Nudging is increasingly used in public health interventions in Western societies to produced health-promoting behavior changes; however, there is lack of clarity as to what constitutes a nudge, scant knowledge of the effectiveness of nudging techniques in public health lifestyle interventions and a number of ethical and value-based concerns. The aim of this review is to address these research lacunae and identify the characteristics of nudges in empirical research on public health interventions intended to induce healthy lifestyle changes, including whether they are effective. We conducted systematic searches for relevant articles published between January 2008 and April 2019 in three databases, PubMed, CINAHL and PsycINFO, and combined this with a metasynthesis to construct interpretative explanations. A total of 66 original studies met the inclusion criteria. The findings of the systematic review showed that most nudging interventions involved diet/nutrition, most were carried out as single experiments, and the majority had the intended effects. Specific nudging techniques were identified with respect to the broader nudging categories of accessibility, presentation, using messages and pictures, technology-supported information, financial incentives, affecting the senses, and cognitive loading; several studies included more than one nudging technique. Although many nudging techniques had the intended effects, it is unclear whether they would work outside the study setting. The synthesis revealed that the studies lacked critical reflection on the assumptions about health that were implicit in nudging interventions, the cultural acceptability of nudges, the context-free assumptions of nudging theory, and the implications of these aspects for the public health context.
BackgroundHealth communication research and guidelines often recommend that medical terminology be avoided when communicating with patients due to their limited understanding of medical terms. However, growing numbers of e‐patients use the Internet to equip themselves with specialized biomedical knowledge that is couched in medical terms, which they then share on participatory media, such as online patient forums.ObjectiveGiven possible discrepancies between preconceptions about the kind of language that patients can understand and the terms they may actually know and use, the purpose of this paper was to investigate medical terminology used by patients in online patient forums.DesignUsing data from online patient–patient communication where patients communicate with each other without expert moderation or intervention, we coded two data samples from two online patient forums dedicated to thyroid issues.ResultsPrevious definitions of medical terms (dichotomized into technical and semi‐technical) proved too rudimentary to encapsulate the types of medical terms the patients used. Therefore, using an inductive approach, we developed an analytical framework consisting of five categories of medical terms: dictionary‐defined medical terms, co‐text‐defined medical terms, medical initialisms, medication brand names and colloquial technical terms. The patients in our data set used many medical terms from all of these categories.Discussion and conclusionsOur findings suggest the value of a situated, condition‐specific approach to health literacy that recognizes the vertical kind of knowledge that patients with chronic diseases may have. We make cautious recommendations for clinical practice, arguing for an adaptive approach to medical terminology use with patients.
ObjectiveEmail consultations have become part of everyday doctor–patient communication in many countries. The objective of this study is to investigate how patients and general practitioners (GPs) perceive the communicative advantages and disadvantages of access via email consultation drawing on a media-theoretical perspective.DesignWe analysed qualitative interview data from general practices in Denmark to identify salient themes.ParticipantsOur data set consists of semi-structured interviews with 30 patients and 23 GPs. The data were collected from February 2016 to September 2019.ResultsThe following themes emerged: (1) lower contact threshold, (2) accessing a new interaction space and (3) access to access. From the patients’ perspective, email consultations provided more convenient contact with their GP. From the GPs’ perspective, email consultations facilitated contact with patients whom they otherwise rarely saw, but also resulted in overuse and inappropriate use. Patients and GPs considered email consultations as inviting new interactions, facilitating also communication about emotional and sensitive issues. Both patients and GPs experienced email consultations as a way in which patients could achieve easier access to face-to-face consultations (access to access).ConclusionDrawing on a media perspective, this study adds knowledge of how the potentials of the medium of email consultations are perceived by GPs and patients. Email consultations do not simply extend existing forms of contact and consultation (face-to-face and telephone); they produce a new communication space with its own possibilities which result in new practices. With increasing use of email consultations, there may be challenges involved in transferring GP–patient communication to the written medium.
Email communication is being integrated relatively slowly into doctor-patient communication. Patients have expressed enthusiasm for
This systematic meta-narrative literature review aims to explore the narratives of trust evident in literature on public (mis)trust relating to climate science published up until May 2021, and to present the main findings from these papers. We identified six narratives of trust: attitudinal trust, cognitive trust, affective trust, contingencies of trust, contextual trust and communicated trust. The papers’ main findings spanned theoretical conclusions on the importance of positionality to trust and morality to trustworthiness, to qualitative findings that the scientific community was mainly trusted, to quantitative findings that explored how trust functioned as an independent, dependent or mediating variable. This literature review sheds important light on the interrelationship between climate science and publics, highlights areas for further research, and in its characterisation of trust narratives provides a language for conceptualising trust that can further interdisciplinary engagement.
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