Designing NUDGE-based interventions for people with excess alcohol drinking: a proof of concept study

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Background Alcohol Use Disorder (AUD) is a major public health issue linked to over 200 medical conditions and driven by complex cognitive, affective, behavioral, and socioeconomic factors. We used a novel “Nudgeathon” approach, based on MINDSPACE behavioral theory, to design targeted interventions for AUD by utilising liver stiffness results to promote change in high-risk drinking behaviours. Methods This study reports on "Nudgeathon," a one-day, collaborative multidisciplinary workshop designed to identify behaviour-change strategies with the potential to enhance AUD management using the MINDSPACE framework. With the intention of combining liver stiffness test results with subtle behavioural nudges, the event brought together stakeholders—healthcare professionals, behavioural scientists, and patients—to co-design prototypes aimed at reducing harmful alcohol consumption without restricting choice. The APPEASE criteria were used to evaluate intervention feasibility based on affordability, practicability, effectiveness, acceptability, safety, and equity. Results In the Nudgeathon, an experienced behavioural scientist introduced participants to behavioural change theories such as the MINDSPACE framework as a guide to design interventions for AUD. Diverse stakeholder groups collaborated to design digital “nudges,” including a liver icon that changes colour based on liver stiffness data to highlight alcohol’s impact. Facilitated by behavioural scientists, these groups developed descriptions of prototype interventions to encourage recovery behaviours. The APPEASE criteria were applied to evaluate the feasibility, resource needs, and potential population impact. Challenges identified through the Nudgeathon included technical requirements for data processing and effective patient communication, especially given the digital format of our planned interventions. Conclusions The Nudgeathon approach leverages behavioural science and digital tools to encourage healthier alcohol-related behaviours, focusing on environmental and psychological cues rather than individual willpower. This method may enhance traditional AUD treatments and engage patients non-responsive to standard recovery. Further research is needed to implement and confirm the effectiveness of the prototype interventions that were identified.

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