A systematic review of nudge theories and strategies used to influence adult health behaviour and outcome in diabetes management.

Journal Article (Journal Article;Systematic Review)

BACKGROUND: Diabetes is a chronic disease associated with a variety of complications, and nudging may be a potential solution to improve diabetes control. Since nudging is a new concept, no review of literature on nudging diabetic patients into improving their health behaviour has been done. Therefore, we aim to collate a list of nudge intervention and determine the context in which nudging is successful. METHODS: We adopted a two-arm search strategy comprising the search of literature databases and snowballing using relevant search terms. We summarized patient characteristics, the nudge intervention, according to nudging strategies, delivery mode and their outcomes. The conditions present in effective nudge interventions were assessed and reported. RESULTS: We retrieved 11,494 studies from our searches and included 33. An additional five studies were added through snowballing. Studies included utilized framing (n=5), reminders (n=10), gamification (n=2), social modelling (n=5) and social influence (n=16). Studies on reminders and gamification were more likely to have a statistically significant outcome. The targeted health behaviours identified were medication adherence, physical activity, diet, blood glucose monitoring, foot care, self-efficacy, HbA1c and quality of life. Of these, studies with adherence to medication, foot care practice and quality of life as targeted health behaviours were more likely to show a statistically significant outcome. CONCLUSION: Nudging has shown potential in changing health behaviour of patients with diabetes in specific context. We identified two possible factors (delivery mode and patient characteristics) that may affect the effectiveness of nudge intervention.

Full Text

Duke Authors

Cited Authors

  • Kwan, YH; Cheng, TY; Yoon, S; Ho, LYC; Huang, CW; Chew, EH; Thumboo, J; Østbye, T; Low, LL

Published Date

  • November 2020

Published In

Volume / Issue

  • 46 / 6

Start / End Page

  • 450 - 460

PubMed ID

  • 32387700

Electronic International Standard Serial Number (EISSN)

  • 1878-1780

Digital Object Identifier (DOI)

  • 10.1016/j.diabet.2020.04.002


  • eng

Conference Location

  • France