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A Nudge in the Right Direction

Alison Ziemianski
October 23, 2018



Handwashing with soap is a behavior that is often done out of habit and is widely recognized as being the most effective way to prevent the spread of infectious disease. Yet approximately 33% of people don’t use soap when washing their hands, and only about 5% of people wash their hands correctly (1). So how do we tackle the ongoing challenge of changing handwashing behaviors? Awareness, knowledge, and understanding of risk factors related to the risks associated with not washing your hands are generally widely understood, so what other behavior influencing tactics are there that might be more effective?


As the saying goes sometimes you just need a nudge in the right direction.


A nudge uses positive reinforcement and indirect suggestions as ways to influence behavior and decision making. Providing subtle hints and alterations to the environment a nudge can have significant behavioral effects. In the case of improving hand hygiene behaviors successful nudges are often simple to implement and are easily noticed. One study showed that visitor use of hand sanitizer increased from 3% to 67% when brightly colored hand sanitization stations that provided concise messaging about the importance of hand sanitizer were set up in easily accessible locations (2).

Generally applied to influence behavior a nudge makes it more likely that an individual will make a choice or behave in a particular way. Nudges do not provide new information or incentives, but are a combination of strategic design, product placement, and visual cues. When the presence of soap is not enough of a nudge to wash your hands how do you decide what will be?


How to Nudge?


To determine which types of nudges will be most effective in influencing hand washing in your facility first consider the user. Nudges used for primary school students may differ from those in a shopping mall, or in an office building, or within a hospital and should take into consideration the following.


  • What products need to be in place for users to wash and dry their hands properly?
  • Location and visibility of handwashing stations, do users have to go out of their way to access them, are they opposite the entrance or exit?
  • Accessibility, can all users interact with the handwashing station?
  • What will stand out and catch the attention of your desired audience? Consideration of colors, styles, and messages should be appropriate and eye catching.
  • Most importantly a nudge should be simple, clearly understandable, and actionable without conscious interpretation.

Considerations also include cost, durability, and complexity of the nudge.


Small Doable Actions


Being in a rush, facility layout, general cleanliness, and product availability at a hand wash station are just a few reasons why someone who is in the habit of washing their hands may not do so. Habits are behaviors triggered unconsciously by cues in our environment. A nudge is a tool that leads to small doable action that encourages people to shift to a desired behavior.


Implemented alone nudges are not enough to change behavior but should be considered as part of a program to increase and improve hand washing compliance. Simply put nudges are strategic suggestions that can trigger an automatic behavior and are best used to complement approaches based on knowledge, understanding of risk, social norms, and emotional drivers.


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