Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment

<h4>Background</h4> Nudging, a strategy that uses subtle stimuli to direct people’s behavior, has recently been included as an effective and low-cost behavior change strategy in low- and middle- income countries (LMIC), targeting behavior-based prevention and control of neglected tropica...

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Autores principales:	Fiona Vande Velde, Hans J. Overgaard, Sheri Bastien
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/46d4730aa26344e0996fd5b0b73f514a
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id	oai:doaj.org-article:46d4730aa26344e0996fd5b0b73f514a
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Fiona Vande Velde Hans J. Overgaard Sheri Bastien Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment
description	<h4>Background</h4> Nudging, a strategy that uses subtle stimuli to direct people’s behavior, has recently been included as an effective and low-cost behavior change strategy in low- and middle- income countries (LMIC), targeting behavior-based prevention and control of neglected tropical diseases (NTDs). The present scoping review aims to provide a timely overview of how nudge interventions have been applied within this field. In addition, the review proposes a framework for the ethical consideration of nudges for NTD prevention and control, or more broadly global health promotion. <h4>Methods</h4> A comprehensive search was performed in several databases: MEDLINE, PsycINFO, and Embase (Ovid), Web of Science Core Collection, CINAHL, ERIC and Econ.Lit (EBSCO), as well as registered trials and reviews in CENTRAL and PROSPERO to identify ongoing or unpublished studies. Additionally, studies were included through a handpicked search on websites of governmental nudge units and global health or development organizations. <h4>Results</h4> This scoping review identified 33 relevant studies, with only two studies targeting NTDs in particular, resulting in a total of 67 nudge strategies. Most nudges targeted handwashing behavior and were focused on general health practices rather than targeting a specific disease. The most common nudge strategies were those targeting decision assistance, such as facilitating commitment and reminder actions. The majority of nudges were of moderate to high ethical standards, with the highest standards being those that had the most immediate and significant health benefits, and those implemented by agents in a trust relationship with the target audience. <h4>Conclusion</h4> Three key recommendations should inform research investigating nudge strategies in global health promotion in general. Firstly, future efforts should investigate the different opportunities that nudges present for targeting NTDs in particular, rather than relying solely on integrated health promotion approaches. Secondly, to apply robust study designs including rigorous process and impact evaluation which allow for a better understanding of ‘what works’ and ‘how it works’. Finally, to consider the ethical implications of implementing nudge strategies, specifically in LMIC. Author summary Behavior is at the core of neglected tropical disease (NTD) prevention and control, certainly within low-, and middle- income countries (LMIC) where resources are often limited. Therefore, strategies to promote behavior change should be included and investigated in future efforts. Nudging, a low-cost strategy that subtly directs people towards positive behavioral choices, has recently gained attention in global health promotion. Nudge strategies have been applied to a wide range of health-promoting behaviors such as handwashing. To understand which strategies were used, where and how these were applied, and whether these were ethically informed and implemented, we undertook a comprehensive review of the available sources. This resulted in 33 included studies, with a total of 67 nudge strategies for behavior-based prevention and control of NTDs in LMIC. Only two studies targeted NTDs in particular, the other 31 included studies were focused on more general health promoting behaviors, with the majority targeting handwashing with soap. The most common nudge strategies were those targeting decision assistance, such as fostering commitment and reminder actions. In general, the ethical assessment presented favorable results. We identified the need for robust study designs to better understand how nudges can be implemented in the future.
format	article
author	Fiona Vande Velde Hans J. Overgaard Sheri Bastien
author_facet	Fiona Vande Velde Hans J. Overgaard Sheri Bastien
author_sort	Fiona Vande Velde
title	Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment
title_short	Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment
title_full	Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment
title_fullStr	Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment
title_full_unstemmed	Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment
title_sort	nudge strategies for behavior-based prevention and control of neglected tropical diseases: a scoping review and ethical assessment
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/46d4730aa26344e0996fd5b0b73f514a
work_keys_str_mv	AT fionavandevelde nudgestrategiesforbehaviorbasedpreventionandcontrolofneglectedtropicaldiseasesascopingreviewandethicalassessment AT hansjovergaard nudgestrategiesforbehaviorbasedpreventionandcontrolofneglectedtropicaldiseasesascopingreviewandethicalassessment AT sheribastien nudgestrategiesforbehaviorbasedpreventionandcontrolofneglectedtropicaldiseasesascopingreviewandethicalassessment
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spelling	oai:doaj.org-article:46d4730aa26344e0996fd5b0b73f514a2021-11-18T09:14:49ZNudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment1935-27271935-2735https://doaj.org/article/46d4730aa26344e0996fd5b0b73f514a2021-11-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584752/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4> Nudging, a strategy that uses subtle stimuli to direct people’s behavior, has recently been included as an effective and low-cost behavior change strategy in low- and middle- income countries (LMIC), targeting behavior-based prevention and control of neglected tropical diseases (NTDs). The present scoping review aims to provide a timely overview of how nudge interventions have been applied within this field. In addition, the review proposes a framework for the ethical consideration of nudges for NTD prevention and control, or more broadly global health promotion. <h4>Methods</h4> A comprehensive search was performed in several databases: MEDLINE, PsycINFO, and Embase (Ovid), Web of Science Core Collection, CINAHL, ERIC and Econ.Lit (EBSCO), as well as registered trials and reviews in CENTRAL and PROSPERO to identify ongoing or unpublished studies. Additionally, studies were included through a handpicked search on websites of governmental nudge units and global health or development organizations. <h4>Results</h4> This scoping review identified 33 relevant studies, with only two studies targeting NTDs in particular, resulting in a total of 67 nudge strategies. Most nudges targeted handwashing behavior and were focused on general health practices rather than targeting a specific disease. The most common nudge strategies were those targeting decision assistance, such as facilitating commitment and reminder actions. The majority of nudges were of moderate to high ethical standards, with the highest standards being those that had the most immediate and significant health benefits, and those implemented by agents in a trust relationship with the target audience. <h4>Conclusion</h4> Three key recommendations should inform research investigating nudge strategies in global health promotion in general. Firstly, future efforts should investigate the different opportunities that nudges present for targeting NTDs in particular, rather than relying solely on integrated health promotion approaches. Secondly, to apply robust study designs including rigorous process and impact evaluation which allow for a better understanding of ‘what works’ and ‘how it works’. Finally, to consider the ethical implications of implementing nudge strategies, specifically in LMIC. Author summary Behavior is at the core of neglected tropical disease (NTD) prevention and control, certainly within low-, and middle- income countries (LMIC) where resources are often limited. Therefore, strategies to promote behavior change should be included and investigated in future efforts. Nudging, a low-cost strategy that subtly directs people towards positive behavioral choices, has recently gained attention in global health promotion. Nudge strategies have been applied to a wide range of health-promoting behaviors such as handwashing. To understand which strategies were used, where and how these were applied, and whether these were ethically informed and implemented, we undertook a comprehensive review of the available sources. This resulted in 33 included studies, with a total of 67 nudge strategies for behavior-based prevention and control of NTDs in LMIC. Only two studies targeted NTDs in particular, the other 31 included studies were focused on more general health promoting behaviors, with the majority targeting handwashing with soap. The most common nudge strategies were those targeting decision assistance, such as fostering commitment and reminder actions. In general, the ethical assessment presented favorable results. We identified the need for robust study designs to better understand how nudges can be implemented in the future.Fiona Vande VeldeHans J. OvergaardSheri BastienPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 11 (2021)

Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment

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