DOI: 10.1111/idh.70144 ISSN: 1601-5029

Evaluation of an EAST Nudge‐Based Oral Health Promotion Leaflet for Workers: A Six‐Month Randomized Controlled Trial

Masaki Takebayashi, Tatsuya Koyama, Yudai Kaneda, Satoru Kanamori, Kiyonobu Kawano, Asako Miyake, Kurenai Takebayashi, Hiroshi Fukuda

ABSTRACT

Objectives

Some workers procrastinate oral care because of cognitive biases and nudges have been proposed as useful interventions to address this problem. This study, a randomized controlled trial, evaluated workers' oral care behaviours 6 months after an Easy–Attractive–Social–Timely ( EAST ) nudge‐based leaflet was distributed.

Methods

Participants were recruited and surveyed online, whereas the intervention leaflet was delivered by postal mail. Participants in the control group received a text‐based leaflet providing detailed information on oral care. Participants in the nudge group received a nudge‐based leaflet. The persuasive text was shortened by more than 70% compared with the control leaflet (easy nudge), incorporated a narrative comic to elicit peer‐related behaviours (attractive and social nudges), and featured a cover designed to prompt immediate reading (timely nudge). The outcomes were changes in oral self‐care, self‐monitoring, professional preventive care, stages of behavioural change, and health literacy, measured using established assessment scales.

Results

In the intention‐to‐treat analysis, 119 participants in the nudge group and 120 in the control group were analysed. No significant between‐group differences were observed for any outcome, including improvement in oral self‐care frequency (18.5% vs. 13.3%, respectively; p  = 0.147).

Conclusions

This is one of the few randomized controlled trials reporting non‐significant findings on oral health nudges, suggesting that an EAST ‐based leaflet may have limitations in sustaining long‐term behaviour change in this setting. Options for future interventions may include using the EAST ‐based leaflet in different contexts, such as a supplementary resource during face‐to‐face health education sessions.

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