A significant proportion of our health is affected by our own behaviour, rather than genetic or environmental factors – namely, our bad behaviour. We smoke, drink alcohol, do drugs, have unsafe sex, eat too much, move too little and generally just do the wrong thing.
Even when we do the right thing, chances are we’ll fail. Less than a quarter of new year resolutions stick, according to research.
So, this new year, how can we be persuaded to do the right thing? Governments, healthcare practitioners and experts are increasingly turning to behavioural science to help them directly affect behaviour and improve health outcomes. But it’s important to take the right approach for your target audience.
The hug, shove, or smack approach
Traditionally, interventions in healthcare have been a mix of hugs, shoves and smacks.
Financial incentives such as vouchers in exchange for healthy behaviour are called “hugs”. Tougher measures that restrict choice, like increasing the price of cigarettes or limiting takeaways in schools, are “shoves”. Bans, such as the restriction on smoking in public places, are simply known as “smacks”.
While hugs may be effective in achieving a desired behaviour, they’re an expensive solution and not ideal, particularly at a time of fiscal austerity. Shoves and smacks can feel high-handed and alienating and can be counter-productive.
How are nudges different?
“Nudges” are an alternative to hugs, shoves and smacks. Insights from behavioural economics and psychology have found that nudges can be used to influence human behaviour in a low-cost, unobtrusive way, by simply changing the way a choice is presented to a person.
Here are four examples:
Changes to environment: Restructuring the environment can influence behaviour. For example, designing a building with fewer lifts will encourage people to take the stairs, thereby increasing their physical activity.
Change default settings: People often behave automatically. Making the desired behaviour the automatic option can help to influence change. For example, making salad the default option instead of chips, or confining sugary and fatty food to a single, more hard-to-get-to aisle at a supermarket.
Using norms: This involves harnessing the “bandwagon effect” by presenting the behaviour as one that a lot of people are adopting. People tend to be more motivated to do something if other people are doing it.
Framing: Another common nudge is to present the same situation from a different perspective. This is called “framing”. For example, presenting a situation in terms of what someone will lose or miss out on is often better at changing behaviour than focusing on what they will gain.
How can we use nudges in health messaging?
At Thrive, we know that nudges can influence individual health behaviour in the same way that it influences population health. So, for example, to encourage a new mum to breastfeed or to encourage a person living with HIV to keep taking the medication, we have developed messaging programmes that use a variety of nudges. Here are eight key nudge techniques:
- Breaking a behaviour down into small, achievable steps
- Setting goals
- Signposting progress
- Acknowledging and congratulating small successes
- Sending reminders and alerts
- Framing the benefits of the desired behaviour in a certain way
- Highlighting the immediate benefits of the desired behaviour
- Addressing common barriers by providing easy solutions
We’ve found that the use of nudge theory in crafting messages has the potential to not only change individual behaviour but also empower whole communities to make informed health choices.
Gayatri Koshy is Head of mHealth at Thrive