t = 3.976). Thus, “Interest in health food”
fully meditated the path between “health value” and “positive out-
come expectation” (H2) in the model (Table 4).

4.5. Testing the moderating effects

4.4. Testing the mediating effects
When the path from “interest in healthy food” to “hedonic
expectations” (H4) was constrained to zero, the effect of “health
value” on “hedonic expectations” (H1) significantly increased
(ˇ = .437, t = 13.956) at p < .001 based on the 2 difference (2
(1) = 91.126) (Table 4). Therefore, “interest in healthy food” partially
mediated the effect of “health value” on “hedonic expectation.” The
mediating effect of “interest in healthy food” to “hedonic expecta-
tion” can be also tested by examining the indirect effect of “health
value” on “hedonic expectation” (Jeon and Hyun, 2013). The medi-
ating effect of “health value” was tested via a Sobel test. The results
of the Sobel study showed that “health value” significantly affected
“hedonic expectation” through “interest in healthy food” (Indirect
All paths were checked for the moderating effects of demo-
graphic variables; however, only the path between positive
outcome expectations and healthy food choice intention was found
to have moderating effects (Table 5). Demographic variables tested
in this study were gender, age, and income. First, the moderating
effect of gender was tested (n = 1465). The chi-square difference
between the constrained model and the unconstrained model was
statistically significant at the .05 level (2 (1) = 3.979). The coef-
ficient for the path between positive outcome expectations and
healthy food choice intention was higher with female (ˇ = .267,
p < .001) than male (ˇ = .258, p < .001).
Second, respondents were split into two sub-groups by age. The
median value for age group was 2, the age of 25 (n = 1465). Group

Table 4
Mediating effects of interest in healthy food.

Paths Standardized estimates Hypothesis

H1 – Health value → Hedonic expectation .402* (.437* a , .401* b ) Supported

H2 – Health value → Positive outcome expectation .029 (.030* , .118* ) Not supported
H3 – Health value → Interest in healthy food .119* (.136* , .129* ) Supported
H4 – Interest in healthy food → Hedonic expectation .267* (0, .274* ) Supported
H5 – Interest in healthy food → Positive outcome expectation .668* (.671* , 0) Supported
H6 – Hedonic expectation → Healthy food choice intention .642* (.647* , .668* ) Supported
H7 – Positive outcome expectation → Healthy food choice intention .259* (.289* , .248* ) Supported

Mediating path
Health value → Interest in healthy food → Hedonic expectation (partial mediation) 2 (1) = 91.126, p < .001
Health value → Interest in healthy food → Positive health outcomes (full mediation) 2 (1) = 627.515, p < .001

Note: numbers in parentheses indicate standardized estimates when the model is constrained (a: H4 is constrained; b: H5 is constrained).
*
p < .001
18 J. Kang et al. / International Journal of Hospitality Management 48 (2015) 12–21
Table 5
Moderating effects of gender, age, and income.
Standardized path coefficient
Gender Male Female
.258 .267
Standardized path coefficient
Age Younger group Older group
.242 .270
Standardized path coefficient
Income Low income High income
.244 .266
Note: moderating effects were on the path between positive outcome expectation
and healthy food choice intention.
1 (younger) was 18–24 year olds and Group 2 (older) was 25 years
old or older. The chi-square difference was found to be significant
on the relationship between positive outcome expectations and
healthy food choice intention (2 (1) = 5.921, p < .05). The result
indicated that positive outcome expectations have more impact
on healthy food choice intention among older customers (ˇ = .270,
p < .001) than younger customers (ˇ = .242, p < .001).
Third, respondents were divided into two groups based on
the median value 2 (n = 1465). Respondents who earned less than
$20,000 were indicated as low income group, whereas those who
equally earned or higher than $20,000 were high income group.
From the chi-square test result, income was found to be a sig-
nificant moderator between positive outcome expectations and
healthy food intention (2 (1) = 11.79, p < .001). This finding indi-
cated that the effect of positive outcome expectations on healthy
food choice intention was statistically different depending on the
income; the path coefficient was .266 (p < .001) in the high income
group, whereas it was .244 (p < .001) in the low income group.
In summary, positive outcome expectations were more effective
in encouraging customer intention to purchase healthy food for
females, the older customer group, and the high income group.
5. Discussions and conclusions
This study aimed to understand the role of health value in the
process of making healthy food choices at casual dining restau-
rants. The results of this study pointed out that individual health
value is the foundation of healthy food choices at casual restau-
rants; a key predictor of hedonic expectations (as shown by H1),
positive outcome expectations (as shown by H2), and interest in
healthy food (as shown by H3). This finding emphasizes the impor-
tance of understanding the health concerns of customers. Health
value stimulated hedonic expectations both directly and indirectly
through interest in healthy food. It also aroused positive outcome
expectations indirectly through interest in healthy food. Customer
intentions to make healthy food choices were enhanced by hedonic
expectation and positive outcome expectations (as shown by H6
and H7). The findings of this study confirmed hierarchical flow from
values to behaviors toward objects (Honkanen et al., 2006; Vinson
et al., 1977). Homer and Kahle’s (1988) study found that people
who place value on their health are more likely to control their
decisions on what foods to eat and where to shop. Further, people
put extra effort into making decisions about purchasing what they
think is the most nutritious food. Along these same lines, restau-
rant consumers who are concerned about their health expect a
healthy tasting food (e.g., light and fresh) and make decisions to
obtain positive outcomes from eating healthy. As a result, those
expectations encourage consumers to purchase healthy food items
at restaurants.
2 (df) Based on the findings, hedonic expectation was important
in inducing positive intention to purchase healthy menu items.
Customers can predict the taste of healthy food items, thereby
3.979 (1)
determining whether they will like or dislike the food (Torres-
Moreno et al., 2012). The general perception that healthy foods
2 (df)
taste “natural” or “light” is due to the reduction in fat or calories
of menu items (Brunsø, 2002). Customers concerned about their
5.921(1) health like natural or light tasting foods as compared to the taste of
high fat or high calorie foods. Given the benefits of eating healthy
2 (df) foods, customers are likely to view healthy tastes as pleasurable.
Accordingly, hedonic aspects of food consumption occur when food
is presented as natural or healthy rather than creamy, glazed, or
11.79(1)
battered. This interpretation is supported by Kähkönen’s (2000)
study, which found that health-conscious customers find healthy
food more pleasurable when the low fat or calories food has a
tasty description. Providing taste-related information is a keystone
in enhancing hedonic expectation of healthy menu items. Health
conscious customers prefer healthy food and enjoy the healthy
taste they expected from healthy foods. These positive responses
increase customers’ intentions to choose healthy menu items.
Positive outcome expectation was found to be an antecedent for
the intention to choose healthy menu items. Increased concerns
about health induce specific eating habits (Prodaniuk et al., 2004).
It is obvious that customers who value their health try to maintain
healthy eating behaviors with the expectation of receiving benefits,
such as losing weight, having a healthier appearance, and feeling
healthy (Anderson et al., 2007). As a result, these expectations influ-
ence customer intention to choose healthy menu items. Customers
may not choose healthy menu items if they do not perceive physical
or psychological benefits, which is consistent with findings Tudoran
et al.’s findings (2012).
Interest in healthy food was found to be a mediating factor,
indirectly influencing the relationships between health value and
expectations. This indicates that interest in healthy food influences
the impact of health value on hedonic and positive outcome expec-
tations (as shown by H4 and H5), which in turn influences healthy
food choice intentions (i.e., future purchase intention, positive
word of mouth, and recommendations to others). The perception of
healthy foods is influenced by the healthfulness of food attributes
and its value customers given to it (Brunsø, 2002). For instance, cus-
tomers believe that consuming low fat or low calorie menu items is
important in maintaining or controlling healthfulness. These cus-
tomers are likely to be interested in healthy foods, which lead
them to expect the hedonic aspect of tasting healthy food, such
as whether it would be a pleasant or unpleasant experience. Fur-
thermore, without an interest in healthy food, positive outcome
expectations cannot be established. The interest in healthy food
(e.g., the belief that healthy foods maintain good health) allows
customers to expect desirable consequences such as being slim or
healthy, and this motivates them to continue healthy eating habits
when dining out (Grunert and Juhl, 1995).
The results of the study suggest that demographic variables
(i.e., gender, age, and income) moderate the path between positive
outcome expectations and healthy food choice intentions. Positive
outcome expectations shows more impact on healthy food choice
intentions in female, older, and higher income customer groups.
The results are consistent with Kassem et al. (2003), Anderson
et al. (2000), and Elbel et al. (2009). It is reasonable to think that
these three groups have specific reasons for choosing healthy menu
options as compared to other groups. Although people may want to
keep their bodies in shape and be attractive, females may pay more
attention to body image because of societal pressures (Anderson
et al., 2007). As a result, they may pay more attention to what they
eat and have higher intentions to control their eating behaviors.
 J. Kang et al. / International Journal of Hospitality Management 48 (2015) 12–21
Older customers are more likely to look for healthy food in order to
decelerate the aging process and reduce the risk of health related
diseases (Sualakamala and Huffman, 2010), which in turn increases
the frequency of choosing healthy options. Customers with higher
incomes tend to spend more on healthy foods. Higher income cus-
tomers may have higher social status and education levels (Kassem
et al., 2003). This group is likely to have higher quality of life expec-
tations and greater desires to keep their bodies in shape, which
may cause them to eat more healthy (Darmon and Drewnoski,
2008).
6. Theoretical contributions
As a theoretical framework, numerous studies have employed
the VAB approach to understand customer behavior in areas such
as selecting retail fish products (Tudoran et al., 2009) and functional
food products (Ares and Gaı́mbaro, 2007; Mialon et al., 2002). This
study was the first to apply the VAB model to a restaurant context.
It should be noted that few studies in the hospitality context con-
sider “value” as a cornerstone of customers’ healthy food choice
intentions (Kim et al., 2013). Moreover, this study suggests value
as a critical component in explaining why health value is impor-
tant and results in healthy food purchase. Although Licata (2009)
pointed out the unpopularity of healthy options, this study revealed
that healthy foods are chosen when customers value their health
which leads to positive hedonic expectations and positive health
outcomes. Thus, this study adds new knowledge to the literature
on customers’ healthy food choices and further strengthens the
foundation of the theoretical framework.
This research also found an important link between customers’
health value and food choice behaviors. Interest in healthy food
played a crucial role in mediating the effect of health value on
food choice intention through hedonic expectations and positive
outcome expectations, which provides future research founda-
tion investigating customer motivations focusing on functional and
emotional aspects of eating healthy food items.
7. Practical implications
This study suggests critical implications to help restaurants
meet their goals – creating sales and satisfying customer needs.
Based on the findings, health value and interest in healthy food
should be considered when developing marketing strategies for
promotion of healthy menu items. Restaurant marketers must
understand their current customer profile and these customers’
health values; thereby enabling them to identify whom they should
target and how they can attract those target customers.
There might be differences in customers’ evaluation of food
item healthfulness and interest in healthy foods because of dif-
ferences in quality of life expectations. Restaurant marketers are
advised to provide different healthy options to each segment.
For health conscious customers, providing nutritional informa-
tion is more important than describing the taste of the healthy
menu item, because their focus is health. Restaurant marketers
may develop a healthy menu and exclusively provide it to cus-
tomers who seek healthy options. On the other hand, customers
who are less willing to choose healthy options, may be given
several healthy options with nutrient information, allowing cus-
tomers to customize the amount of fat or calories. This customized
approach may be effective, especially when customers prefer high
calorie and/or high-fat menu items, but at the same time they
want to maintain their health. In this case, restaurants can mod-
erately promote healthy options to encourage customers’ healthy
selections.
19
Health-conscious customers have hedonic and/or positive out-
come expectations when ordering healthy menu items. Marketers
are advised to investigate what customers want from eating healthy
foods. Knowing customer expectations can give marketers ideas
about what aspects restaurants should emphasize in promotional
messages. For example, hedonic expectation is related to the
pleasantness of eating healthy foods and can be strengthened
if descriptions of food are presented on the menu. Describing
food characteristics (e.g., crispy, fresh) can be more effective in
forming customer expectations than providing a list of healthy
ingredients. Thus, creative promotional efforts may provoke cus-
tomers to pay attention to the information given and imagine
its taste, which enhances hedonic expectations toward healthy
menu items. In addition, positive outcome expectations play an
important role in encouraging healthy choices, especially when
customers have interest in healthy food. Restaurants could pro-
mote positive outcome expectations about healthy menu items.
For example, nutritional benefits would appeal to health conscious
customers.
It seems necessary that restaurants develop marketing strate-
gies to arouse customer interest in healthy foods. First, restaura-
teurs are advised to be creative in delivering messages on healthy
food items. For instance, a comparison of calories between healthy
menu items and regular menu items may make customers think
about healthy options. Second, restaurants may consider pro-
motional events (e.g., competitions or tasting parties) in which
customers can actively participate. For example, restaurants can
give random prizes to customers who select certain healthy menu
items and use celebrity chefs or famous spokespersons in their
commercials.
Aside from increasing interest in healthy foods, another
approach may be to focus efforts on increasing health value.
Although customers are less interested in promotional messages
about new menu items, they are likely to pay attention to non-
promotional messages (Kotler et al., 1999). Thus, restaurants can
use public relation campaigns to communicate the importance of
health and wellness in one’s life, which may lead to increased atten-
tion toward healthy food menu items.
8. Limitations and future research
As with all studies, this study has limitations. First, this study
only focused on customers who had eaten healthy menu items
at restaurants, which may limit the generalization of the study
outcomes. Future studies should explore the perceptions of cus-
tomers who have not eaten healthy menu items. Understanding
this customer group will help in developing marketing strategies
that appeal to this potential customer base. Second, the survey
was conducted in one U.S. region, therefore, it may lack gener-
alizability. Future studies should consider more diverse samples,
including consumers from big cities and suburban areas across the
country. Because people in different geographical areas present
different patterns of purchasing behavior, they are likely to have
different preferences and habits for food consumption. Third, the
majority of the sample population in this study was female and
was made up of young adults between 18 and 34 years old.
These customers are likely to be more concerned about their
body shape and appearance than long-term health consequences.
Future studies can be expanded to other groups, especially cus-
tomers who are 35 years old or older. Fourth, the present study
did not measure actual purchasing behaviors because of the dif-
ficulties of observing and measuring them. However, if possible,
future researchers could include actual purchase behavior into the
model.
20 J. Kang et al. / International Journal of Hospitality Management 48 (2015) 12–21

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