The Use of Nudging for Primary Prevention: A Review and Perspectives for Germany

Nudging as a means of influencing human behaviour has received increasing attention by policy makers, including those in the field of public health. Nudges are generally understood as specific aspects of a choice architecture that make certain behaviours more likely to occur without mandating them through binding rules, and without relying on economic incentives. Following the example of the United States and Great Britain, the German government has established a working group tasked with advising the federal government on the use of nudging and other behavioural interventions in policy making. The working group's inception in February 2015 inspired a lively public debate. While numerous opportunities for the use of nudging in primary prevention and health promotion in Germany exist, the concept has not yet been widely used in practice. We discuss the basic theoretical concepts of nudging, relating the underlying ideas to the terminology used in prevention and health promotion. In addition, we present typologies and practical examples for nudging interventions, and discuss criticisms raised in the academic and public debate. Finally, we discuss implications for research and policy, highlighting how nudging and related approaches can be used to strengthen primary prevention in Germany.