Acceptance of healthy lifestyle nudges in the general population of Singapore

• Published in: BMC public health Vol. 22; no. 1; pp. 1 - 1297
• Main Authors: Tan, Yeow Wee Brian, Tan, Edward Ryan, Sin, Koh Yen, AshaRani, P. V, Abdin, Edimansyah, Roystonn, Kumarasan, Wang, Peizhi, Devi, Fiona, Vaingankar, Janhavi, van Dam, Rob M, Sum, Chee Fang, Lee, Eng Sing, Chow, Wai Leng, Chong, Siow Ann, Subramaniam, Mythily
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 05.07.2022; BioMed Central; BMC
• Subjects: Acceptance; Acceptance tests; Behavior; Decision making; Demographics; Demography; Diabetes; Diabetes mellitus; Diet; Ethnicity; Government; Health aspects; Health attitudes; Health behavior; Health care; Health policy; Health promotion; Healthy lifestyle; Hypertension; Information; Interviews; Life style; Lifestyles; Minority & ethnic groups; Nudges; Policies; Population; Population policy; Public health; Questionnaires; Respondents; Rules; Singapore; Sociodemographics; Surveys; Singapore
• DOI: 10.1186/s12889-022-13668-x
• ISSN: 1471-2458

Background In recent years, behaviourally driven policies such as nudges have been increasingly implemented to steer desired outcomes in public health. This study examines the different nudges and the socio-demographic characteristics and lifestyle behaviours that are associated with public acceptance of lifestyle nudges. Methods The study used data from the nationwide Knowledge, Attitudes and Practices study (KAP) on diabetes in Singapore. Three types of nudges arranged in increasing order of intrusiveness were examined: (1) information government campaigns, (2) government mandated information and (3) default rules and choice architecture. Acceptance was assessed based upon how much respondents 'agreed' with related statements describing heathy lifestyle nudges. Multivariable linear regressions were performed with socio-demographics and lifestyle behaviours using scores calculated for each nudge. Results The percentage of respondents who agreed to all statements related to each nudge were: 75.9% (information government campaigns), 73.0% (government mandated information), and 33.4% (default rules and choice architecture). Respondents of Malay/Others ethnicity (vs. Chinese) were more likely to accept information government campaigns. Respondents who were 18 - 34 years old (vs 65 years and above), female, of Malay/Indian ethnicity (vs Chinese), were sufficiently physically active, and with a healthier diet based on the DASH (Dietary Approach to Stop Hypertension) score were more likely to accept nudges related to government mandated information. Respondents of Malay/Indian ethnicity (vs Chinese), and who had a healthier diet were more likely to accept default rules and choice architecture. Conclusion Individuals prefer less intrusive approaches for promoting healthy lifestyle. Ethnicity and lifestyle behaviours are associated with acceptance of nudges and should be taken into consideration during the formulation and implementation of behaviourally informed health policies. Keywords: Healthy lifestyle, Nudges, Acceptance, Singapore