高齢者の行動変容をナッジする

行動経済学研究において高齢者はナッジによるサポートを必要とする集団であることが示唆されるが,高齢者の意思決定を支援するナッジ理論はこれまで十分に開発されているとは言えない。筆者らは,後期高齢者を中心とした住居型コミュニティにおいて,高齢者の技術受容の課題を考慮したタブレット利用環境を構築し,ナッジメッセージがタブレット利用行動にもたらす影響を無作為化比較対照試験にて検証した。具体的にはタブレットの利用を促進する性質の異なる2種類のナッジメッセージ(締切強調・損失強調メッセージ,コミットメントナッジ)を介入とし,介入後16週間を観察期間とした。その結果,それぞれのナッジメッセージの特性に応じた効...

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Published in医療と社会 Vol. 35; no. 1; pp. 81 - 92
Main Authors 山田, ゆかり, 福間, 真悟
Format Journal Article
LanguageJapanese
Published 公益財団法人 医療科学研究所 28.04.2025
Subjects
Online AccessGet full text
ISSN0916-9202
1883-4477
DOI10.4091/iken.35-81

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Abstract 行動経済学研究において高齢者はナッジによるサポートを必要とする集団であることが示唆されるが,高齢者の意思決定を支援するナッジ理論はこれまで十分に開発されているとは言えない。筆者らは,後期高齢者を中心とした住居型コミュニティにおいて,高齢者の技術受容の課題を考慮したタブレット利用環境を構築し,ナッジメッセージがタブレット利用行動にもたらす影響を無作為化比較対照試験にて検証した。具体的にはタブレットの利用を促進する性質の異なる2種類のナッジメッセージ(締切強調・損失強調メッセージ,コミットメントナッジ)を介入とし,介入後16週間を観察期間とした。その結果,それぞれのナッジメッセージの特性に応じた効果が認められたことから,行動経済学における従来の知見が後期高齢者にも適用可能であることが示唆された。また,この効果は男性高齢者によって牽引されたものであったことから,観察されたナッジメッセージの効果はナッジする「行動」の特性に大きく依存したことが示唆された。高齢者の介護予防を目指したナッジを効果的に活用するには,高齢者の視点にたち,関心をひきつける活動をどのように提案するかが重要であり,その上でナッジメッセージを適切に組み込むことで,より高い効果を期待できる。
AbstractList 行動経済学研究において高齢者はナッジによるサポートを必要とする集団であることが示唆されるが,高齢者の意思決定を支援するナッジ理論はこれまで十分に開発されているとは言えない。筆者らは,後期高齢者を中心とした住居型コミュニティにおいて,高齢者の技術受容の課題を考慮したタブレット利用環境を構築し,ナッジメッセージがタブレット利用行動にもたらす影響を無作為化比較対照試験にて検証した。具体的にはタブレットの利用を促進する性質の異なる2種類のナッジメッセージ(締切強調・損失強調メッセージ,コミットメントナッジ)を介入とし,介入後16週間を観察期間とした。その結果,それぞれのナッジメッセージの特性に応じた効果が認められたことから,行動経済学における従来の知見が後期高齢者にも適用可能であることが示唆された。また,この効果は男性高齢者によって牽引されたものであったことから,観察されたナッジメッセージの効果はナッジする「行動」の特性に大きく依存したことが示唆された。高齢者の介護予防を目指したナッジを効果的に活用するには,高齢者の視点にたち,関心をひきつける活動をどのように提案するかが重要であり,その上でナッジメッセージを適切に組み込むことで,より高い効果を期待できる。
Author 山田, ゆかり
福間, 真悟
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References Banerjee S and John P(2021)“Nudge Plus: Incorporating Reflection into Behavioral Public Policy,” Behavioural Public Policy. 1-16.
Huffman D, Maurer R and Mitchell OS(2019)“Time Discounting and Economic Decision-Making in the Older Population,” Journal of the Economics of Ageing. 14(100121):100121.
“Enhancing the Impact of Aging Research for Its Intended Beneficiaries,”(2021)Nature Aging. 1(9):749.
Herrera AP, Snipes SA, King DW, Torres-Vigil I, Goldberg DS and Weinberg AD(2010)“Disparate Inclusion of Older Adults in Clinical Trials: Priorities and Opportunities for Policy and Practice Change,” American Journal of Public Health. 100 Suppl 1(S1):S105-112.
Sheldon KM, Osin EN, Gordeeva TO, Suchkov DD and Sychev OA(2017)“Evaluating the Dimensionality of Self-Determination Theory’s Relative Autonomy Continuum,” Personality & Social Psychology Bulletin. 43(9):1215-1238.
Yamada Y, Uchida T, Ogino M, Ikenoue T, Shiose T and Fukuma S(2020b)“Changes in Older People’s Activities during the Coronavirus Disease 2019 Pandemic in Japan,” Journal of the American Medical Directors Association. 21(10):1387-1388. e1.
Dohmen T, Falk A, Golsteyn BHH, Huffman D and Sunde U(2017)“Risk Attitudes across the Life Course,” Economic Journal(London, England). 127(605):F95-116.
Conci M, Pianesi F and Zancanaro M(2009)“Useful, Social and Enjoyable: Mobile Phone Adoption by Older People” in Human-Computer Interaction - INTERACT 2009, 63-76. Lecture Notes in Computer Science. Berlin, Heidelberg: Springer Berlin Heidelberg.
Fukuma S, Ikenoue T, Yamada Y, Saito Y, Green J, Nakayama T and Fukuhara S(2021)“Changes in Drug Utilization after Publication of Clinical Trials and Drug-Related Scandals in Japan: An Interrupted Time Series Analysis, 2005-2017,” Journal of Epidemiology. 31(7):410-416.
McCreadie C and Tinker A(2005)“The Acceptability of Assistive Technology to Older People,” Ageing and Society. 25(01):91-110.
Yamada Y, Okuda T, Uchida T, Ikenoue T and Fukuma S(2024)“Monitoring Reaction Time to Digital Device in the Very-Old to Detect Early Cognitive Decline,” Npj Aging. 10(1):40.
Murthy VH, Krumholz HM and Gross CP(2004)“Participation in Cancer Clinical Trials: Race-, Sex-, and Age-Based Disparities,” JAMA: The Journal of the American Medical Association. 291(22):2720-2726.
白岩加代子(2017)「地域在住高齢者の行動変容ステージと身体機能の関係」『Japanese Journal of Health Promotion and Physical Therapy』7(2):57-62
介護予防マニュアル改訂委員会編(2012)「行動変容を促す介護予防ケアマネジメントのポイント」『介護予防マニュアル』厚生労働省
Joe J and Demiris G(2013)“Older Adults and Mobile Phones for Health, A Review,” J. Biomedical Informatics. 45(5):947-954.
Rony MKK, Parvin MR, Wahiduzzaman M, Akter K and Ullah M(2024)“Challenges and Advancements in the Health-Related Quality of Life of Older People,” Advances in Public Health. 2024(1):1-18.
Morse AN, Labin LC, Young SB, Aronson MP and Gurwitz JH(2004)“Exclusion of Elderly Women from Published Randomized Trials of Stress Incontinence Surgery,” Obstetrics and Gynecology. 104(3):498-503.
Yamada Y, Uchida T, Shiose T, Ikenoue T, Kusunoki M, Kuwata C, Tatsumi A and Fukuma S(2020a) “Learning Health System in a Senior Retirement Community: A Platform to Promote Implementation Research,” Gerontology and Geriatric Medicine. 6(3):1-6.
柴田祥江(2018)「高齢者の夏期室内温熱環境実態と熱中症対策」『日本生気象学会雑誌』55(1):33-50
Davis FD, Bagozzi RP and Warshaw PR(1989)“User Acceptance of Computer Technology: A Comparison of Two Theoretical Models,” Management Science. 35(8):982-1003.
Dhruva SS and Redberg RF(2008)“Variations between Clinical Trial Participants and Medicare Beneficiaries in Evidence Used for Medicare National Coverage Decisions,” Archives of Internal Medicine. 168(2):136-140.
Buttgereit T, Palmowski A, Forsat N, Boers M et al.(2021)“Barriers and Potential Solutions in the Recruitment and Retention of Older Patients in Clinical Trials-Lessons Learned from Six Large Multicentre Randomized Controlled Trials,” Age and Ageing. 50(6):1988-1996.
Fukuma S, Sasaki S, Taguri M, Goto R, Misumi T, Saigusa Y and Tsugawa Y(2022)“Effect of Nudge-Based Intervention on Adherence to Physician Visit Recommendations and Early Health Outcomes among Individuals Identified with Chronic Kidney Disease in Screens,” Journal of the American Society of Nephrology:JASN 33(1):175-185.
Chung JE, Park N, Wang H, Fulk J and McLaughlin M(2010)“Age Differences in Perceptions of Online Community Participation among Non-Users: An Extension of the Technology Acceptance Model,” Computers in Human Behavior. 26(6):1674-84.
Deci EL, Olafsen AH and Ryan RM(2017)“Self-Determination Theory in Work Organizations: The State of a Science,” Annual Review of Organizational Psychology and Organizational Behavior. 4(1):19-43.
Yamada Y, Uchida T, Sasaki S, Taguri M, Shiose T, Ikenoue T and Fukuma S(2023)“Nudge-Based Interventions on Health Promotion Activity Among Very Old People: A Pragmatic, 2-Arm, Participant-Blinded Randomized Controlled Trial,” Journal of the American Medical Directors Association. 24(3):390-394.e5.
Mori Y, Mizuno A and Fukuma S(2024)“Low On-Treatment Blood Pressure and Cardiovascular Events in Patients without Elevated Risk: A Nationwide Cohort Study,” Hypertension Research: Official Journal of the Japanese Society of Hypertension. 47(6):1546-1554.
岡浩一朗(2000)「行動変容のトランスセオレティカル・モデルに基づく運動アドヒレンス研究の動向」『体育学研究』45(4):543-561
Hall S, Longhurst S and Higginson IJ(2009)“Challenges to Conducting Research with Older People Living in Nursing Homes,” BMC Geriatrics. 9(1):38.
Dibartolo MC and McCrone S(2003)“Recruitment of Rural Community-Dwelling Older Adults: Barriers, Challenges, and Strategies,” Aging & Mental Health. 7(2):75-82.
Marteau TM, Ogilvie D, Roland M, Suhrcke M and Kelly MP(2011)“Judging Nudging: Can Nudging Improve Population Health?” BMJ. 342(jan25 3):d228-d228.
Sakoi N, Mori Y, Tsugawa Y, Tanaka J and Fukuma S(2024)“Early-Stage Chronic Kidney Disease and Related Health Care Spending,” JAMA Network Open. 7(1):e2351518.
Forsat ND, Palmowski A, Palmowski Y, Boers M and Buttgereit F(2020)“Recruitment and Retention of Older People in Clinical Research: A Systematic Literature Review,” Journal of the American Geriatrics Society. 68(12):2955-2963.
References_xml – reference: Yamada Y, Uchida T, Sasaki S, Taguri M, Shiose T, Ikenoue T and Fukuma S(2023)“Nudge-Based Interventions on Health Promotion Activity Among Very Old People: A Pragmatic, 2-Arm, Participant-Blinded Randomized Controlled Trial,” Journal of the American Medical Directors Association. 24(3):390-394.e5.
– reference: Dibartolo MC and McCrone S(2003)“Recruitment of Rural Community-Dwelling Older Adults: Barriers, Challenges, and Strategies,” Aging & Mental Health. 7(2):75-82.
– reference: McCreadie C and Tinker A(2005)“The Acceptability of Assistive Technology to Older People,” Ageing and Society. 25(01):91-110.
– reference: Banerjee S and John P(2021)“Nudge Plus: Incorporating Reflection into Behavioral Public Policy,” Behavioural Public Policy. 1-16.
– reference: 柴田祥江(2018)「高齢者の夏期室内温熱環境実態と熱中症対策」『日本生気象学会雑誌』55(1):33-50
– reference: Dohmen T, Falk A, Golsteyn BHH, Huffman D and Sunde U(2017)“Risk Attitudes across the Life Course,” Economic Journal(London, England). 127(605):F95-116.
– reference: Sheldon KM, Osin EN, Gordeeva TO, Suchkov DD and Sychev OA(2017)“Evaluating the Dimensionality of Self-Determination Theory’s Relative Autonomy Continuum,” Personality & Social Psychology Bulletin. 43(9):1215-1238.
– reference: Morse AN, Labin LC, Young SB, Aronson MP and Gurwitz JH(2004)“Exclusion of Elderly Women from Published Randomized Trials of Stress Incontinence Surgery,” Obstetrics and Gynecology. 104(3):498-503.
– reference: Conci M, Pianesi F and Zancanaro M(2009)“Useful, Social and Enjoyable: Mobile Phone Adoption by Older People” in Human-Computer Interaction - INTERACT 2009, 63-76. Lecture Notes in Computer Science. Berlin, Heidelberg: Springer Berlin Heidelberg.
– reference: Fukuma S, Ikenoue T, Yamada Y, Saito Y, Green J, Nakayama T and Fukuhara S(2021)“Changes in Drug Utilization after Publication of Clinical Trials and Drug-Related Scandals in Japan: An Interrupted Time Series Analysis, 2005-2017,” Journal of Epidemiology. 31(7):410-416.
– reference: Murthy VH, Krumholz HM and Gross CP(2004)“Participation in Cancer Clinical Trials: Race-, Sex-, and Age-Based Disparities,” JAMA: The Journal of the American Medical Association. 291(22):2720-2726.
– reference: 介護予防マニュアル改訂委員会編(2012)「行動変容を促す介護予防ケアマネジメントのポイント」『介護予防マニュアル』厚生労働省
– reference: Davis FD, Bagozzi RP and Warshaw PR(1989)“User Acceptance of Computer Technology: A Comparison of Two Theoretical Models,” Management Science. 35(8):982-1003.
– reference: Forsat ND, Palmowski A, Palmowski Y, Boers M and Buttgereit F(2020)“Recruitment and Retention of Older People in Clinical Research: A Systematic Literature Review,” Journal of the American Geriatrics Society. 68(12):2955-2963.
– reference: Joe J and Demiris G(2013)“Older Adults and Mobile Phones for Health, A Review,” J. Biomedical Informatics. 45(5):947-954.
– reference: Yamada Y, Uchida T, Ogino M, Ikenoue T, Shiose T and Fukuma S(2020b)“Changes in Older People’s Activities during the Coronavirus Disease 2019 Pandemic in Japan,” Journal of the American Medical Directors Association. 21(10):1387-1388. e1.
– reference: Marteau TM, Ogilvie D, Roland M, Suhrcke M and Kelly MP(2011)“Judging Nudging: Can Nudging Improve Population Health?” BMJ. 342(jan25 3):d228-d228.
– reference: Dhruva SS and Redberg RF(2008)“Variations between Clinical Trial Participants and Medicare Beneficiaries in Evidence Used for Medicare National Coverage Decisions,” Archives of Internal Medicine. 168(2):136-140.
– reference: Yamada Y, Okuda T, Uchida T, Ikenoue T and Fukuma S(2024)“Monitoring Reaction Time to Digital Device in the Very-Old to Detect Early Cognitive Decline,” Npj Aging. 10(1):40.
– reference: Hall S, Longhurst S and Higginson IJ(2009)“Challenges to Conducting Research with Older People Living in Nursing Homes,” BMC Geriatrics. 9(1):38.
– reference: Buttgereit T, Palmowski A, Forsat N, Boers M et al.(2021)“Barriers and Potential Solutions in the Recruitment and Retention of Older Patients in Clinical Trials-Lessons Learned from Six Large Multicentre Randomized Controlled Trials,” Age and Ageing. 50(6):1988-1996.
– reference: Rony MKK, Parvin MR, Wahiduzzaman M, Akter K and Ullah M(2024)“Challenges and Advancements in the Health-Related Quality of Life of Older People,” Advances in Public Health. 2024(1):1-18.
– reference: 白岩加代子(2017)「地域在住高齢者の行動変容ステージと身体機能の関係」『Japanese Journal of Health Promotion and Physical Therapy』7(2):57-62
– reference: Chung JE, Park N, Wang H, Fulk J and McLaughlin M(2010)“Age Differences in Perceptions of Online Community Participation among Non-Users: An Extension of the Technology Acceptance Model,” Computers in Human Behavior. 26(6):1674-84.
– reference: Yamada Y, Uchida T, Shiose T, Ikenoue T, Kusunoki M, Kuwata C, Tatsumi A and Fukuma S(2020a) “Learning Health System in a Senior Retirement Community: A Platform to Promote Implementation Research,” Gerontology and Geriatric Medicine. 6(3):1-6.
– reference: Huffman D, Maurer R and Mitchell OS(2019)“Time Discounting and Economic Decision-Making in the Older Population,” Journal of the Economics of Ageing. 14(100121):100121.
– reference: 岡浩一朗(2000)「行動変容のトランスセオレティカル・モデルに基づく運動アドヒレンス研究の動向」『体育学研究』45(4):543-561
– reference: “Enhancing the Impact of Aging Research for Its Intended Beneficiaries,”(2021)Nature Aging. 1(9):749.
– reference: Fukuma S, Sasaki S, Taguri M, Goto R, Misumi T, Saigusa Y and Tsugawa Y(2022)“Effect of Nudge-Based Intervention on Adherence to Physician Visit Recommendations and Early Health Outcomes among Individuals Identified with Chronic Kidney Disease in Screens,” Journal of the American Society of Nephrology:JASN 33(1):175-185.
– reference: Deci EL, Olafsen AH and Ryan RM(2017)“Self-Determination Theory in Work Organizations: The State of a Science,” Annual Review of Organizational Psychology and Organizational Behavior. 4(1):19-43.
– reference: Herrera AP, Snipes SA, King DW, Torres-Vigil I, Goldberg DS and Weinberg AD(2010)“Disparate Inclusion of Older Adults in Clinical Trials: Priorities and Opportunities for Policy and Practice Change,” American Journal of Public Health. 100 Suppl 1(S1):S105-112.
– reference: Mori Y, Mizuno A and Fukuma S(2024)“Low On-Treatment Blood Pressure and Cardiovascular Events in Patients without Elevated Risk: A Nationwide Cohort Study,” Hypertension Research: Official Journal of the Japanese Society of Hypertension. 47(6):1546-1554.
– reference: Sakoi N, Mori Y, Tsugawa Y, Tanaka J and Fukuma S(2024)“Early-Stage Chronic Kidney Disease and Related Health Care Spending,” JAMA Network Open. 7(1):e2351518.
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Snippet 行動経済学研究において高齢者はナッジによるサポートを必要とする集団であることが示唆されるが,高齢者の意思決定を支援するナッジ理論はこれまで十分に開...
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SubjectTerms IoT
ナッジ
後期高齢者
技術受容
行動変容
Title 高齢者の行動変容をナッジする
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