Nudging to move: a scoping review of the use of choice architecture interventions to promote physical activity in the general population

Abstract

Background Nudges are used to alter lifestyles and thus curb the rise of non-communicable diseases. Physical activity is a core prevention strategy to reduce the burden of non-communicable diseases. This paper aims to (1) give an overview of the scope of interventions using choice architecture techniques to promote physical activity at the population levels and (2) identify research gaps by analysing the different approaches in terms of class and type of intervention used. Methods A systematic electronic database search was combined with snowball citation sampling of a starter set of publications to search for studies published through October 2018 reporting interventions to promote physical activity at the population level using choice architecture techniques. The methodology of the Joanna Briggs Institute for Scoping Reviews was applied. Results In all, 35 publications were included. Most of the interventions used point-of-choice prompts tested at railway stations, shopping malls and airports ( N = 27). Eight studies were online studies. While all studies were aimed at the general population, details, if reported at all, were vague and basic. All studies focused on individual-level lifestyle behaviour. None of the studies attempted to alter population-based lifestyle behaviour. Online and “real-world” approaches were rarely combined. Neither, interventions targeting meso- and macro-level structures nor combinations of individual-level and specific meso- or macro-level interventions were found. Conclusion Nudging is in principle an effective approach to promote physical activity within the general population. However, there are large gaps in research. Available opportunities have not yet been exhausted. Further research is needed that is explicitly based on behavioural insights and covering the full range of nudging approaches, particularly focussing on theoretical developments, practical feasibility tests and scale-up activities. Electronic supplementary material The online version of this article (10.1186/s12966-019-0844-z) contains supplementary material, which is available to authorized users.

Choice architecture interventions to change physical activity and sedentary behavior: a systematic review of effects on intention, behavior and health outcomes during and after intervention

“…This systematic literature review extends the work of Forberger et al (2019) [31] and Hollands et al (2013) [14] by providing a systematic and comprehensive overview of studies that used choice architecture interventions to encourage physical activity or to discourage sedentary behavior in adults. The results of the current review suggest that prompting is a promising choice architecture technique to increase stair use over elevator or escalator use.…”

“…Two scoping reviews have previously provided an overview of studies using choice architecture interventions to promote physical activity [14,31], though both reviews only sparsely reported on the effectiveness of the interventions on physical activity. Moreover, there is still a lack of insight regarding the extent to which choice architecture interventions can effectuate durable behavior change after removal of the intervention [15].…”

Reducing cardiometabolic risk in adults with a low socioeconomic position: protocol of the Supreme Nudge parallel cluster-randomised controlled supermarket trial

“…To promote physical activity, there is an increasing focus on using environmental cues to promote physical activity [42], such as point-of-choice prompt signs that stimulate stair use. Such environmental cues provide relevant information in the environment when the choice is considered.…”

Why food reformulation and innovation are key to a healthier and more sustainable diet

“…The power of nudges and use of consumer insight to guide promotions and campaigns is widely recognised by successful businesses and is increasingly being used as a tool by public health professionals and policy makers. A nudge may be defined as an individual component of choice architectureput simply, a single element that alters the context surrounding a choice (Forberger et al 2019), making that choice more attractive. Choice architecture is a framing device used to alter the presentation of a choice, in order to attempt to influence the outcome of that decision (Science & Technology Select Committee 2011).…”