My Favorite Nudges from Community Health Workers

By: Jack Stevens, PhD, Nationwide Children’s Hospital

During the last three years, I have had the pleasure to learn from community health workers (CHWs) through site visits and virtual webinars. CHWs have shared their innovative “nudging” of clients towards healthy choices. Nudges are brief interventions that encourage recommended activities while respecting clients’ ultimate decisions. Nudges are part of behavioral economics (BE), a scientific field featuring strategies designed to help people make choices consistent with their long-term goals.  Here are four of my favorite nudges from CHWs:

1. Plastic pill boxes. These containers have multiple small compartments which are labeled for specific times and/or days. Clients can transfer pills from prescription bottles to these boxes to organize medications for the upcoming week. Each small compartment serves as a reminder and helps prevent clients from accidentally taking a double dose of a medication. 

2. Paper checklists. While many clients use electronic devices for reminders of daily healthy tasks, other people do not feel comfortable with these forms of technology. Instead, these clients prefer checklists on individual pieces of paper.    

3. Peer comparisons. Learning about the healthy habits of similar people can help convince clients that a particular behavior is important and realistic. Examples of peer comparisons include “Many of my other clients take this type of medication” and “Many others from our community have received a COVID-19 booster.” 

4. Three-way phone calls. Making appointments with clinical providers are often the first steps in improving health and well-being. This scheduling can be made easier through three-way phone calls involving a client, a doctor’s office, and a CHW.  

About the author: Jack Stevens, PhD, is a psychologist with Nationwide Children’s Hospital and a professor at the Ohio State University Department of Pediatrics. He has been part of the team for the CDC-funded COVID Response Grant led by Health Impact Ohio.