The (bitter) sweet taste of nudge effectiveness:The role of habits in a portion size nudge, a proof of concept study

Seemingly insignificant daily practices, such as sugar usage in tea, can have a great accumulated impact on societal issues, such as obesity. That is why these behaviours are often the target of nudge interventions. However, when these behaviours are performed frequently they may turn into habits that are difficult to change. The aim of the current study was to investigate whether a portion size nudge has the potential to work in accordance with (instead of against) existing habits. Specifically, it was tested whether a portion size nudge would be more effective in reducing the amount of sugar added to tea, when people have a strong habit of adding a fixed amount of teaspoons of sugar to a cup of tea. The study (N= 123) had a mixed factorial design with teaspoon size (reduced size vs. control) as a within-subject factor, and habit disruption context condition (hot tea vs. cold tea) as a between-subjects factor. A paired t-test indicated that this nudge reduced sugar intake on average by 27% within subjects. When the context allowed for automatic enactment of the habit, the effectiveness of this nudge was moderated by habit strength. Surprisingly, the nudge effect was actually less pronounced when people had a strong habit. Implications for effective nudge interventions are discussed.<br/

Estimating the impact of COVID-19 self-test availability and modifications in test-strategy on overall test uptake using an experimental vignette study

To inform future Dutch COVID-19 testing policies we did an experimental vignette study to investigate whether inclusion of the less reliable lateral flow tests (self-tests) would change test-uptake sufficiently to improve population-level test sensitivity. A representative sample (n = 3,270) participated in a 2-by-2 online experiment to evaluate the effects of test-guidelines including self-testing advice (IV1), and the effects of self-test availability (IV2) on expected test uptake (PCR test, self-test or no test) and sensitivity of the overall test strategy (primary outcome). Across four scenarios, changing test advice did not affect expected testing behaviour. Self-test availability, however, increased the timeliness of testing, the number of people testing, and overall test strategy sensitivity. Based on these findings, we recommend that (national) policy facilitates a supply of self-tests at home, for example through free and pro-active distribution of test-kits during a pandemic. This could substantially enhance the chances of timely detecting and isolating patients

Put a limit on it:The protective effects of scarcity heuristics when self-control is low

Low self-control is a state in which consumers are assumed to be vulnerable to making impulsive choices that hurt long-term goals. Rather than increasing self-control, the current research exploits the tendency for heuristic-based thinking in low self-control by employing scarcity heuristics to promote better consumption choices. Results indicate that consumers low in self-control especially benefited and selected more healthy choices when marketed as “scarce” (Study 1), and that a demand (vs supply) scarcity heuristic was most effective in promoting utilitarian products (Study 2) suggests low self-control involves both an enhanced reward orientation and increased tendency to conform to descriptive norms

Mental health of healthcare workers during the first year of the COVID-19 pandemic in the Netherlands: a longitudinal study

PurposeIn March 2020, the WHO declared COVID-19 a pandemic. Previous virus outbreaks, such as the SARS outbreak in 2003, appeared to have a great impact on the mental health of healthcare workers. The aim of this study is to examine to what extent mental health of healthcare workers differed from non-healthcare workers during the first year of the COVID-19 pandemic.MethodsWe used data from a large-scale longitudinal online survey conducted by the Corona Behavioral Unit in the Netherlands. Eleven measurement rounds were analyzed, from April 2020 to March 2021 (N = 16,615; number of observations = 64,206). Mental health, as measured by the 5-item Mental Health Inventory, was compared between healthcare workers and non-healthcare workers over time, by performing linear GEE-analyses.ResultsMental health scores were higher among healthcare workers compared to non-healthcare workers during the first year of the pandemic (1.29 on a 0–100 scale, 95%-CI = 0.75–1.84). During peak periods of the pandemic, with over 100 hospital admissions or over 25 ICU admissions per day and subsequently more restrictive measures, mental health scores were observed to be lower in both healthcare workers and non-healthcare workers.ConclusionDuring the first year of the COVID-19 pandemic, we observed no relevant difference in mental health between healthcare workers and non-healthcare workers in the Netherlands. To be better prepared for another pandemic, future research should investigate which factors hinder and which factors support healthcare workers to maintain a good mental health

Mental models of the protein shift: Exploring consumers' perceptions of the transition

The protein transition is one of today's major societal challenges to mitigate climate change. To support lasting consumer engagement, it has been suggested to look into consumers' understanding of the protein transition to identify barriers that go beyond the practical issues of changing one's diet. The current study explored consumers' mental models of how the transition unfolds to examine which factors consumers perceive as important drivers of the transition. With a fixed set of factors and actors identified with a questionnaire, Dutch consumers (N = 214) mapped their mental models. The content and structure of the mental models were analyzed with a focus on how consumers perceive their own role. Animal well-being and environmental concerns were most often included as important drivers. The findings showed a lack of consensus about which actor(s) drive the transition (i.e., none of the actors were included by a majority of the participants). This diffusion of responsibility may be a barrier for consumers to act. Moreover, the relative simplicity of the observed mental models suggests that consumers do not yet employ systems thinking. A systems thinking mindset may help consumers understand how the system behind the transition works and how their individual contributions matter. Two avenues to encourage consumer engagement were identified: 1) emphasizing the responsibility of different actors and what consumers can contribute, and 2) encouraging a systems thinking mindset

2 days versus 5 days of postoperative antibiotics for complex appendicitis:a pragmatic, open-label, multicentre, non-inferiority randomised trial

Background: The appropriate duration of postoperative antibiotics for complex appendicitis is unclear. The increasing global threat of antimicrobial resistance warrants restrictive antibiotic use, which could also reduce side-effects, length of hospital stay, and costs. Methods: In this pragmatic, open-label, non-inferiority trial in 15 hospitals in the Netherlands, patients with complex appendicitis (aged ≥8 years) were randomly assigned (1:1) to receive 2 days or 5 days of intravenous antibiotics after appendicectomy. Randomisation was stratified by centre, and treating physicians and patients were not masked to treatment allocation. The primary endpoint was a composite endpoint of infectious complications and mortality within 90 days. The main outcome was the absolute risk difference (95% CI) in the primary endpoint, adjusted for age and severity of appendicitis, with a non-inferiority margin of 7·5%. Outcome assessment was based on electronic patient records and a telephone consultation 90 days after appendicectomy. Efficacy was analysed in the intention-to-treat and per-protocol populations. Safety outcomes were analysed in the intention-to-treat population. This trial was registered with the Netherlands Trial Register, NL5946. Findings: Between April 12, 2017, and June 3, 2021, 13 267 patients were screened and 1066 were randomly assigned, 533 to each group. 31 were excluded from intention-to-treat analysis of the 2-day group and 30 from the 5-day group owing to errors in recruitment or consent. Appendicectomy was done laparoscopically in 955 (95%) of 1005 patients. The telephone follow-up was completed in 664 (66%) of 1005 patients. The primary endpoint occurred in 51 (10%) of 502 patients analysed in the 2-day group and 41 (8%) of 503 patients analysed in the 5-day group (adjusted absolute risk difference 2·0%, 95% CI −1·6 to 5·6). Rates of complications and re-interventions were similar between trial groups. Fewer patients had adverse effects of antibiotics in the 2-day group (45 [9%] of 502 patients) than in the 5-day group (112 [22%] of 503 patients; odds ratio [OR] 0·344, 95% CI 0·237 to 0·498). Re-admission to hospital was more frequent in the 2-day group (58 [12%] of 502 patients) than in the 5-day group (29 [6%] of 503 patients; OR 2·135, 1·342 to 3·396). There were no treatment-related deaths. Interpretation: 2 days of postoperative intravenous antibiotics for complex appendicitis is non-inferior to 5 days in terms of infectious complications and mortality within 90 days, based on a non-inferiority margin of 7·5%. These findings apply to laparoscopic appendicectomy conducted in a well resourced health-care setting. Adopting this strategy will reduce adverse effects of antibiotics and length of hospital stay. Funding: The Netherlands Organization for Health Research and Development.</p

“Don’t Mind If I Do”: The Role of Behavioral Resistance in Self-Control’s Effects on Behavior

High self-control is known to be related to the performance of behaviors that have long-term benefits, such as healthy eating. Recently, studies have suggested that people with high self-control may perform goal-directed behaviors not by exerting effortful control but rather by employing smart, effortless strategies. The current paper investigates the crucial role of behavioral resistance in the relation between self-control and goal-directed behaviors: we propose that people with high self-control feel less resistance toward goal-directed behaviors compared to people with low self-control, and that this is associated with the increased frequency of performing these behaviors. Three cross-sectional studies were conducted in which participants reported on their level of self-control, behavioral resistance toward behaviors in the sustainability, healthy eating, exercise, and study/work domains, and their behavior in those domains. Findings consistently show that the relation between self-control and various behaviors is indeed partially mediated by behavioral resistance, although the study designs preclude establishing causal relations. It is implied that lower resistance makes it easier for people with higher self-control to perform the goal-directed behaviors, without requiring much effort. This notion yields an interesting, novel perspective on how people with high self-control manage to function so well

The Effect of Self-Control on Sleep in Adolescents

Many Americans get insufficient sleep (Sheehan, Frochen, Walsemann, &amp; Ailshire, 2019; Gallup, 2013), and insufficient sleep has been linked to worsened health (Cappuccio, D'Elia, Strazzullo, &amp; Miller, 2010) and educational outcomes (Wolfson &amp; Carskadon, 2003). Recent research suggests that one reason people may get insufficient sleep is that they procrastinate going to bed (Kroese, Evers, Adriaanse, &amp; de Ridder, 2016). This issue has been construed as a self-regulatory failure, and research has demonstrated that fewer self-regulatory resources are associated with greater bedtime procrastination, and subsequently less sleep (Kroese et al., 2016). However, this phenomenon has largely only been investigated in adults. Its prominence and impact has not been assessed in adolescents, even though sleep deficiency is prominent among youth (Wheaton, Jones, Cooper, &amp; Croft, 2018) and may impact important aspects of their lives related to education, health, and well-being (Short, Gradisar, Lack, &amp; Wright, 2013; Smaldone, Honig, &amp; Byrne, 2007). In this study, we seek to investigate how s

What Goals Do Adolescents Have

Everyone has certain goals in life: we may want to get a nice(r) job, lose weight, or save money for a big trip. To be able to reach such goals, people can make use of different strategies. For example, making very specific plans on how and when to go exercising, or calling a friend for social support when you feel the urge to buy those too-expensive shoes. Setting goals and taking steps to attain those goals is particularly important during adolescence, when young people are faced with crucial developmental tasks including finishing their school and finding a job. In this study we will explore what goals young people have, and what strategies they tend to use to work toward their goals. The study is based on a large cohort study in Europe and we want to see how insights from U.S. adolescents compare to our findings in Europe