Effectiveness Of Nudges Research Articles

Nudge for Environmental Restructuring in Diabetes Self-Management: Comment on Existing Systematic Reviews.

Diabetes self-management education and support are necessary for all people living with diabetes, but its accessibility is limited worldwide. Nudge strategies have been proposed as an environmental outreach for diabetes management. This article provides further insights regarding environmental restructuring nudges into the cumulative evidence on diabetes self-management interventions from existing systematic reviews that classified primary trials using the behavior change technique taxonomy (BCTTv1). Among the 137 relevant articles searched through the bibliographic databases until 2022, three systematic reviews were scrutinized. Environmental restructuring nudges have been tested in interpersonal communications for diabetes self-management. Although nudge-based techniques were used with other types of behavior techniques in various trial contexts, the independent effects of social restructuring nudges were not denied in previous meta-analyses. Environmental restructuring nudges may be feasible in diabetes management, but they are still controversial with internal and external validation. Considering care accessibility for diabetes management, social restructuring nudges applied to healthcare providers are expected to complement healthcare systems. For future implementation, the rationale for the practice should be explicit in the conceptualization and evidence synthesis of diabetes-specific nudge interventions based on global sources.

Campus food service users' support for nudge strategies for fruit and vegetable-rich items: findings from a large Canadian national sample.

Although customer support is critical to the wider uptake of nudging strategies to promote fruits and vegetables (FV) in institutional food service (FS) settings, empirical research is sparse and typically based on small convenience samples. An online survey was conducted to assess support, perceived effectiveness and intrusiveness of nine nudge types drawn from Münscher et al.'s Taxonomy of Choice Architecture. We focused on the setting of campus FSs across Canada. A national sample of post-secondary students regularly using campus FSs was used (N 1057). Support for changing the range of options (B3) was the highest, closely followed by changing option-related effort (B2) and changing option-related consequences (B4). Facilitating commitment (C2), changing default (B1) and providing a social reference point (A3) received lowest support. Furthermore, we extracted three clusters of respondents based on perceived effectiveness and intrusiveness of nudge types. Characterised by a relatively low level of perceived effectiveness and moderately high level of intrusiveness, Cluster 1 (61⋅7 % of the sample) reported the lowest support for nudges. Cluster 2 (26⋅6 %), characterised by intermediate effectiveness and low intrusiveness of nudging, reported a high level of support for nudges. Lastly, Cluster 3 (11⋅7 %), characterised by high perceived effectiveness of as well as high perceived intrusiveness, reported the highest level of support for nudges. Findings confirm overall support for FV nudging, with significant differences across nudge types. Differences in customers' acceptance and perception across nudge types offer campus FS operators initial priors in selecting nudges to promote FV.

Nudge interventions to reduce unnecessary antibiotic prescribing in primary care: a systematic review

ObjectivesAntibiotic prescribing in primary care contributes significantly to antibiotic overuse. Nudge interventions alter the decision-making environment to achieve behaviour change without restricting options. Our objectives were to conduct a systematic...

Diminishing returns: Nudging Covid-19 prevention among Colombian young adults.

Nonpharmaceutical interventions (NPIs) like social distancing, face masks, and handwashing will continue to be a frontline defense against Covid-19 for some time. But their effectiveness depends critically on compliance by young adults, who are most likely both to become infected and to infect others. We conducted a randomized controlled trial in Bogotá, Colombia, to assess the effectiveness of informational nudges emphasizing the private and public benefits of compliance on university students' concern about Covid-19, recent compliance with NPI recommendations, and intended future compliance. Although nudges boosted concern, they had limited effects on either recent or intended future compliance. We attribute these null results to high baseline levels of information about and compliance with NPIs, an informational diminishing returns scenario that is likely to be increasingly common globally.

The Impact of Social Nudges on User-Generated Content for Social Network Platforms

Content-sharing social network platforms rely heavily on user-generated content to attract users and advertisers, but they have limited authority over content provision. We develop an intervention that leverages social interactions between users to stimulate content production. We study social nudges, whereby users connected with a content provider on a platform encourage that provider to supply more content. We conducted a randomized field experiment (N [Formula: see text]) on a video-sharing social network platform where treatment providers could receive messages from other users encouraging them to produce more, but control providers could not. We find that social nudges not only immediately boosted video supply by 13.21% without changing video quality but also, increased the number of nudges providers sent to others by 15.57%. Such production-boosting and diffusion effects, although declining over time, lasted beyond the day of receiving nudges and were amplified when nudge senders and recipients had stronger ties. We replicate these results in a second experiment. To estimate the overall production boost over the entire network and guide platforms to utilize social nudges, we combine the experimental data with a social network model that captures the diffusion and over-time effects of social nudges. We showcase the importance of considering the network effects when estimating the impact of social nudges and optimizing platform operations regarding social nudges. Our research highlights the value of leveraging co-user influence for platforms and provides guidance for future research to incorporate the diffusion of an intervention into the estimation of its impacts within a social network. This paper was accepted by Victor Martínez-de-Albéniz, operations management. Funding: H. Dai thanks the University of California, Los Angeles (UCLA) [Hellman Fellowship and Faculty Development Award] for funding support. R. Zhang is grateful for financial support from the Hong Kong Research Grants Council [Grant 16505418]. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2022.4622 .

Effect of Nudges to Clinicians, Patients, or Both to Increase Statin Prescribing

Statins reduce the risk of major adverse cardiovascular events, but less than one-half of individuals in America who meet guideline criteria for a statin are actively prescribed this medication. To evaluate whether nudges to clinicians, patients, or both increase initiation of statin prescribing during primary care visits. This cluster randomized clinical trial evaluated statin prescribing of 158 clinicians from 28 primary care practices including 4131 patients. The design included a 12-month preintervention period and a 6-month intervention period between October 19, 2019, and April 18, 2021. The usual care group received no interventions. The clinician nudge combined an active choice prompt in the electronic health record during the patient visit and monthly feedback on prescribing patterns compared with peers. The patient nudge was an interactive text message delivered 4 days before the visit. The combined nudge included the clinician and patient nudges. The primary outcome was initiation of a statin prescription during the visit. The sample comprised 4131 patients with a mean (SD) age of 65.5 (10.5) years; 2120 (51.3%) were male; 1210 (29.3%) were Black, 106 (2.6%) were Hispanic, 2732 (66.1%) were White, and 83 (2.0%) were of other race or ethnicity, and 933 (22.6%) had atherosclerotic cardiovascular disease. In unadjusted analyses during the preintervention period, statins were prescribed to 5.6% of patients (105 of 1876) in the usual care group, 4.8% (97 of 2022) in the patient nudge group, 6.0% (104 of 1723) in the clinician nudge group, and 4.7% (82 of 1752) in the combined group. During the intervention, statins were prescribed to 7.3% of patients (75 of 1032) in the usual care group, 8.5% (100 of 1181) in the patient nudge group, 13.0% (128 of 981) in the clinician nudge arm, and 15.5% (145 of 937) in the combined group. In the main adjusted analyses relative to usual care, the clinician nudge significantly increased statin prescribing alone (5.5 percentage points; 95% CI, 3.4 to 7.8 percentage points; P = .01) and when combined with the patient nudge (7.2 percentage points; 95% CI, 5.1 to 9.1 percentage points; P = .001). The patient nudge alone did not change statin prescribing relative to usual care (0.9 percentage points; 95% CI, -0.8 to 2.5 percentage points; P = .32). Nudges to clinicians with and without a patient nudge significantly increased initiation of a statin prescription during primary care visits. The patient nudge alone was not effective. ClinicalTrials.gov Identifier: NCT04307472.

Nudges and compensation: Evaluating experimental evidence on controlling rice straw burning

The customary occurrence of crop residue burning substantially increases air pollution. We examine the effects of nudges and cash compensation in curbing this practice using a field experiment in the rice-growing region of northern India. Information treatments include positively-framed and negatively-framed social norms and environmental awareness nudges. We identify the effects of information with and without cash transfers for manifestly avoiding residue burning. We show that cash compensation and two types of nudges – positively-framed social norms and environmental awareness – significantly reduce residue burning. We observe a stronger impact from cash compensation than nudges, and that these effects complement each other. Policymakers should take advantage of the complementarity between these interventions, particularly when low-cost informational nudges can potentially reduce environmentally harmful practices. This paper adds to the narrative on information framing effects in field experiments and discusses how nudges and extrinsic incentives could augment each other in public good contributions.

Nudging digital physical activity breaks for home studying of university students-A randomized controlled trial during the COVID-19 pandemic with daily activity measures.

University students are of particular public health interest because they are at high risk for physical inactivity and sedentary behaviors. In conjunction with the COVID-19 pandemic, sedentariness and physical inactivity were reinforced, as the pandemic led to an increase in home studying. Physical activity (PA) breaks have been identified as promoting factors for university students' physical and mental health. Therefore, the present study explored an approach to nudge students to take PA breaks at home while studying. The purpose was to test the effectiveness of digital nudging for PA breaks for 10 days using a randomized intervention design during the COVID-19 pandemic. It included an intervention group who received daily digital motivational prompts for PA break videos and a minimal intervention control group who got low-level access to PA break videos via a one-time link sent to the media library. Using a sample of university students in the southwest of Germany (n = 57), two-level binary logistic regression models were calculated to predict daily participation in PA breaks during the intervention period depending on the nudging intervention, as well as previous participation in PA breaks, the general PA level of the subjects before the intervention, the time spent on PA and on home studying in a day, the kind of day during the intervention (weekday vs. weekend), and the students' age. Results revealed that the digital nudging intervention did not show any significant effect on the likelihood to participate in PA breaks on a given day (0.69 ≤ β ≤ 0.75, p > 0.3). Instead, an individual-level effect revealed that the longer a student studied at home over the course of a day, the more likely he or she was to take a PA break (1.07 ≤ β ≤ 1.11, p < 0.001). Current findings show that individual characteristics such as daily time spent on home studying, which can change over the course of the intervention phase, are relevant considerations within nudging intervention in university setting. This provides initial insights especially for digital PA breaks for students during home studying.

Can colored sidewalk nudge city tourists to walk? An experimental study of the effect of nudges

Physical inactivity has been an increasing sub-health condition. Nudging people to participate in physical activities consequently becomes a public health priority. This study aims to showcase how color as a design factor can work to nudge city travelers to take on walking. Alongside the color effect, this experimental study incorporates another two design factors, namely, priming and social norms. The findings suggest that the use of colored sidewalks stimulate perceptual salience and individuals' moods, thereby increasing travelers' desire for walking. Priming tourists with sneakers and displaying social norms were also found to increase travelers’ interest in walking. The current study is innovative in incorporating color in the design of walkable routes in cities for its visitors. It is the first to apply nudges into the context of walkable city design oriented towards tourists.

Real-life effects of nudging and pricing strategies in the supermarket to promote healthy diets

Abstract Background Unhealthy dietary patterns pose a major public health challenge. Individual-level efforts to promote heathy diets (e.g. nutrition education) have limited effect on the long term. Context-specific interventions focussing on point-of-purchase may create opportunities for sustainable dietary changes. We evaluated real-life effects of nudging and pricing strategies in supermarkets on dietary intake. Methods In this parallel cluster-randomised controlled trial, we randomized 12 Dutch supermarkets in socially deprived neighbourhoods to a control group (n = 6), or intervention group (n = 6). Healthy food nudges were implemented in intervention stores across 13 food groups, combined with healthy product price decreases and unhealthy product price increases. Eligible participants were aged 30-80 years and regular shoppers at participating stores. The primary outcome was dietary guideline adherence measured via an index score (0-150), at baseline and after 3, 6 and 12 months. Secondary outcomes included parameters of cardiometabolic health (HbA1c, lipid profile, and waist circumference), the percentage of healthy food purchases in the supermarket, socio-cognitive factors, and supermarket customer satisfaction. Effects were analysed with linear mixed models. Results This study included 173 participants from intervention clusters and 220 from control clusters. Preliminary evaluation of the 3-month follow-up data revealed no effectiveness of the nudging and pricing strategies compared to the control supermarkets in terms of dietary guideline adherence (β -0.8, 95%CI -4.2; 2.7). Results on all outcomes will be available at time of the conference. Conclusions This novel supermarket trial is the first to evaluate real-life long-term effects of nudging and pricing strategies based on a comprehensive set of study outcomes and using a strong methodological design. Findings can direct future design of context-specific interventions focussing on the promotion of healthy diets. Key messages • Context-specific interventions focussing on point-of-purchase may create opportunities for sustainable dietary changes. • Findings from this supermarket trial testing real-life and long-term effects of nudging and pricing strategies can direct future design of context-specific interventions focussing on healthy diets.

Investigating the Effect of Nudges on Consumers’ Willingness to Pay for Genetically Modified Corn Oil

Shifting from conventional methods of food production to genetic modification methods benefits sustainable agri-food production and environmental preservation. However, one of the main problems genetically modified food manufacturers have ever had to deal with is the public acceptability of GM foods. This study has two major objectives. First, it intends to apply principles from behavioral economics to investigate how consumers’ willingness to pay for GM corn oil can be affected. For this purpose, two different nudges are tested by providing consumers with positive information regarding GMO and changing the wording of the GMO label. Then, a comparison between the effectiveness of each of them is provided. Second, it investigates the impact of trust in GM food institutions, GMO information, and perceived GMO risk on both WTP for GM edible oil and the effectiveness of each nudge. A between-subjects choice experiment with a sample size of 550 Iranian corn oil consumers was conducted in Mashhad from March to April 2021. The results of mixed logit models indicate that both nudges affected consumer valuation of GM corn oil significantly, while their effectiveness differed according to the consumer level of trust in the GM food institutions and the perceived risk of GMO. Increasing consumer trust and information raises the WTP for GM corn oil; however, perceived risk has no effect. This study introduces effortless tools that GM food manufacturers can consider in their marketing strategies to affect consumers in the desired way.

Evaluating the effectiveness of email-based nudges to reduce postoperative opioid prescribing: study protocol of a randomised controlled trial

IntroductionSurgical patients are commonly prescribed more opioids at discharge than needed to manage their postoperative pain. These excess opioids increase the risks of new persistent opioid use, opioid-induced ventilatory impairment...

Your Behaviors Reveal What You Need: A Practical Scheme Based on User Behaviors for Personalized Security Nudges

Since personalization was introduced to security nudges, several approaches using the correlations between the General Decision-Making Styles (GDMS) and nudge effects have been proposed. However, the GDMS-based schemes do not apply to real systems well since it is challenging, if not impossible, to obtain the GDMS without psychological scales. Instead, we propose a practical scheme that leverages users’ system-use behaviors to personalize security nudges. To verify the effectiveness of the developed scheme, we analyze the data collected through two between-subjects lab experiments (N1 = 312, N2 = 696). By comparing the efficacy of the behavior-based and the GDMS-based approaches, we find that the behaviors outperform the GDMS in accurately predicting nudge effects, and more importantly, the behavior-based personalization scheme is comparably effective and more robust in improving nudge effects. This confirms that the behavior-based framework can be a practical and promising solution when implementing personalized nudge schemes to improve security behaviors.

Pay or Nudge Employees Into Change? An Experiment on the Effect of Nudging for Organizational Change

Organizational change often fails due to employees’ resistance to change resulting in unforeseen expenses, delays, or other disruptions in organizations. In our experiment, we compare behavioral interventions—a pro-change default rule and a pro-change recommendation—with a costly pay raise to foster supportive behavior. We support the effectiveness of a default nudge in enhancing change-related success. Our results indicate that a recommendation nudge has no significant effect in change-related scenarios. In addition, we find that a pay raise has a positive effect that is likely to be triggered by positive reciprocity. If this pay raise fails to materialize, we report supporting evidence for negative reciprocity. We compare the effect sizes for these nudges and the pay raise and provide insights for the relative cost-effectiveness of such nudges compared to a pay raise for organizational change. We conclude with managerial implications.

Is there a Social Impact Paradox in Cross-Channel Communication? A Management Perspective

Customers use multiple channels to inform themselves about products and services before making a buying decision. As companies provide information on their owned platforms, their customers experience a multi-channel journey on their way to the company website. While companies try to nudge potential customers into consuming provided information, potential effects of previous customers experiences (such as social media browsing) on the effect of digital nudges (i.e. social norms) and the perception of such guidance are not thoroughly investigated yet. First studies imply that customers react differently to nudges depending on their previous channel experience. This paper contributes by focusing on digital nudging during the pre-purchase phase of the customer journey. The potential effect of social norm nudges on information search intentions and the influence of previous social media usage are investigated. Two online experiments examined previous social media usage as a potential moderator of the social norms nudge efficacy as well as the influence of previous social media usage on the perception of social norms nudges. Results show that previous social media usage influences perception as well as the efficacy of a social norms nudge on a company website in certain circumstances. Although social norms do not always significantly affect user behavior, users that consumed social media before seeing a social norms nudge, have an altered perception of these nudges. Choice architects implementing digital nudges are challenged to carefully consider such effects when applying nudges on their user interfaces.

The Possibility of Nudge Effects from Sensory Stimulation

The Possibility of Nudge Effects from Sensory Stimulation

The Mechanism for Matching the Supply Content and Policy Instruments of Resistive Public Policy

In the continuous development of behaviorist public policy theory, nudge tools have gradually become a policy tool of great interest to the academic community, which believes these tools can improve the effectiveness of public policy. However, scholars frequently disregard the impact of policy attributes on the policy effect when the policy content is matched with explicit policy tools and potential policy tools. Most studies have confirmed the application effect of nudges in policies that are receptive, but there is little research on their application in policies that are resistive. Through research on the supply content and promotion mechanism of policy resistance, we determined that the nudge policy tool does not demonstrate significant benefits for the effect of policy behavior, while, among the explicit policy tools, the preaching tool has a significant impact on the effect of policy behavior.

Effects of digital nudging on the adoption of APPs for value co-creation among online consumers

Effects of digital nudging on the adoption of APPs for value co-creation among online consumers

On the evaluation of visual nudges to promote safe cycling: Can we encourage lower speeds at intersections?

Objective Crashes between cars and cyclists at urban intersections are common, and their consequences are often severe. Typical causes for this type of crashes included the excessive speed of the cyclist as well as car drivers failing to see the cyclist. Measures that decrease the cyclists’ speed may lead to safer car-cyclist interactions. This study aimed to investigate the extent to which cyclists may approach intersections at a lower speed when nudged to do so. Methods Visual flat-stripe nudges were placed on bicycle lanes in the proximity of uncontrolled intersections (with a history of car-cyclist crashes) in two locations in Gothenburg, Sweden. This specific nudge was the one obtaining the best results from a previous study that tested different nudges in controlled experiments. Video data from the intersections were recorded with a site-based video recording system both before (baseline), and after (treatment), the nudge was installed. The video data was processed to extract trajectory and speed for cyclists. The baseline and treatment periods were equivalent in terms of day of the week, light, and weather conditions. Furthermore, two treatment periods were recorded to capture the effect of the nudge over time in one of the locations. Results Leisure cyclists showed lower speeds in treatment than in baseline for both locations. Commuters were less affected by the nudge than leisure cyclists. This study shows that visual nudges to decrease cyclist speed at intersections are hard to evaluate in the wild because of the many confounders. We also found that the effect of visual nudges may be smaller than the effect of environmental factors such as wind and demographics, making their evaluation even harder. Conclusions The observed effect of speed might not be very high, but the advantage both in terms of cyclist acceptance and monetary cost makes an investment in the measure very low risk. This study informs policymakers and road authorities that want to promote countermeasures to intersection crashes and improve the safety of cyclists at urban intersections.

Can vaccination intentions against COVID-19 be nudged?

AbstractOnce vaccines against COVID-19 became available in many countries, a new challenge has emerged – how to increase the number of people who vaccinate? Different policies are being considered and implemented, including behaviourally informed interventions (i.e., nudges). In this study, we have experimentally examined two types of nudges on representative samples of two countries – descriptive social norms (Israel) and saliency of either the death experience from COVID-19 or its symptoms (UK). To increase the legitimacy of nudges, we have also examined the effectiveness of transparent nudges, where the goal of the nudge and the reasons of its implementation (expected effectiveness) were disclosed. We did not find evidence that informing people that the vast majority of their country-people intend to vaccinate enhanced vaccination intentions in Israel. We also did not find evidence that making the death experience from COVID-19, or its hard symptoms, salient enhanced vaccination intentions in the UK. Finally, transparent nudges as well did not change the results. We further provide evidence for the reasons why people choose not to vaccinate, and whether different factors such as gender, belief in conspiracy theories, political ideology, and risk perception, play a role in people's intentions to vaccinate or susceptibility to nudges.