Acceptance of healthy lifestyle nudges in the general population of Singapore Tan et al BMC Public

Tan et al. BMC Public Health (2022) 22:1297

https://doi.org/10.1186/s12889-022-13668-x

RESEARCH

Acceptance of healthy lifestyle nudges

in the general population of Singapore

Yeow Wee Brian Tan1*, Edward Ryan Tan2

, Koh Yen Sin1

, P. V. AshaRani1

, Edimansyah Abdin1

,

Kumarasan Roystonn1

, Peizhi Wang1

, Fiona Devi1

, Janhavi Vaingankar1

, Rob M van Dam3

, Chee Fang Sum4

,

Eng Sing Lee5

, Wai Leng Chow6

, Siow Ann Chong1 and Mythily Subramaniam1,3

Abstract

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 diferent nudges and the socio-demographic char￾acteristics 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 gov￾ernment 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 calcu￾lated for each nudge.

Results: The percentage of respondents who agreed to all statements related to each nudge were: 75.9% (infor￾mation 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 govern￾ment campaigns. Respondents who were 18 – 34 years old (vs 65 years and above), female, of Malay/Indian ethnicity

(vs Chinese), were sufciently 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. Respond￾ents 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 behav￾iours 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

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Background

Leading a healthy lifestyle by engaging in behaviours

such as healthy eating, and regular exercise are well￾established contributors to good health and successful

aging [1]. Nonetheless, developed nations such as Singapore

have seen a marked rise in largely preventable chronic

medical conditions such as hypertension, diabetes,

high total cholesterol, and obesity [2]. Given the multi￾tude of health benefits that adopting a healthy lifestyle

confers, it is unsurprising that there has been greater

focus directed towards promoting healthier lifestyle

Open Access

*Correspondence: [email protected]

1

Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok

Green Medical Park, Singapore 539747, Singapore

Full list of author information is available at the end of the article