Can behavioural science nudge us into positive action?

An Applied Behavioural Science (ABS) event held at The London School of Economics (LSE) recently delved into how small behavioural changes can bring major benefits to our community. Here are the snapshots from the event:

Rajeev Budhiraja

Senior Advisor to Middle East Communications Network (MCN), and former founding equity partner and CEO of various McCann agencies in the region; Promoseven 360, MRM, McCann Health, and DRAFT

Rajeev Budhiraja, a Dubai-based veteran advertising professional, obtained a postgraduate degree in behavioural sciences from the London School of Economics and Political Science (LSE) this summer and became a champion of bringing about changes to serve society.

During his 30 years in advertising, Budhiraja was overcome with a pertinent thought: what good is advertising doing for the wider community? And to what extent is it positively changing behaviour on critical issues like the environment, lifestyle diseases, religious and political extremism, gender inequality etc.?

A superficial investigation led him to conclude that information imparted through advertising raised awareness but was not enough to change long-term behaviour. To influence positive habit formation, information plus was required. The desire to seek this last mile led Budhiraja to pursue the study of Behavioural Sciences at LSE.

Unfortunately, due to Covid-19 and travel restrictions, the batchmates could not meet in person. Further, there was an interest to see how the academic principles could be applied in the real world, which was the germinal and seminal thought behind the inaugural edition of Applied Behavioural Science (ABS) held in London from July 18 to 21.

A group of student volunteers led by Budhiraja put the event together, and a gala dinner at the House of Commons was a fitting finale to the four-day symposium.

The event featured 26 eminent speakers, including renowned academics from LSE, Yale, University College London, Ashoka University, Cambridge & Warwick, civil servants, and private sector practitioners from banking, market research & consultancy.

There was a significant presence of speakers from the Middle East and our wider region.

The challenges tackled were diverse, such as reducing missed doctor appointments in Israel and litter woes in Qatar, improving infant nutrition in India, and increasing Covid-19 vaccine uptake in Lebanon. The opportunity to apply behaviour science is vast, but so are its challenges. The learnings from the inaugural event, which promises to be an annual affair, ignited several talking points by leading practitioners.

Hopefully, some of the domain specialists’ inputs will give you a deeper insight into this fast-growing field, whose impact is likely to have far-reaching consequences in this century and beyond.

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Dr Matteo Galizzi

Co-Director of the Executive MSc (EMSc) programme in Behavioural Science and Associate Professor at LSE

Behavioural science is about understanding how people think, feel, and behave and, as such, is continuously cross-fertilising insights and methods from economics, psychology, data science, and other disciplines.

Graduating from LSE’s flagship EMSc programme is just the beginning of a journey together, marking the access to a growing community of academics, alumni, and practitioners who are literally at the forefront of applying behavioural science to the real world: as our department’s motto states, “from the world to the lab and back”.

In line with the motto, the EMSc programme hosted a brilliant workshop on Applied Behavioural Science in July, organised by our graduating alumnus Rajeev Budhiraja and his peers.

The workshop brought to the LSE speakers and panellists applying behavioural science to various contexts, settings, and challenges in the real world, including our EMSc alumni Anna Meadows (Principal Consultant, Behavioural Science-IPSOS, UK) and Will Sandbrook (Executive Director of NEST Insight). The success of this event is making us consider establishing it as an annual feature in the future.

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Professor Nikos Nikiforakis

Co-Director, Center for Behavioural Institutional Design (C-BID) at New York University (NYU) Abu Dhabi

A sedentary lifestyle is a cause of many lifestyle diseases in the UAE. To combat this, Professor Nikiforakis led a team at the Center for Behavioral Institutional Design (C-BID), along with Professor Ernesto Reuben, to nudge senior citizens in Abu Dhabi to be more physically active. The intervention was branded the Forever Fit Program (FFP) and was developed in partnership with the Abu Dhabi Department of Community Development (DCD).

The experiment ran over four weeks and comprised over 200 participants. It involved the distribution of a booklet including age-appropriate, easy-to-perform exercises communicated in a fun and exciting manner, along with information on the long-run health benefits of physical activity, including incorporating simple movements into their daily lives. Regular phone surveys were used to assess whether physical activity had increased.

The results showed a 202 per cent increase in the daily time a senior adult spent on physical activity. Further, even amongst a group of previously inactive participants, the experiment showed a 145 per cent increase in daily physical activity. Additionally, the frequency of exercise increased in 63% of the participants. The experiment's success has led to an effort to extend this programme to all senior adults in Abu Dhabi.

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Adi Berliner

Head of AI for behavioural change at Clalit Innovation, Israel

A fundamental weakness in the standard approach to improving health-related behaviour is targeting people's knowledge instead of their decisions and actions. Consequently, there’s an urgent need to leverage behavioural insights into practical solutions in healthcare.

One behavioural challenge in Israel was reducing the no-show rates in outpatient clinics at Clalit (a not-for-profit that provides free healthcare for over 50 per cent of Israeli residents), estimated at 25 per cent. These no-shows cause increased wait time for an available appointment, inefficient clinical management, and high overbooking rates.

Nine appointment reminder SMS messages were tested as part of a solution (along with Professor Dan Ariely and the Ministry of Finance). Five of these resulted in lower no-show rates, the most influential being one using emotional guilt, which read, “Not showing up to your appointment without cancelling in advance delays hospital treatment for those who need medical aid”. This exercise reduced no-show rates by 33 per cent and improved advanced cancellation by 17 per cent compared to the previous reminder. Besides, an AI-driven reminder personalisation engine capable of analysing thousands of different patient parameters and tailoring a personalised reminder to each patient was developed. The mechanism achieved an additional six per cent reduction in no-show rates. The tech solution salvaged more than 200,000 appointments in a year, leading to more efficient clinical management and improved quality of care.

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Dr Fadi Makki

Director at B4Development, Qatar

Since its inception in 2016, B4Development in Qatar has conducted over 100 behavioural experiments, mainly focusing on social impact in the Arabian Gulf nation. The current focus is on the upcoming FIFA World Cup in Doha, Qatar, between November 20 and December 18. An estimated 1.2 million fans are expected to visit Qatar for the World Cup, posing various challenges such as traffic congestion and littering in stadiums and public venues. In preparation, multiple experiments were conducted to reduce littering, increase waste recycling in stadiums and encourage public transport during the recent Arab Cup and FIFA World Cup tournaments. These generated valuable learnings.

Using salient floor stickers effectively reminded spectators to take their garbage after a match. Highlighting the moral value of recycling with signs that read “Do good! Recycle right!” reduced the number of incorrect disposals in recycling bins by almost 36 per cent and increased the number of correct disposals by 11 per cent.  Updating people’s perceptions of current trends worked as an effective nudge to a discernible change in behavioural patterns.

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Neela A. Saldanha

Executive Director at the Yale Research Initiative on Innovation & Scale (Y-RISE)

Behavioural science is in an exciting phase: 14 years after “Nudge” was published, we can see its impact on health, education, financial inclusion, climate change and conflict resolution, among others. Importantly, it is going global: we see its footprint in the Global South — Asia, Africa, the Middle East, Latin America, and the Caribbean, where 85 per cent of the world’s population lives.

In this next phase, more remains to be done. To scale solutions, every policymaker and implementer needs to think and act like a behavioural scientist. This means we need to sharply increase the number of people familiar with behavioural science in the Global South so they can implement behavioural solutions. We must invest in long-term collaborations between local organisations and experts to test interventions. We will need to get creative about building communities to share lessons about what works (and does not). The more we can think creatively about harnessing the power of the 85 per cent, the more we can ensure truly global impact!

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Josh Martin, Ex-Executive Director of Beyond Conflict and Managing Director at ideas42 & Saugato Datta, Managing Director, ideas42

Policies and programmes make assumptions about how people behave and require certain decisions or actions from them for maximum impact. Therefore, we need to understand what drives behaviour if we want programmes to succeed.

Consider direct cash transfers, which are increasingly used worldwide — programmes where governments regularly provide financial support to society’s most vulnerable to help them eventually escape poverty. But behavioural science tells us that humans are fallible and have limited self-control — we often don’t do what we intend to do.  So, beneficiaries may have trouble using the cash they receive to achieve their goals.

ideas42, a leading behavioural science non-profit research and design firm that oversees work related to anti-poverty programs in the developing world, collaborated with the World Bank and multiple African governments to test tools leveraging goal setting and affirming people’s belief in themselves. The results are promising. In Tanzania, recipients who received the behavioural interventions were 65 per cent more likely to have saved over the prior month and five per cent more likely to have already made a productive investment than those who only received the cash without any intervention. Similar results have been found in randomised trials in Kenya, Madagascar, the Democratic Republic of the Congo, and South Sudan. These interventions are also very cost-effective: they improve outcomes more cheaply than giving people more cash. Over time, these simple, cheap, effective interventions could become ubiquitous in cash transfer programs worldwide.

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Dr  Fadi Makki, Founder of Nudge Lebanon & Nabil Saleh, Vice-President Nudge Lebanon

Nudge Lebanon is a non-profit, nongovernmental initiative that provides a unique approach to social and institutional challenges. Since its launch in 2017, it has been a pioneer in the Middle East, delivering research, interventions, training, and workshops related to behavioural science.

In 2020-21, Nudge Lebanon undertook a range of experiments focused on Covid-19 to improve compliance to prevention measures, mitigate the adverse effects of the virus on mental health and increase vaccine uptake amongst the general population. An extensive project with one of the UN agencies was geared to improve vaccine uptake amongst Lebanon's vulnerable and underprivileged refugee population. The project encompassed a) the development of a behavioural map to identify the challenges impeding the successful implementation of the immunisation program, b) integration of behavioural insights within the communication materials to inform the content and delivery of messages, and c) four waves of experimentation that included on-site interventions to increase registrations for the Covid-19 vaccine, training for health volunteers and staff, an experimental survey to increase willingness to vaccinate and intervention to increase attendance to vaccination appointments. Results of the project suggest an increased willingness to vaccinate by 26 per cent, registration rate rose by 20 per cent, and vaccine uptake went up by 180 per cent by the end of the project.

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Dr Pavan Mamidi

Director of the Centre for Social and Behaviour Change (CSBC), Ashoka University, India

Despite being the fifth-largest economy globally, a population of 1.38 billion presents India with many social challenges.  The Centre for Social and Behaviour Change (CSBC), founded by Ashoka University and the Bill and Melinda Gates Foundation, supports public social policy through behaviourally informed interventions and has established the Behavioural Insights Unit within NITI Aayog (the erstwhile Planning Commission of India).

The projects range from providing iron supplements to pregnant women in impoverished communities to overcoming Covid vaccine hesitancy in rural Bihar, from supporting financial inclusion to preventing climate change, from promoting ante-natal care to partnering with the railways to improve cleanliness in railway coaches and platforms.

One of the recent interventions involved nudging online consumers to make conscious decisions about sharing their data. Online populations increasingly consent to share personal information with service providers without paying close attention to the legal terms of consent they accept in a hurry. This information can compromise online users' privacy and lead to identity theft, a growing global problem.

Two interventions that reduced the incidence of sharing personal information were

A. “Speed bumping” the decision-making process. Users were forced to spend more time on the acceptance page. They were not allowed to move forward until a minimum time for reflection had passed, and this cool-down period reduced the number of people sharing personal data.

B. Presentation of a summary fact sheet on how their information would be used and star ratings of privacy levels also helped move the outcome variables.

A second experiment worth noting was influencing low-income parents in rural India to feed their children aged between six and 23 months according to minimum World Health Authority (WHO) standards. This issue is compounded by parents having misconceptions about nutrition.

Misconception # 1: Infants between six and 23 months old are likely to choke on solid food, leading parents to rely on light pulses and rice.

Misconception # 2: They must be fed in proportion to their relative size to adults.

Additionally, considerations of privacy related to diet to protect caste and religious identity make it more challenging to develop horizontal norms of good diet practices.

The task was to influence parents to feed infants with adequate frequency and diversity. The intervention that worked was creating WhatsApp groups of four or five parents, each with trained facilitators guiding conversations about best practices within these groups. Standardised and simplified messaging produced significant increases in both frequency and diet diversity.

So, what are the key takeaways?

Many of the world's significant challenges, reducing food waste, driving safer, climate change, inadequate savings for retirement, lack of inclusiveness, etc., are behavioural. To overcome them, there is a need to influence human behaviour in a structured manner, at scale. Behavioural science accepts the irrationality of individual decision-making and seeks solutions that work. From the first behaviour change unit embedded within the UK government in 2010, there are now over 200 such bodies worldwide, including in the UAE, Saudi Arabia, Qatar, India, Israel, and Lebanon. The discipline is destined to grow and play an increasingly significant role in social policy in the future.