Acceptability of nudging in influencing people’s behaviour (the case of food nudge interventions)

Objective: To investigate the perceived acceptability of food nudging interventions among individuals with type 2 diabetes mellitus in the Czech Republic. Design: Mixed-methods study combining a quantitative survey and qualitative expert interviews. Setting: Outpatient and community settings involving patients diagnosed with type 2 diabetes mellitus in the Czech Republic. Method: A survey was conducted with 505 patients assessing the acceptability of 33 different food nudging strategies, supplemented by expert interviews to provide contextual insights and validate the findings. Results: Non-digital nudges, such as product placement and discount incentives, were generally well accepted, whereas digital nudges (e.g. text message reminders) had significantly lower acceptance across all sociodemographic groups. Acceptability varied by gender and age, with women and younger participants showing greater openness to nudging. Experts interpreted the findings and discussed potential mechanisms and contextual conditions under which nudging may influence dietary behaviour. Conclusion: Food nudging appears to be an acceptable behavioural policy tool for patients with type 2 diabetes mellitus, especially in non-digital formats, although its real-world effectiveness still needs empirical verification. This study offers a conceptual model to guide tailored nudging and survey design rather than to explain causal mechanisms. Implementation should remain culturally sensitive, ethically transparent, and respectful of patient autonomy. Future research should assess behavioural responses and long-term health outcomes to determine whether chosen interventions produce sustained improvements beyond short-term acceptability and intention effects.