Table 4 Details of the Nudge Intervention Strategies Used in Each Study
Study | MINDSPACE Framework Factor | Digital Nudge | Heuristic-Systematic Model | Was the Intervention Effective? | |
|---|---|---|---|---|---|
Specific Strategy | Keywords | ||||
[20] | Messenger | An expert health professional provides participants with information about the risk of breast cancer based on the questions they ask | Information provided by professional | System 2 | Yes |
Defaults | A letter was sent to each participant describing the study and providing a number they could call to indicate unwillingness to participate | Opt-out available | System 1 | ||
Defaults | A personalized and tailored email is sent to all intervention group participants each month through a systematic reminder | Automatic reminder | System 1 | ||
Salience | New content has been highlighted on the homepage of the website, where participants are presented with a new breast cancer-related “Tip of the Day” each time they log on to the website | Highlighting information | System 1 | ||
Priming | Message framing has been altered to describe verbal messages related to breast cancer intended to increase participants’ cognitive knowledge about breast health and reduce cancer concerns. For example: • “Approximately 90% of females will never develop breast cancer.” • “Most women diagnosed with breast cancer survive beyond five years after diagnosis.” • “Heart disease causes more than eight times as many deaths as breast cancer.” • “Early detection significantly improves breast cancer treatment rates.” | Message framing | System 1 | ||
Salience | A visual presentation of the results of the risk prediction was given to the participants through the use of precise figures and illustrative graphs | Figures and graphs | System 1 | ||
Affect | Participants can access the website to view “personal stories” of different women who share their experiences with breast cancer risk | Share personal stories | System 1 | ||
[32] | Affect | African American women shared firsthand narratives to persuade participants to reconsider health beliefs that may negatively affect adherence to mammography screening | Share personal stories | System 1 | Yes |
Commitments | Participants were encouraged to take a “breast health pledge” based on the data they provided in the baseline survey. For instance, a participant who had never undergone mammography pledged to schedule one in the coming months | Health pledge | System 2 | ||
[33] | Messenger | Four women representing different demographic profiles were chosen to deliver intervention messages | Women with different characteristics | System1 | No |
Defaults | Eligible women received a letter explaining the study and were given the opportunity to call a toll-free number within two weeks if they preferred not to be contacted | Opt-out available | System 1 | ||
Salience | The DVD presented video and other visual representations when delivering the message | Different visual manifestations | System 1 | ||
[34] | Incentives | Participants received a $20.00 gift certificate at each data collection time point | Getting the prize | System 2 | Yes |
Defaults | Prior to contacting women, introductory letters were mailed, explaining the study and providing an opt-out opportunity through returning a postage-paid postcard or calling a toll-free number | Opt-out available | System 1 | ||
Defaults | The web-based program reinforces the fact that colorectal cancer can happen to anyone by automatically delivering messages to women who are not aware of the personal risk of colorectal cancer or the benefits of screening, and that screening identifies cancer early when treatment is most successful | Automatic reminder | System 1 | ||
[35] | Defaults | Women who had not opted out by 2 weeks were called by the survey center and if they expressed interest | Opt-out available | System 1 | Yes |
Salience | A web-based program featured a talk show format | Talk show (loanword) | System 1 | ||
[36] | Messenger | A health navigator assessed participants’ knowledge and barriers related to screening to provide information about the benefits of breast cancer screening, as well as information about traveling to the clinic if necessary | Health navigator | System 2 | Yes |
[37] | Incentives | Participants received a $20 incentive for each survey completion | Getting the prize | System 2 | No |
[21] | Incentives | The cost of mammography was covered, with no co-pay or out-of-pocket funds | Provides free screening | System 1 | No |
Defaults | Those who preferred not to be contacted could opt out by calling a toll-free number within two weeks of receiving the letter | Opt-out available | System 1 | ||
Salience | All women viewed an animation illustrating the development and spread of breast cancer throughout the body, demonstrating metastasis | Broadcasts animation | System 1 | ||
Messenger | The DVD began with a narrator introducing the program. Four women characters representing different demographic profiles, including an African American woman, delivered the intervention messages | Women with different characteristics | System 1 | ||
[41] | Messenger | A health navigator was available to assist with navigating cancer screening information, addressing technical problems, and providing transportation and interpretation services | Health navigator | System 2 | Yes |
Incentives | Each participant received US $20 for each face-to-face interview, plus US $20 reimbursement for text message data fees over the 6-month intervention period | Getting the prize | System 2 | ||
Incentives | Regardless of whether a participant answered a knowledge question correctly, she received a digital pink ribbon and collected these ribbons throughout the intervention in exchange for rewards | Getting the prize | System 2 | ||
Incentives | A website was created containing a list of area clinics, highlighting those offering free or discounted mammograms | Provides free screening | System 1 | ||
Priming | Motivational statements such as, “Call today for an appointment!” were included | Motivational statements | System 1 | ||
Affect | Korean American women shared their personal experiences with mammogram screening, including how they handled issues related to their cultural beliefs | Share personal stories | System 1 | ||
Defaults | An embedded GPS navigation system provided participants with directions and distances from their residence to their clinic of choice | Automatic reminder | System 1 | ||
Salience | A website was created containing a list of area clinics, highlighting those offering free or discounted mammograms | Highlighting information | System 1 | ||
[39] | Defaults | Patients who did not call to opt-out were contacted by a recruiter who explained the study | Opt-out available | System 1 | No |
Salience | The program presented an animation to illustrate the anatomy and physiology of the colon and the development of colorectal cancer from polyps | Broadcasts animation | System 1 | ||
[40] | Incentives | All participants received $25 for attending the visit, and those completing the 6-month survey received an additional $25 | Getting the prize | System 2 | No |
Defaults | Patients who did not call and decline were telephoned within 2 weeks by staff and invited to enroll in the study | Opt-out available | System 1 | ||
Norms | The program introduced two friends discussing a mutual friend who had recently been diagnosed with colorectal cancer. The two friends were stage-matched to the study participant, with one friend being in the same stage as the participant and the other being one stage ahead | Peer comparison | System 1 | ||
Messenger | The DVD began with a narrator introducing the program. Four women characters representing different demographic profiles, including an African American woman, delivered the intervention messages | Women with different characteristics | System 1 | ||
[30] | Messenger | The interactive tailored DVD’s narrative theme was a doctor’s house call to discuss ways to maintain good health, specifically through colon cancer screening | Information provided by professional | System 1 | Yes |
Messenger | Two survivors of colorectal cancer provided testimonials highlighting the benefits, despite not thinking they were at risk for the disease, like many people | Cancer survivors | System 1 | ||
Defaults | For patients who cannot attend their screening appointment, they need to call the Endoscopy department to make a change or cancel | Opt-out available | System 1 | ||
Affect | Two survivors of colorectal cancer provided testimonials highlighting the benefits, despite not thinking they were at risk for the disease, like many people | Personal experience | System 1 | ||
[38] | Incentives | Participants were reimbursed with a $20 gift card and mailed an additional $20 gift card after completion of the follow-up survey | Getting the prize | System 2 | Yes |
Incentives | The study paid for a fecal immunochemical test and colonoscopies to remove the cost, a major barrier to access to screening | Provides free screening | System 2 | ||
[31] | Messenger | Assistance to participants in capturing screening-related information through lay health advisors | Lay health advisors | System 1 | Yes |
Incentives | Each participant received a $25 gift certificate after completing each survey | Getting the prize | System 2 | ||
Incentives | Participants received more accessible services, including referrals for low-cost or free mammograms | Provides free screening | System 1 | ||
Incentives | Availability of transportation assistance to participants, including free bus passes and referrals to relevant agencies | Provides transportation assistance | System 1 | ||