Nudging for Social Change : An Analysis of Nudge Theory in Communication strategies of the Public Health Initiative — Swachh Bharat Mission-Gramin, in Rural Tamil Nadu

Abstract This study explores the use of nudge theory, or nudges, in the IEC (Information Education Communication) part of SBM-G (Swachh Bharat Mission - Gramin) in rural Tamil Nadu, India. The study takes a multi-method qualitative approach, using qualitative content analysis to analyse IEC materials from Phase 1 and Phase 2 of SBM-G with a cross-disciplinary background drawn from social science, global health, behavioural science, and communication studies. The analysis focuses on revealing key themes and nudge principles in message framing and design. Furthermore, perspectives from individuals engaged with or affected by SBM-G will also be included through reflective narrative inputs to gain in-depth contextual understanding. Nudge-based strategies have received growing interest in tackling public health challenges, especially in the context of reducing open defecation (OD). This study highlights how culturally grounded nudges, guided by nudge theory and the Theory of Public Theory (TPB), are informed by tenets of participatory theory and can effectively initiate sanitation behaviour change, especially when integrated with broader SBCC strategies. While nudges prompt initial adoption, sustained change requires follow-up support, community engagement, and systemic infrastructure. Trust in authority figures enhances message delivery but can suppress local voices. Sociocultural sensitivity, ethical considerations, and intersectionality (e.g., caste, gender, education) critically shape outcomes. This study will advance the understanding of effective, community-based health communication strategies by investigating how the integration of nudge theory into SBM-G IECs can improve participatory methods for sustainable health equity.