Initiated and used by public policy to support national priorities, the concept of nudging is now a topic of interest to the wider world of health and quality of life more generally. Moreover, in addition to being applied about health issues, nudge has been used for some years in various fields such as the environmental sector, the economic sector, the social sector, as well as in business activities within companies. So that everyone understands what we are talking about here, nudges can be defined as subtle interventions to guide choices without restricting them. In other words, it’s a behavioural strategy used to influence individuals towards better decision-making choices by paying particular attention to how these are presented. Specifically, nudges are based on the exploitation of cognitive biases, which are predispositions of a psychological, sociological or physiological nature that can, often unconsciously, influence our final decision-making. Thierry Libaert explains ‘we generate a sort of cognitive conflict in the individual by allowing him to resolve it through a new behaviour.’. This is certainly an additional support to action.
Concretely, various techniques can be used to induce behaviour. Firstly, there is the default choice. In this case, the individual is directly offered the ‘best solution’, while being free to modify this choice. For example, in the field that interests us, namely public health, this could be illustrated by a coffee machine which would be set without sugar by default, but with the possibility for the user to add sugar if he wishes. Then, the second technique has a relevant playful aspect by giving to the ‘best choice’ greater visibility. The most famous use of this strategy is attributed to the employees of Schiphol Airport in Amsterdam who wanted to reduce ‘leakage’ in the urinals of the toilets and thus reduce cleaning costs. Fly stickers were then placed on the bottom of urinals to encourage men to aim at this stimulus. This technique used was radically more effective than prevention or moral awareness messages as it resulted in an 80% reduction in cleaning costs. In addition, to encourage people to use stairs rather than escalator and thus improve them to exercise, the Stockholm metro has turned these stairs into a giant piano. This playful strategy paid off and resulted in a 70% increase in the use of the steps. Finally, there is the technique known as imitation, which consists of giving to individual a collective result in order to encourage him to behave within the norm. The latter relies on comparison bias and social desirability. For example, a hotel creates a sign in a room stating ‘75% of guests in this room reuse their towels’. Here, the idea isn’t to debate the ethics of this potential deception, but outcomes show that 44% of customers kept their towels after the display, compared to 35% when it isn’t done.
More recently, nudges have been used in the context of the Covid-19 pandemic. Indeed, at a time when the rate of people vaccinated in France was encouraging rising, it was still too low to control the virus circulation. In this way, various experimenters have conducted scientific trials to test the effectiveness of nudges on the vaccination phenomenon. The techniques used consisted of sending reminder messages at different time intervals. As a first step, the messages sent out only informed participants their vaccine was available at a nearby medical centre; and in some subgroups, they informed them about vaccination with a short video. This message, which is rather unsubtle but with the wording is adapted according to the scientists, was aimed at people who forgot to get vaccinated for different reasons or who didn’t have access to enough information to make up their minds about vaccination.
To conclude, the outcomes of these experiments have demonstrated that the techniques presented above have led to an overall increase in the number of vaccinations carried out.
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