Nudging in Public Health Lifestyle Interventions: A Systematic Literature Review and Metasynthesis

Ledderer, Loni; Kjær, Marianne; Madsen, Emilie Kirstine; Busch, Jacob; Fage-Butler, Antoinette

doi:10.1177/1090198120931788

Cited by 84 publications

(60 citation statements)

References 113 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Such studies promote understanding of nudging, as they characterise the contours of nudging activities in certain spheres. Empirical studies of nudging have highlighted that some nudges work, at least in experimental contexts, while others (such as nudges to take the stairs) can have the opposite effect (Ledderer et al, 2020). It would be jnteresting to find out if the placement of carrots at the point of payment make any positive difference to sales.…”

Section: Discussionmentioning

confidence: 99%

Health-related nudging

Fage-Butler¹

2020

CLaW

Self Cite

View full text Add to dashboard Cite

The aim of this paper is to present a methodological approach that provides analytical, critical and normative purchase on nudges’ bypassing of reflection, using a combination of multimodal analysis, Foucauldian theory, and Habermas’s (1996) concept of deliberative democracy. The approach is demonstrated using an example of a health-related nudge from the Danish context: healthy product placement in a supermaket. Multimodal analysis highlights how various modes (colour, symbol, front and back, positioning and discourse) contribute meanings to the nudge. A Foucauldian perspective provides critical perspectives on nudges as shaping practices, as short of epistemic content and thus potentially difficult to resist, and as representing a politicisation of public space. Nudges’ lack of transparency is discussed in relation to Habermas’s normative framework of deliberative democracy where recognising public perspectives and ensuring consensus are key. Limitations of the article include a smaller data set; however, the data are used to illustrate the methodological approach. On the basis of the findings, I argue for the importance of furthering critical public discourse on nudging. That way, nudgees may be better positioned to spot nudges, and the implications of policymakers using this technique of governance can be more effectively scrutinised.

show abstract

Section: Discussionmentioning

confidence: 99%

Health-related nudging

Fage-Butler¹

2020

CLaW

Self Cite

View full text Add to dashboard Cite

show abstract

“…The successfulness of this "nudging" approach is difficult to assess because the situation quickly escalated to lockdown. More generally, the degree to which nudges are successful is questionable (Ledderer et al, 2020). Furthermore, in a recent systematic literature review, Ledderer et al (2020) concluded that while nudging can effectively produce immediate change, there was little evidence that nudging interventions resulted in lasting behavioral alterations.…”

Section: Awareness and Behavior Changementioning

confidence: 99%

Bridging the Gap Between UK Government Strategic Narratives and Public Opinion/Behavior: Lessons From COVID-19

et al. 2020

View full text Add to dashboard Cite

In the UK, there exists an important "action gap" between Government advice on measures necessary to counter the threat of COVID-19, and the behavior of a significant minority of the population. There are several reasons for this disconnect, including lack of message potency (i.e., credibility and congruence), inflexible/habitual behavior patterns, prevailing beliefs (i.e., vulnerability to, and seriousness of COVID-19), and individuals valuing personal concerns above general public health. For official messages to be effective and advice adhered to, strong, coherent "strategic narratives" are required. This article, using a psychological perspective, critically examined prevailing COVID-19 UK Government announcements during the lockdown (23/03/2020) and initial easing phase (10/05/2020). Specifically, it focused on important communication inconsistencies, and identified factors that may facilitate and create barriers to the adoption of essential public health directives. This included deliberation of factors that enhanced source impact, diminished the influence of message content, and the negative consequences of contrary information. Accordingly, this article proposes a framework for providing a unifying strategic narrative on COVID-19, one that helps to maximize the impact of key messages and promote effective behavior change. This framework places an emphasis on engaging the full range of actors and considers ways of reducing the efficacy of false information. The article provides recommendations that will potentially improve the reception of government policy and suggests how strategic narratives can harness the drivers of behavioral change needed to meet challenges such as COVID-19.

show abstract

“…While the initial wave of nudging studies targeted mainly the adoption of healthier behaviours during exercise [ 13 , 14 ], eating [ 15 – 17 ] and quitting smoking [ 18 ], nudging is now increasingly being perceived as a policy strategy to improve public services [ 5 , 19 – 21 ] like the healthcare system [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Nudging healthcare professionals in clinical settings: a scoping review of the literature

Sant'Anna¹,

Vilhelmsson

Wolf

2021

BMC Health Serv Res

View full text Add to dashboard Cite

Background Healthcare organisations are in constant need of improvement and change. Nudging has been proposed as a strategy to affect people’s choices and has been used to affect patients’ behaviour in healthcare settings. However, little is known about how nudging is being interpreted and applied to change the behaviour of healthcare professionals (HCPs). The objective of this review is to identify interventions using nudge theory to affect the behaviour of HCPs in clinical settings. Methods A scoping review. We searched PubMed and PsycINFO for articles published from 2010 to September 2019, including terms related to “nudging” in the title or abstract. Two reviewers screened articles for inclusion based on whether the articles described an intervention to change the behaviour of HCPs. Two reviewers extracted key information and categorized included articles. Descriptive analyses were performed on the data. Results Search results yielded 997 unique articles, of which 25 articles satisfied the inclusion criteria. Five additional articles were selected from the reference lists of the included articles. We identified 11 nudging strategies: accountable justification, goal setting, suggested alternatives, feedback, information transparency, peer comparison, active choice, alerts and reminders, environmental cueing/priming, defaults/pre-orders, and education. These strategies were employed to affect the following 4 target behaviours: vaccination of staff, hand hygiene, clinical procedures, prescriptions and orders. To compare approaches across so many areas, we introduced two independent dimensions to describe nudging strategies: synchronous/asynchronous, and active/passive. Conclusion There are relatively few studies published referring to nudge theory aimed at changing HCP behaviour in clinical settings. These studies reflect a diverse set of objectives and implement nudging strategies in a variety of ways. We suggest distinguishing active from passive nudging strategies. Passive nudging strategies may achieve the desired outcome but go unnoticed by the clinician thereby not really changing a behaviour and raising ethical concerns. Our review indicates that there are successful active strategies that engage with clinicians in a more deliberate way. However, more research is needed on how different nudging strategies impact HCP behaviour in the short and long term to improve clinical decision making.

show abstract

Nudging in Public Health Lifestyle Interventions: A Systematic Literature Review and Metasynthesis

Cited by 84 publications

References 113 publications

Health-related nudging

Health-related nudging

Bridging the Gap Between UK Government Strategic Narratives and Public Opinion/Behavior: Lessons From COVID-19

Nudging healthcare professionals in clinical settings: a scoping review of the literature

Contact Info

Product

Resources

About