Behaviour change presentation
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The document discusses behavior change strategies in various domains, such as health, environment, and social behaviors, emphasizing the 4-E model: Encourage, Enable, Engage, and Exemplify. It highlights the importance of understanding human behavior and leveraging social influences, incentives, and norms to drive change. Additionally, it addresses the role of government in facilitating behavior change and the need for ongoing evaluation and adaptation of strategies.
Behaviour change presentation
- 1. Behaviour Change …art or science? Clive Bates Director General, Sustainable Futures Welsh Assembly Government
- 3. Some relevant areas Post-16 participation Energy efficiency Parenting Transport choices Education/skills Adult literacy Environment Reduce, reuse, recycle Life skills (cooking etc) Consumption choices Volunteering Fly-tipping Drugs, alcohol, tobacco Anti-social behaviour Teenage pregnancy Crime prevention Health Obesity Community Terrorism Keeping appointments Social mobility Organ donation Litter / graffiti Active job seeking Pension provision Service culture Self-care Prosperity Entrepreneurship Care / ageing Mental health Personal aspiration Active ageing Diversity End-of-life choices
- 4. Behaviour change is big money Projected UK health care spending (% GDP public & private, annotations at 2002-3 prices) % GDP 14 US spent About £220 bn 14.6% GDP in over 15 years 2002 (OECD) 12 ke ta £30bn up ow Sl 10 Fully engaged 8 £154bn £96bn 2007-8 6 4 19 78 19 83 19 88 19 93 20 98 20 03 20 13 20 18 20 08 3 -2 - - - - - - - - - 17 77 82 87 92 97 02 07 12 22 19 Source: Wanless, 2002 Securing Our Future Health: Taking A Long-Term View
- 5. 1. Use a simple model that people can remember
- 6. 1. The 4-E approach to behaviour change Taxes & fiscal measures Remove barriers to act Regulation & fines Set defaults / opt-out vs opt-in League tables Form clubs / communities Targets / perf management Provide information Prizes / rewards / bonuses Enable Choose intervention timing Preferential treatment Personalise Status recognition Provide space / facilities Subsidies / discounts Build confidence Feedback Ease/cost of access Encourage Catalyse Engage Community/network action Evidence base Deliberative fora Walk the talk & lead Segmentation / focus Consistency across policies Exemplify Secure commitment Sustained approach Personal contacts Credibility / confidence Role models / 'super-users' Benchmarking / evaluation Paid/unpaid media campaigns Learning & improvement Pester power / Peer pressure Political consensus building Workplace norms
- 7. 4-E approach to behaviour change Taxes & fiscal measures Remove barriers to act Regulation & fines Set defaults / opt-out vs opt-in League tables Form clubs / communities Targets / perf management Provide information Prizes / rewards / bonuses Enable Choose intervention timing Preferential treatment Personalise Status recognition Provide space / facilities Subsidies / discounts Build confidence Feedback Ease/cost of access Encourage Catalyse Engage Community/network action Evidence base Deliberative fora Walk the talk & lead Segmentation / focus Consistency across policies Exemplify Secure commitment Sustained approach Personal contacts Credibility / confidence Role models / 'super-users' Benchmarking / evaluation Paid/unpaid media campaigns Learning & improvement Pester power / Peer pressure Political consensus building Workplace norms
- 8. Some examples using the 4-E framework • Smoking • Drink driving • Recycling
- 9. Smoking prevalence All > age 16 (Britain) 50 45 40 35 30 25 20 15 10 5 0 1975 1980 1985 1990 1995 2000 2005 2010
- 10. Smoking and behaviour change High excise taxes Ban marketing practices NHS 'stop smoking' treatment Address smuggling Smoke-free policies Enable Quit-lines (nb. Personal incentives) Pharmaceutical deregulation Encourage Catalyse Engage Smoke-free policies Social marketing campaigns Clear messages from NHS Exemplify More graphic warnings Consistent package Major news media assault Clear goals Constant revisiting evidence Commercial arguments “Denormalisation”
- 11. But others forces are at work... ...as the force of the A cigarette for the beginner psychological symbolism is a symbolic act. I am no subsides, the longer my mother’s child, pharmacological effects I’m tough, I am an take over to sustain the adventurer, I’m not habit square... Dunn W. Vice President for Research and Development, Philip Norris. Why one smokes. 1968 Minnesota Trial Exhibit 3681.
- 12. Smoking: from the dark side Advertising Orchestrating smuggling Role models Lights Adult product definition Enable Filters Duty Free Wide availability Fighting smoke-free places Encourage Catalyse Engage Aspirational sell to poor Product placement in films Exemplify Coupons and catalogues Sponsorship Coaching arguments Normalisation Distracting PR Bogus science
- 13. Drink driving Reported drink drive accidents and fatalities: GB 1980-2008 1980=100 120 100 80 60 40 Accidents Fatalities 20 0 1980 1985 1990 1995 2000 2005 2010 DFT: Reported Road Casualties Great Britain 2008: Annual Report
- 14. Drink driving Breathalyser Soft drinks normalisation More severe penalties Taxi services & Police enforcement Enable other innovations Driver training as part of penalty Encourage Catalyse Engage Strong sustained 30 year campaign Exemplify media campaign Vilification of politicians No 'nod and wink' Clever segmentation
- 15. Drink driving Reported drink drive accidents and fatalities: GB 1980-2008 1980=100 Rise of Alcopops 60 50 120 40 ml/week per person 30 100 20 10 80 0 1992 1994 1996 1998 2000 2002 2004 2006 60 Seatbelts 40 Compulsory Accidents 1983 Fatalities 20 0 1980 1985 1990 1995 2000 2005 2010 DFT: Reported Road Casualties Great Britain 2008: Annual Report
- 16. Drink driving Reported drink drive accidents and fatalities: GB 1980-2008 1980=100 Decline of breath tests 900 800 120 Number of breath tests (thousand) 700 England and Wales 600 100 500 400 80 300 1992 1994 1996 1998 2000 2002 2004 2006 60 40 Accidents Fatalities 20 0 1980 1985 1990 1995 2000 2005 2010 DFT: Reported Road Casualties Great Britain 2008: Annual Report
- 17. Recycling and behaviour change UK recycling rate Kg per person 200 180 160 140 120 100 80 60 40 20 0 1991-92 1993-94 1995-96 1997-98 1999-00 2001-02 2003-04 2005-06 2007-08
- 18. Recycling and behaviour change Landfill tax Collection services Landfill diversion targets Containers / bags Infraction Enable Sorting Local authorities (difficulties remain) incentive structure changed Encourage Catalyse Engage Common endeavour Government targets No free-riding Money committed Exemplify Waste Awareness SD indicators Long-term view (to 2025) But... controversy and sensitivity
- 19. Organ donation J o h n s o n , E . J . a n d G o l d s t e i n , D . ( 2 0 0 3 ) . D o d e f a u l t s s a v e l i v e s ? S c i e n c e , 3 0 2 : 1 3 3 8– 1 3 3 9 .
- 20. Blood / organ donation Payment? Enable Default (opt out) Encourage Catalyse Engage Exemplify
- 21. Blood money Donors per thousand population 50 40 38.1 30 20 10 7.1 2.3 0 Developed Transition Developing World Health Organisation: Blood Transfusion Safety Unit 2007 data.
- 22. Paying for blood creates poor incentives Percentage of voluntary unpaid blood donations, 2007
- 23. Contracts for exercise Participation in walking programme 100 81 80 60 40 31 20 0 Contract No contract Williams BR, Bezner J, Chesbro SB, Leavitt R. The effect of a behavioral contract on adherence to a walking program in postmenopausal African American women. Top Geriatr Rehab.2005;21(4):332- 342.
- 24. Contracts to create reciprocity Solidarity with others Peer pressure Enable Encourage Catalyse Engage Exemplify Contract & reciprocity
- 25. Teachers Expectations affect Student Outcome Proportion pupils achieving 30 point grade increase 30 25 20 21 “The soft bigotry of low expectations” 15 10 5 5 0 Randomly selected but labelled Control group "High achievers" Rosenthal, Robert & Jacobson, Lenore. Pygmalion in the classroom (1992). Expanded edition. New York: Irvington Quote: attributed to George W Bush
- 26. The Pygmalion Effect Enable Encourage Catalyse Engage Exemplify Expectation setting and belief
- 27. 4-E behaviour change model in use
- 28. 2. Think of people as ‘human’
- 29. 2. Understand human behaviour Rational all-knowing individualised long-term utility maximisation
- 30. MINDSPACE
- 31. MINDSPACE Messenger: We are influenced by who communicates information Incentives: Our responses are shaped by biases and shortcuts Norms: We tend to do what those around us are already doing Defaults: We ‘go with the flow’ of pre-set options
- 32. MINDSPACE Salience: Our attention is drawn to what is novel and seems relevant to us Priming: Our acts are often influenced by sub-conscious cues Affect: Emotional associations can powerfully shape our actions Commitment: We seek to be consistent with our public promises, and reciprocate acts Ego: We act in ways that make us feel better about ourselves
- 33. The Science of Persuasion 6 weapons of influence •Reciprocation: You did something for me and now I owe you •Consistency: One thing I do or think leads to another •Social proof: 9 out of 10 cats prefer... •Liking: I will buy Tupperware from you because I like you •Authority: More doctors smoke Lucky Strike •Scarcity: Get it now, or I’ll be sorry when it’s gone Robert Cialdini, The science of persuasion, Scientific American, 284, 76-81.
- 34. Some “biases” in real behaviour • Loss aversion • Recency It's illogical • Peak experience Captain... • Herding • Heuristics • Omission • Habit • Confirmation • Hyperbolic discounting
- 35. List of cognitive human “biases” Behaviour & Decision- Probability & belief Social making Bandwagon effect Ambiguity effect Actor-observer bias Base rate fallacy Anchoring effect Egocentric bias Bias blind spot Attentional bias Forer effect Choice-supportive bias Authority bias False consensus effect Confirmation bias Availability heuristic Fundamental attribution error Congruence bias Availability cascade Halo effect Contrast effect Belief bias Herd instinct Déformation professionnelle Clustering illusion Illusion of asymmetric insight Denomination effect Capability bias Illusion of transparency Distinction bias Conjunction fallacy Illusory superiority Endowment effect Disposition effect Ingroup bias Experimenter's Gambler's fallacy Just-world phenomenon Extraordinarity bias Hawthorne effect Notational bias Focusing effect Hindsight bias Outgroup homogeneity bias Framing Illusory correlation Projection bias Hyperbolic discounting Ludic fallacy Self-serving bias Illusion of control Neglect of prior base rates effect Self-fulfilling prophecy Impact bias Observer-expectancy effect System justification Information bias Optimism bias Trait ascription bias Interloper effect Ostrich effect Ultimate attribution error Irrational escalation Overconfidence effect Just-world phenomenon Positive outcome bias Loss aversion Pareidolia Mere exposure effect Primacy effect Money illusion Recency effect Moral credential effect Disregard of regression toward the mean. Need for Closure Selection bias Negativity bias Stereotyping Neglect of probability Subadditivity effect Normalcy bias Subjective validation Not Invented Here Telescoping effect Omission bias Texas sharpshooter fallacy Outcome bias Well travelled road effect Planning fallacy Consistency bias Post-purchase rationalization Cryptomnesia Pseudocertainty effect Egocentric bias Reactance Restraint bias False memory Hindsight bias For more information Selective perception Semmelweis reflex Reminiscence bump Rosy retrospection Wikipedia search: Status quo bias Von Restorff effect Self-serving bias Suggestibility “List of cognitive biases” Wishful thinking Zero-risk bias
- 36. 3. Understand the population
- 37. 3. Understand the population
- 38. Use segmentation Willing to act 1: Positive greens I think it’s important that I do as much as I can to limit my 2: Waste watchers impact on the environment. ‘Waste not, want not’ that’s 18% important, you should live life thinking about what you are 3: Concerned consumers doing and using. 12% I think I do more than a lot of people. Still, going away is important, I’d find that hard to give up..well I wouldn’t, so 7: Honestly disengaged carbon off-setting would make Maybe there’ll be an me feel better. 14% environmental disaster, maybe not. Makes no difference to me, I’m just living life the way I 5: Cautious participants want to. 18% I do a couple of things to help the environment. I’d really like to do more, well as long as I saw others were. 14% 4: Sideline supporters 6: Stalled starters I think climate change is a big I don’t know much about problem for us. I know I don’t climate change. I can’t afford think much about how much a car so I use public water or electricity I use, and I transport.. I’d like a car forget to turn things off..I’d like to though. 10% do a bit more. 14% Able to act
- 39. 4. Be careful with the relationship between citizen and state
- 40. 4: Establish the case for intervention “The only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant”. But… Children? Addiction? Influence of background? Mental illness? Collective costs? Regret...?
- 41. From soft paternalism to regulation Public (external) impacts Passive smoking - workers Passive smoking - public Hooking kids Unregulated addiction Health impacts Private impacts
- 42. 5. Adopt a learning approach
- 43. 4+2 Es approach to behaviour change Enable Explore Encourage Catalyse Engage Evaluate Exemplify
- 44. 5. Culture change: self-sustaining behaviour
- 45. Summary 1. Four-E behaviour-change model Encourage Enable Engage Exemplify 2. Understand real behaviour 3. Segment and personalise 4. Judge public acceptability (which changes) 5. Experiment and evaluate
- 46. Reading up... Thaler & Sustein Mark Earls Robert Cialdini Dan Ariely
- 47. Reading up... Government Government Institute for Cabinet Office communications Social Research Government & Cabinet Office