The Science of Behaviour Change

[Music] in my five minutes I'm going to start off with the question where does behavior fit in and I want to start off with a very big statement that I think that all of the challenges facing our society today is absolutely dependent on understanding human behavior and solving the problems changing human behavior I'm just going to say a little bit about health and a little bit about environment so if we take health nearly all of the kind of ill health that we try to avoid depends on us changing our behavior and here I have pictures of the big four the four behaviors that account for 50% of the avoidable deaths so we have smoking excessive alcohol consumption sedentary lifestyles and unhealthy eating there are many more than that but those four together account for a lot of the avoidable morbidity and mortality so that's just preventing getting ill to begin with but then it's the whole area of managing ill health managing chronic conditions managing disability as we're living longer we're spending much more of our lives managing a variety of different chronic conditions I've mentioned up here diabetes pain even something like medication adherence something like 30% on average of medication is not taken in the way that it should be for maximum effect think of all that waste of investment in the drugs to begin with and then the waste in terms of potential benefits for people so this is a whole area in which understanding behavior and supporting people to change their behavior can make a huge difference and then finally there's the Health Service itself this health professional behavior having good quality health care absolutely depends on what health professionals do and the more that they draw on evidence-based scientific findings the better quality of the healthcare sadly we know that many health professionals don't follow the evidence-based guidelines that they should so that's a whole area of work and an area of work that I've also been involved with so that just I hope showing you bit about the domains even of health and then the environment I just want to give two examples for my work one is being part of a large multidisciplinary project aimed at reducing and plastic waste and I don't have to tell this audience about the problems of plastic in the oceans I should say that all of my work is multidisciplinary working with lab scientists working with policy makers and in this case we're really looking at the circular economy how to reduce the production and the consumption of plastic and also increase reuse recycling a second project is reducing carbon emissions this project is a very ambitious one we're again working with engineers working with environmental epidemiologists working with systems dynamics scientists we're trying to support cities to bring about citywide transformations of a big scale to reduce carbon emissions and we're working with two cities in China two in Africa and two in Europe I want to now go on to give you probably the simplest way of thinking about behavior as the basis for understanding how to move on from understanding behavior to change in behavior so the simplest way of thinking about it is that behavior depends on an interaction between three necessary conditions and maybe you could try and think thought experiments in your heads about what those conditions might be and take any behavior but for the sake of argument I'll take cycling cycling is good for our health good for the environment now in order to cycle to get more people more of us cycling we need to make sure that we've got the capability we know how to ride a bike we know that cycling is good for our health and the environment we can have those skills but the cycling is not going to happen unless we also have we're coming to that motivation you know so one needs to want to do it otherwise it's not going to happen one can have all the capability in the world one can have all the motivation in the world it still won't happen unless we have the opportunity which yes you need a bicycle you need the resources to acquire the bicycle and you actually need some safe places to cycle so if we really want to change behavior and this applies to everything always just try and think about what's the capability that's needed what's the motivation what's the opportunity and what needs to shift for this particular behavior for this population in this context I'll get just a little bit more complicated here and so capability is the psychological the knowledge and skills but also the physical ability motivation and we'll hear more about this later is both the this is jargon but the reflective mechanisms which are out of top-down base for our brain our conscious decision making weighing up pros and cons rational what we think influences our behavior and the reality is that a lot of our behaviors and influenced by the more automatic mechanisms our drives our emotions our habits and with opportunity there's the physical opportunity but also really importantly the social environment around us with very social animals very influenced by our social environment now think about this as a diagnostic tool if you have of a health problem and you want a solution to it you go to see your GP you expect your GP to do a good interview observation come up with a formulation or diagnosis before you get prescribed a course of action which might include medication or something else similarly with behavior one absolutely needs to start with a good behavioral diagnosis what's going on here what needs to change before one comes up with a strategy that's likely to be effective for that particular behavior in that particular context and too often people think I know about behavior I behave I see other people behaving I've got my ideas jump into solutions without doing this sort of careful assessment work so I'm going to now show you a framework where you can move from this way of understanding behavior to what are the broad strategies that are likely to be effective but any given behavior in its context and this framework is called the behavior change wheel and it was developed as a result of a synthesis of bringing together of 19 different frameworks of behavior change that we identified in the literature and they were all a bit partial and there was a lot of overlap so I thought let's bring them all together now I shall show you it I don't expect you to take at all on board in this lightning talk but here it is in the middle is the Green hub and you see there we've got capability opportunity and motivation so that's a starting point depending on which of those six segments your assessment thinks this needs to change to change behavior will point to one or more of these nine possible intervention strategies and then the gray outside ring policy so for long term sustainability and thinking about the most effective behavior change interventions of those that happen at many different levels and is sustained over time we do need governments organizations institutions to be supporting behavior change with appropriate in addition to small specific interventions that are aimed at individuals or groups or communities and if anybody wants to see more about this here's the website of the Center for behavior change but a health warning the website is currently being upgraded so doesn't look in good shape at the moment but in the future you can find out more from there and I want to finish with a couple of the challenges that I think we face in terms of making our interventions more effective we've got a long way to go I think we've got a lot of potential now and the first challenge actually comes out of the potential that we've really only begun getting in the last few years which is the ability to measure behavior all of my career or most of my career we've had to gather data about behavior in terms of often what people say about what they do through surveys and questionnaires this is really inaccurate because people often forget people often have various kinds of biases and so or they don't they just don't pay attention to actually what was going on but now we can measure directly we have wearables such as this mobile phones have a lot of information about where you are voices your the tone of your voice how much light the type of weather etc and then we can also put sensors into the environment so we can see what's happening in relation to the environment the people are moving about in real-time so we're not just taking snapshots of behavior a few months apart we can take ongoing streams of data about behavior however the challenge that this produces is we have huge amounts of data streams of data from many different sources we can also get data about our physiological and internal functioning and how do we put all of this together in order to really understand what's going on in that we can bring about change so on the one hand there's fantastic potential I wish I starting my career now because I think it's a really exciting time but this is one of the challenges we face the other I think is about involving behavior science beyond the individual so quite often people think about behavioral science as just about individuals but what we're trying to do is think about individuals in relation to each other in relation to the environment and much of my work is really looking at bigger scale application behavioral science to bigger scale problem problems so I mentioned earlier this particular project complex urban systems for sustainability and health well where does behavioral science come in we're working with communities so understanding how to get people together to elicit the kind of problems and the solutions bring that together think about levers for change and help develop policies that are likely to be implementable and actionable and then also think about right we can have really good policies about what should be changed in terms of making this city a healthier place with less carbon emissions but putting policies into practices rather likes to ruler mention direct putting our New Year's resolutions into practice and governments are littered with good policies that aren't put into practice behavioral scientists can work out who needs to do what when where how in order to make this policy actually happen and this depends on big complex systems of how behaviors of key players interact and by mapping this big system out one can then begin to think about what's the entry point into the system what's the best entry point to change that system around so I really want to leave you with the idea that behavioral science yes it's about individuals but that can be scaled up so one can think about changing cities as well as individuals thank you very much thank you so good good evening everyone I'm Susan and I didn't actually coordinate our talks but you might think so as you'll see in a minute so I want to start with a bit of basic science and this is a field actually we're connecting basic science if some basic science of psychology with applications is is actually really worthwhile in bits of science we understand well that's not very necessary so if you're trying to get us a spaceship to the moon you don't have to rethink the foundations of Newtonian or Einsteins the contribution to physics that you can take for granted and you can simply figure out how to apply it but that's because we really understand or somebody not me understands how that works really well but in psychology we don't understand anything very well so the basic science is not something you can take for as read you have to figure out what bits of basic science are relevant to your problem and try to understand them and try to think how they apply so I think in this field rather unusually there's a lot of sense in having connections between the people doing the basic research and people doing quite applied pieces of work and I think that also makes it a very exciting place to be so to sniff is about basic science one which you can see from the figure on the left and it may just be too small to see very clearly there should be patches a and B can we see those yes there's a there's B and they are obviously but let's start a dark patch there and that's a light patch there now I wouldn't be showing you of course that if it were not the case that they were in fact the same because I'm a psychologist and I never like to do anything too obvious and we're all we all tend to play these tricks but he's that weird trick isn't it I mean how can it be that those two patches imb can actually be the same brightness they exactly the same amount of light is entering your eye when you look either of them now the odd thing is that that's because that is that's that's of illustrating something that's extremely general and though it's a very basic fact about perception it applies just across all sorts of interesting applied problems so the simplest way to explain what's happening there is that in the case of patch a it's a dark thing it looks dark because surrounding it are light things so its comparative it looks dark compared for things around it on the other hand B which is actually precisely the it looks light because it's light compared to the things around it so even though you ought to be able to see those two things which are right next to each other almost right next to each other as the same you can't because you're forced to compare with the very closest neighbors and that's something that's very interesting when you think about anything else you care about if you think think for example how what would happen to a population if it everybody got richer you might think ooh maybe we won't feel any richer because whether we judge ourselves to be rich or poor or happy or sad or happy with our houses or our cars or our families or anything else may depend a lot on comparison to how things used to be how things are for other people so if everything gets better everything gets worse maybe we just don't notice and indeed there as you'll know I'm sure many of you happiness surveys show exactly that so we've had long long periods of increasing wealth and welfare in many domain dimensions in the UK and across many parts of the world but overall life satisfaction absolutely the same now that might be because we aren't actually getting in any happier or it might be that this is an artifact of the way we're reporting our happiness but either way this kind of phenomena has got something very profound to do with that and in a world in which you're trying to make people happier and live better lives then this is an important thing to worry about is economic growth in fact pointless or is it in fact very a very good idea but we're just not picking it up because our surveys is somehow victim to this fallacy yeah well leave that as an open question the other thing I want to tell you in terms of very quick snippets much more briefly is on the right we have a little diagram of the idea of virtual bargaining which is something I work a lot on these days so virtual bargaining is the idea that when we interact socially we don't just talk and explicitly say I'll do this you do that I think this you think that we also do a lot of that same kind of thing implicitly so I'm working out in this situation I think you're thinking that you're telling me this you think I should open the door and you should walk through it and I'll go to the left you go to the right I'll pull in you old push and most of the time we can get along very successfully with each other and collaborate very effectively where we actually have to articulate very little the real magic of communication is how little we have to do most of our communication is in fact as it was silent we're doing it all virtually and I think this is a very important concept because if you want to understand when people work together well worked together badly it's they work together well when their virtual bargains are the things that are left unsaid are the same for all of us if we all think yes if we had to spell out what the point of this activity is or why we're doing it what our assumptions are we'd spell it out in the same way things are going to go well if we all have dissonant assumptions hidden in the backs of our minds there things are going to go badly I think that's again very important from the point of view of social cohesion trying to solve any kind of complex social problem we have to figure out what are hidden assumptions are and ideally ensure that there is aligned as possible let's briefly focus on some action not scientist excites now this is not nothing to do with me this first one plastic bag taxes this is something that we've all experienced in the in England fairly recently in Wales and Scotland this is actually data from Ireland and you can see the astonishing effect of a fairly small plastic bag tax get it going from a rate of plastic bag use there and I think that's about 20 2001 to 2001 and it crashes goes up a bit then the taxes increase it goes down and it sort of goes along the bottom forevermore and the same thing has been observed not quite as drastically for other countries with plastic bag taxes have been introduced and that's an astonishing thing because press the plastic bag cost is really low so if an economist would never imagine that people would think what these plastic bags are so expensive I'm not buying having them what the tax is doing is sending a signal it's chairs in fact it's sharing something we all feel which is using plastic bags is bad the shops kind of telling me it's bad or rather the government's telling me it's bad I know it's bad and that little prompt that little prod makes one less likely sir to take a plastic bag and to feel bad if you do and sure enough after a while those habits start to shift and plastic bags get eliminated and no one's any the worse off there are important shifts we have to make which are bigger and harder than that one is switching to heat pumps away from gas that's a bigger challenge for the UK another one is shifting our diets away from meat not necessarily completely but pushing towards a more plant-based diet from an environmental point you that's very important probably also good from many aspects of health and the other is pushing ourselves towards electric cars now that's something that's happening but is it happening fast enough these are all things that are important behavioral changes that individuals have to make and we need find ways of encouraging them to do them quickly let's put that in the context of that a wider problem as one that Susan was talking about earlier the challenge of environmental Anitra havior change in context of the environment the climate change committee of which I'm a member which is the UK body that advises government on carbon emissions and greenhouse gas emissions generally has recently - it's a two-hour break delight and some astonishment put out a report on the with the objective that UK reduces greenhouse gases to zero by 2050 sooner would be good but by 2050 is here at the outside and that has been taken up and legislated in the last few weeks so that's really an important step to commit to that but how do you do it it's going to require enormous amounts of changes of individual behavior such as I mentioned before it's also going to require again as Susan mentioned collective changes let me just give you two brief hints about how we might go about this and why it's tricky the first thing is that if I want to reduce my carbon emissions as an individual but the consumer their trouble is it's very much like trying to reduce the cost of my shopping with no prices on the goods so I wander around the supermarket i buy things and someone said you're just spending too much you're spending too much you must reduce your expending and if I were to respond yes but there's no prices on anything there's no till I just walk into the supermarket and buy things and and nothing happens and then you're telling me it's too expensive how am I supposed to know that is exactly the position with respect to consumption with regard to greenhouse gas emissions because we don't know they tips in the most vague way what the impacts for individual behaviors are so we need to do something about that one way you might do that is to have shadow prices on every good which don't express the cost of the good in money they express an analogous cost in terms of environmental impact you might think about various ways to do that but unless we have something like that when just not going to know so with the best will in the world we will fail as individuals but actually individuals are only part of this problem part of the solution we also have to reorganize our society very fundamentally and clearly governments are very big part of that so having targets and actually putting forward legislation to implement those targets is really important to convince other parts of government industry individuals that change is coming for example if we're going to move to electric vehicles I'm not going to be the only person with my electric vehicle and no charging infrastructure in fact everyone's going to be having electric vehicles in whatever it is 10 or 15 or 20 years depending on how aggressive we want to be I think we should be pretty aggressive on those targets precisely because it will help us organize our our behavior effectively towards a common goal it's easy to stress the importance of governments it's easy to stress the importance of individuals within between those are all those other mid-level organizations of companies and local authorities and groups of people in all shapes and sizes and understanding heads are how they themselves to self-organize to achieve common goals is very important and I think we're only going to make progress on really radical and fast progress on switching to lower greenhouse gas emissions if every part of our society from top to bottom starts to change its behavior it's only starting to happen lots of organizations are thinking starting to think differently of course thinking differently is one thing acting differently is a really crucial thing thank you [Applause] thank you so when you think about it most government activity ultimately has something to do with human behavior whether that's trying to increase educational attainment which is crime which is corruption goes to recycled by electric cars eat more healthfully etc often there's a behavioral essence at the center of that so we think it's important and useful that behavioral science is provided to policymakers and that's essentially what the Bayville insights team we're set up to do to inject that expertise and behavioral science to the policy-making process and there are various ways that can be done you know we can improve the way the conventional tools at regulation and Taxation can be designed and implemented or we can use more novel tools things like nudging which I'm sure we'll talk a bit about later but I think where behavioral science is most interesting and novel in the policy world is where I draws upon some of the more recent findings as to the extent to which our behavior is influenced by a number of factors particularly social factors which we've heard a bit about already particularly contextual factors which we've also heard a bit about and some of non-conscious drivers of behavior so just to exemplify what I mean by that well if you offer people a choice of coffee small medium and large across the population of course you get a bit of a distribution of preferences there but most people tend to gravitate towards the medium and you ask them why and they said well the small is a bit too small for me the bigs a bit too big for me the medium is the right size but if you do this and you add a bigger option take away the smaller and then you ask them again they go for the new medium and you ask them why and they say well the small is a bit too small for me and the bigs of it too big for me mediums of right size so we're very good at sort of overlaying these retrospective sort of somewhat rational explanations on our own behavior but was actually going on there as our choices massively influenced by the context or the way in which that choice had presented therefore of course if you want to influence people's choices to some extent you can manipulate the way they're present and this is classic marketing stuff you go into a cinema the reason they've got that extra extra extra large popcorn is not because they expect to sell very many of them but because by having it means they're gonna sell more of the large cons so you can change the choice set and the framing the context really matters a great deal ok so how do we use any of this stuff in the policy-making process well I want to just briefly give you one example in a context of reducing excessive antibiotics options so prescribing too many antibiotics in cases where they're not strictly necessary is a big social problem is of course contributing to enter microbial resistance and degrading effectiveness on of antibiotics globally so it's an important policy problem to try and reduce excessive prescription rate so in this instance the sort of conventional approach might be to try and raise awareness amongst GPS educate them to some extent implore them to think more carefully about whether or not they need to prescribe that's fine but a behavioural insights approach would just be a bit more systematic and trying to understand what are the actual drivers the actual opportunities from a sort of more nuanced more sophisticated behavioral science perspective and it's not a way to rocket science but it's an important process to go through so for example it's not necessarily GPS knowledge or awareness of the problem it's things more like they don't know their high prescribers they have no idea what's normal they don't really consider themselves are doing best and that's often the case so will they listen to government advice maybe maybe not there is often huge pressure from patients patients come in they've got five minutes of the GP they want to receive something and a prescription is obviously something that they're happy with so that sort of social interaction there and of course they're under limited time pressure like I said they've only got a few minutes and often it's the easiest solution just to give a prescription rather than to have a more lengthy conversation or take an alternative course of action so what might we do to overcome those issues well in this particular project of ours we were sending out communications this was with public health England to GPS we tried to address you address each of those issues so firstly we tried to identify the most credible messenger so in this case it was English chief medical officer someone that GPS would very much respect we tried to address that issue of patient pressure so that was something that a GP could give to that patient even without giving them a prescription so they could give himself care leaflets but they could also give too late prescription so prescriptions that couldn't be cashed in for a few days and then often of course the patient would realize they don't need it we removed that sort of inconvenience hassle factor by just giving three quite clear easy steps that GPS could follow as an alternative to prescribing antibiotics and finally we use this idea of sort of social influence or sort of peer sort of peer influence so we put a message in that letter saying the great majority 80% of practices in your area that was tailored to the recipient prescribed fewer antibiotics per head than yours and the reason we reason we tailored it to their area was because of course one counter-argument as well in my area I've got lots of old patients I need to prescribe more and so on so this was targeted specifically at the 20% highest prescribing GPS we then tested this in a randomized controlled trial so we had about 1,500 GP practices a random half of them received this letter a random half didn't and then we look at the difference in prescription rates over the subsequent six months what we find is that the you may laughs hold on one minute those practices that receive the letter prescribe three and a half percent less antibiotics than those who did not receive the letter now three and a half percent doesn't sound like a lot that is statistically significant for anyone that's interested in that kind of detail and actually in the context this is quite meaningful so at the time the NHS have put up a fund of around four million pounds to try and reduce prescription rates by one percent and then subsequently put up a hundred and fifty million pounds to reduce by four percent this intervention cost twenty thousand pounds and we've got a three and a half percent reduction that's pretty significant in this particular context also there was another campaign going on in parallel in a different set of practices using more conventional techniques posters in the waiting rooms etc and that kind of general awareness raising effort and that was also evaluated and had no impact whatsoever so this is a classic nudge because it's not it's not a silver bullet it's not saving the world in one hit but it's very cost effective it changes behaviour on the margins and is actually very worthwhile okay I think I've just got probably less than a minute left and I want to give you eight more examples so hold on to your seats just a few just a sort of flavor of the kind of things that we can do by the way these are not all ours this is the collection of studies some of them are ours some of them not so we can use defaults if you haven't changed your energy tariffs in the last couple years you're probably on the default tariff which by the way is probably the most expensive tariff we default people into the green electricity tariff I can increase the numbers on those terrorists by ten times way more effective than any kind of messaging campaign to implore people to provide to me shift themselves if you want to reduce food waste one of the most impactful ways of doing that is simply to remove the tray from canteens it's just a little bit more difficult to go over the fill your tray with stuff you're not going to eat you still let people go back and get more if they want you're not restricting their freedom of choice to eat what they want but you're just adding a slight friction into overeating or overtaking of that food from to get people to buy more energy-efficient washing machines and other appliances indicating the price in terms of lifetime running cost rather than just having the upfront cost can do that to some extent because of course we tend to focus very much on the immediate cost but we tend to discount consequences in the future and if you want to encourage cycling we did a trial where we're trying to encourage uptake of a cycle share scheme in the USA we found that people that had just moved home to the area where the cycle scheme was available were four times more likely to update this scheme than those already lived next to this area when it's like skin was available so this is the idea of tiny moments we're much more likely to change our behavior when I habits and our routines and being disruptive anyway if you want to encourage plant-based food one tip is to not segregate it from the meat food if you do segregate it meat eaters tend to see it as a strong signal that it's not for them it's sort of associations of other nests and a quick and easy way of them whittling down the choices to them is to first rule out the things that are in the vegetarian section so if you can integrate options you're more later encourage people to consider them many behaviors are somewhat contagious so the panels it would seem fit that fit that description so people are more likely to install solar panels if they can see other people having install solar panels in their area from their home along a similar vein if you tell people that the majority of people in a hotel reuse their towel that is a more effective way of getting people to do it than saying anything about the environment and similarly if you want to encourage people to use less energy using a social comparison so giving people bills to compare their energy use to that of their more efficient neighbors has across many studies been shown to effectively to a modest degree but a very worthwhile degree about three three and a half percent reduction in their energy consumption so I'll leave it there if anyone's interested in this stuff I'm just gonna leave that on screen a few sort of very popular books you may be interested in reading thank you very much [Applause]

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Views: 27,716

Rating: 4.4826956 out of 5

Keywords: behaviour, behaviour change, theory, psychology, nudge theory, societal change, rationality, royal institution, ri, susan michie, nick chater, toby park, Stavroula Kousta

Id: 154OttZtQ8w

Length: 32min 29sec (1949 seconds)

Published: Fri Sep 13 2019