How nudges make healthy choices easy at work

“No time” is one of the most common reasons Australians give for not engaging in healthier behaviour, such as more exercise or cooking nutritious meals.

What if you didn’t have to make more time to attend to your health because it was integrated into every working day? 

That’s the potential of “the nudge”. A nudge is a tweak in design that makes healthy choices the easier ones, while preserving our freedom to choose. A simple example is placing fruit, rather than less healthy snacks, at the canteen cash register.

Nudge theory was developed by Richard Thaler, co-author of the influential book Nudge, Improving Decisions About Health, Wealth, and Happiness and the winner of the 2017 Nobel Prize in Economic Sciences. Thaler’s theory is born of behavioural economics, which recognises and takes advantage of the fact that, most of the time, we act out of habit or in response to our environment, rather than due to conscious deliberation.

One example of a nudge that can be used to improve people’s health and wealth is to make the “better” choice, such as participating in a savings plan, the default option. This technique plays on our autopilot tendency to stick with the status quo, because it’s too much bother to change, even for our own good. We are still free, however, to opt out of the savings plan if we truly object to it.

When the Healthier Queensland Alliance piloted its My health for life program for men in a male dominated transport company in mid-2019, it made good use of healthy defaults.

When faced with the common challenge of low rates of engagement, the organisation decided to change participation in the program’s health checks from opt-in to opt-out.

Working with key influencers to make this change, the company increased participation in the program by 20 per cent.

Subtle, everyday nudges

Nudging isn’t a new concept to Katrina Walton, director of Brisbane-based Wellness Designs, a boutique workplace wellness business.

“If a workplace identifies physical activity as a priority, for example, we look at how we can influence a range of workplace factors to make moving easier, and not to simply educate individuals and hope they’ll  change,” Walton says.

She offers the examples of walking or standing meetings, encouraging workers to “walk an email” when possible, moving bins and printers to a distant place in the building, wireless headsets for call centre staff so they can stand and move when taking calls, or making stairwells more attractive. “We had one client who went so far as to make the lifts much slower to deter people from using them,” Walton says.

Policy changes can also help remove barriers to better health.

Walton gives the example of flexible work policies that help workers feel comfortable spending an extra 15 minutes of their lunch on exercise.

Daily work activities that take up much of our time, such as screen-based work, emails and meetings, are particularly good targets for healthy nudges.

Sit-stand desks are proven to reduce prolonged sitting and increase standing. What about computer programs that prompt us to take a stretch? A 2016 Australian study of 57 workers found these computer prompts reduced sedentary behaviour by 8 per cent.

Whether the effects of prompts last longer term is unknown. The pop-ups can become annoying, leading workers to turn them off or ignore them. A defining feature of an ideal nudge is that it is timely and catches us when we are receptive, not mid-stream on an important task.

One company that tackled out-of-hours emails in order to protect its employees’ overnight leisure time was global management consulting firm Boston Consulting Group (BCG). It created a pop-up window to appear whenever managers attempted to send a message after office hours.

Described in BCG’s paper, The Persuasive Power of the Digital Nudge, the message read: “You are trying to send an email to BCG users outside normal office hours. Please choose one of the following options: a) mark email as low priority; b) defer sending until the next business day; c) send email as is; or d) cancel. The nudge was designed to appear at the exact moment managers needed a reminder.

When Anushka Bandara, co-founder of software and app development company Elegant Media, was exploring ways to help his staff thrive, he decided to transform their meetings. “Our meetings were all sitting down, and we would drink lots of coffee,” Bandara says.

After eliciting ideas from staff, Elegant Media implemented stand-up Zoom meetings, often punctuated by stretch breaks. Team members are now required to drink water or herbal teas during meetings, avoid sugar and bring fruit and nuts or other healthy alternatives.

A 2019 meta-analysis found that small, healthy food nudges such as this can reduce daily energy intake by up to 209 kcal, the same number of calories found in 21 cubes of sugar.

Nudges aren’t new. Advertisers and retailers have exploited them for decades to prompt us to buy stuff we don’t need and eat food we’ve resolved to avoid. However, nudges have probably been underutilised by those of us promoting wellbeing at work.

Engaging staff in reviewing the design of their working days and generating ideas for embedding healthy tweaks is likely to generate many simple and inexpensive ways to help us act in our own best interests.

Health by stealth can be simple, cheap and effective

Sticking colourful footprints on a set of stairs prompted a significant increase in stair use over a six-week period, according to one workplace study. When the footprints were removed, stair use decreased again.

Labelling some foods as unhealthy and placing them below eye level in a hospital cafeteria reduced the number of people eating them.

The ideal nudge

Easy: defaults, simplifying messages or removing the hassle factor
Attractive: rewards, recognition, making the healthy option fun
Social: creates networks, encourages accountability buddies
Timely: occurs in a receptive moment when key decisions are being made