Peng Ruotong, Du Yunfei, Chang Jing, Guo Yongzhen, Hu Shaolong, Wan Xiao, Cao Zeng, Feng Hui
Xiangya School of Nursing, Central South University, Changsha, China.
Hebei Normal University, Shijiazhuang, China.
Int J Nurs Stud. 2025 Jan;161:104946. doi: 10.1016/j.ijnurstu.2024.104946. Epub 2024 Oct 28.
Nudge is an attempt to easily and cheaply influence an individual's health judgments, decisions, or behaviors in nuanced and predictable ways. To date, there are no published reviews of the evidence for or against nudges as health promotion strategies in older adults.
This review aims to summarize what is known about the impact of various nudges that target different kinds of health behavior in older adults.
A scoping review.
We conducted a comprehensive search across the PubMed, Web of Science, Embase, EBSCOhost, and the Cochrane Library databases from the earliest available date to March 2024. To gain a broad understanding of this field, we used relevant search terms related to 'nudge' and 'older adult'. All articles selected and data extracted were double-checked. Nudges were summarized and analyzed according to Thaler's dual-systems theory taxonomy.
Overall, 18 articles were selected. Nudges have been applied to reduce overuse in healthcare (n = 7), enhance vaccination uptake (n = 4), raise dietary intake (n = 3), increase physical activity (n = 1), improve lifestyle management (n = 1), improve hand hygiene (n = 1), and improve terminal treatment (n = 1). Twelve nudges were used to promote health for older adults. Type I nudges included environmental cues, reminders, default options, and feedback. Type II nudges were framing, social norms, social comparison, highlighted suggested choices, pre-commitment, accountability justification, expert authority, and gamification. Most, but not all, nudges have proven to be feasible and effective for health promotion among older adults.
This encouraging evidence suggests there is potential for nudges to promote health among older adults. Future research should tailor nudges to individual and cultural characteristics, explore the most effective nudges and long-term effects, expand nudges to more health domains, implement age-friendly digital nudges, and analyze the nursing economics of nudges.
Open Science Framework websites (OSF.IO/PGY25).
助推是一种试图以微妙且可预测的方式轻松且低成本地影响个人健康判断、决策或行为的手段。迄今为止，尚无关于支持或反对将助推作为促进老年人健康策略的证据的已发表综述。
本综述旨在总结关于针对老年人不同类型健康行为的各种助推措施的影响的已知情况。
一项范围综述。
我们从最早可用日期至2024年3月在PubMed、科学网、Embase、EBSCOhost和考科蓝图书馆数据库中进行了全面检索。为了对该领域有广泛的了解，我们使用了与“助推”和“老年人”相关的相关检索词。所有选定的文章和提取的数据都进行了双重核对。根据泰勒的双系统理论分类法对助推措施进行了总结和分析。
总体而言，共选定18篇文章。助推措施已被应用于减少医疗保健中的过度使用（n = 7）、提高疫苗接种率（n = 4）、增加饮食摄入量（n = 3）、增加身体活动（n = 1）、改善生活方式管理（n = 1）、改善手部卫生（n = 1）以及改善临终治疗（n = 1）。有12种助推措施用于促进老年人的健康。第一类助推措施包括环境提示、提醒、默认选项和反馈。第二类助推措施包括框架效应、社会规范、社会比较、突出显示的建议选择、预先承诺、问责理由、专家权威和游戏化。大多数（但并非全部）助推措施已被证明对促进老年人健康是可行且有效的。
这一令人鼓舞的证据表明，助推措施在促进老年人健康方面具有潜力。未来的研究应根据个体和文化特征量身定制助推措施，探索最有效的助推措施及其长期效果，将助推措施扩展到更多健康领域，实施适合老年人的数字助推措施，并分析助推措施的护理经济学。
开放科学框架网站（OSF.IO/PGY25）。
