Y.S.KOH1, Y.W.B.TAN1, E.R.TAN2, A.PV1, R.KUMARASAN1, F.D.SIVA KUMAR1, P.Z.WANG1, C.F.SUM3, E.S.LEE4, R.M.VAN DAM2, M.SUBRAMANIAM1
Institute of Mental Health1, National University of Singapore2, Admiralty Medical Centre3, NHG Polyclinics4
Nudging helps to steer decisions towards healthier options. However, its effectiveness is influenced by public acceptance. This study examines the acceptance of different nudges by the population and the socio-demographic characteristics and lifestyle behaviors that are correlated with acceptance.
The study used data from the nationwide Knowledge, Attitudes and Practices study (KAP) on diabetes in Singapore. Three types of nudges were examined: (1) government information campaigns (GIC), (2) information government mandated (IGM) (compulsory labelling of certain food products) and (3) default rules and choice architecture (DRCA). Their acceptance was assessed based on how much the respondents ‘agreed’ with related statements that described healthy lifestyle guidelines. Using scores calculated for each nudge, multivariable linear regressions were performed with socio-demographics and lifestyle behaviours (sedentary behaviour, physical activity and Dietary Approach to Stop Hypertension [DASH]).
The percentage of respondents who agreed to all statements related to each nudge were: 75.7% (GIC), 72.7% (IGM) and 33.3% (DRCA). Respondents who were Malay (vs Chinese) and with sedentary behaviour < 7 hours/day were more likely to accept GIC. Respondents who were Indian (vs Chinese), sufficiently physically active and had a healthier diet (DASH ≥ 19) were more likely to accept nudges related to IGM. Respondents who were Malay/Indian (vs Chinese) and had a healthier diet were more likely to accept DRCA.
Generally, respondents preferred less intrusive approaches to promoting healthy lifestyle. Ethnicity and lifestyle behaviours were associated with acceptance of nudges and should be accounted for when implementing nudges in the population.