Desludging Elicits Less Opposition Than Nudging.

Area of Science:

• Public health
• Behavioral science
• Health policy

Background:

• Many Americans are not up-to-date with colorectal cancer screening.
• Two intervention types exist: nudging (e.g., default appointments) and de-sludging (removing barriers).
• Public attitudes toward de-sludging are largely unknown, unlike nudging, which has faced controversy.

Purpose of the Study:

• To compare public perceptions of nudging versus de-sludging interventions for colorectal cancer screening.
• To determine if opposition and negative perceptions differ between nudging and de-sludging.
• To assess if political affiliation influences these perceptions.

Main Methods:

• A randomized cross-sectional survey of 8,735 U.S. residents.
• Participants were randomized to view one of ten intervention descriptions (five nudging, five de-sludging).
• Data collected and analyzed between 2023-2024.

Main Results:

• Nudging interventions were more frequently associated with opposition compared to de-sludging.
• Nudging also elicited greater perceived ineffectiveness and threats to freedom.
• These findings were consistent across different political affiliations.

Conclusions:

• Public support appears higher for de-sludging interventions compared to nudging.
• Prioritizing de-sludging may be a more effective strategy for increasing colorectal cancer screening uptake.
• Intervention design should consider public acceptance and perceived autonomy.