Improving sanitation in rural India

Sometimes a well-intended action does not lead to the desired outcome.  Consider the Indian government’s efforts to provide toilets to rural villages.  The government built toilets, but people did not use them.  This is ultimately failure to conduct proper research before implementing a plan. 

The government failed to engage the local people and failed to understand entrenched cultural beliefs surrounding toilets.  Thus, their plan did not align with the motivations of the stakeholders involved. 

Armed with a better understanding of the stakeholders, the government employed the endowment effecting by giving the people ownership of the project.  The endowment effect states that people tend to value things more simply because they own them.  They invited the villagers to be part of the process by choosing the location, designing, and even building the facilities themselves.  This increases the level of emotional engagement and encourages people to take pride in their communities.    

Flu Shot: Yes or No?

Is your drug not selling at your ideal level? Wondering how to boost sales?  New research suggests that using physician prompts via electronic health records (EHRs) could significantly increase the number of flu vaccinations given. 

In this study, scientists used EHRs to notify physicians when a patient was eligible for a flu shot.  These prompts encourage physicians to discuss flu shots with patients by asking them to mark “yes” or “no” for the patient’s decision.  As a result, flu vaccinations increased 6% at the clinic in this study.  Compared to the previous year, this is a 37% relative increase in flu shots.  This method works by changing the choice architecture and adding a level of active, emotional engagement to the decision-making process.

What is the current choice architecture surrounding your drug? Hypothetically, choice architecture should have no impact on a completely rational individual, but behaviour science tells us that real people are anything but rational.  What can you do to make behaviour change easier?  Remember the details matter, and the answer to increasing sales might be as simple as asking a “yes” or “no” question.

Lost in the Memory Palace

Although we have a lot to learn about how our brains process and store memories, we do know that memory is malleable.  The brain is a muscle that can be trained.  Acronyms and mnemonic devices are tools to improve memory, but new research supports additional methods.  

A recent study published in Neuron supports a memory technique developed by the ancient Greeks, known as the method of loci.  The method of loci helps improve memory by associating each item with a vivid image in a familiar location.  Researchers assert that this technique exploits something our brains already do well—recalling images in particular locations.  These findings show that anyone can use this technique to improve his memory and that the effects are long lasting.  Researchers found that after training, brain scans of individuals actually changed. 

As a healthcare marketer, we are constantly trying to develop new ways to build positive connections with our brands.  Brand building is about building long-term memories about a brand.  While this task is not always easy, this research helps us better understand how there are many ways that this might happen

There are people who can quickly memorize lists of thousands of numbers, the order of all the cards in a deck (or ten!), and much more. Science writer Joshua Foer describes the technique -- called the memory palace -- and shows off its most remarkable feature: anyone can learn how to use it, including him.

"Ancient Technique Can Dramatically Improve Memory Research Suggests" https://www.theguardian.com/science/2017/mar/08/ancient-technique-can-dramatically-improve-memory-research-suggests-memory-palace

Unpacking Trump: The Primacy Effect

With the increasing use of electronic systems, doctors are often choosing a drug from a drop-down menu.  Have you ever thought about how the position of your drug on this list impacts the rate at which it is prescribed? Rational thinking suggests it makes no difference; however, behaviour science says yes!

Amidst Donald Trump’s unexpected victory of the Presidency, some have speculated on the impact the primacy effect may have had on the election.  The primacy effect states that individuals are more likely to remember items that appear at the beginning of a list.  The author says many undecided voters in key battleground states may have voted for Trump simply because his name appeared first on the ballot.

As a healthcare marketer, the key question now becomes, “Where do you sit on that list?” Is your drug the first one listed or is it lost somewhere in the middle?  Sometimes being listed first can make all of the difference. 

Source: http://www.bbc.co.uk/news/magazine-39082465

Opt-in, Opt-Out? Default Architecture in French Organ Donation

Meet the man who died the most. In movies. This film was directed by Steve Rogers and is part of a larger campaign by the Agence de la biomédecine to increase awareness around organ donation among French youth. 

Effective January 1, every French citizen is now an organ donor by default.  This is a reversal of the previous policy of opting-in to become an organ donor.  If you do not wish to be an organ donor, you may join the “refusal register” online. So far, only 150,000 people have joined this list out of France’s 66 million citizens.  Proponents of this change hope it will increase the number of organ donations, as there are significant shortages in both France and the EU. 

Although it is too early to evaluate this change, the law is influenced by the Behaviour Economics of Dan Ariely.  Ariely compares data from countries that operate under both systems.  It turns out that in both scenarios a large number of people simply choose the default option.  Mostly because of laziness, people tend to look for the easiest choice.  It’s not quite that simple, however.  The author here suggests that the “opt-in” versus “opt-out” choice architecture also changes the frame of reference from one of altruism to obligation. 

So how else can this default choice architecture influence your business in the healthcare industry?  Consider the ways in which you can influence physicians, pharmacists, patients, and their environments to make your product the default option.  Is it possible to reframe the context or reposition your product?  Sometimes achieving your desired results can be as simple as resetting the default.

“France’s New Opt-Out Organ Donation System Is a Good Idea"  http://nymag.com/scienceofus/2017/01/frances-new-opt-out-organ-donation-system-is-a-good-idea.html

Stayin' Alive

How can you get people with no medical knowledge able to do cardiopulmonary resuscitation (CPR) in an emergency? The Stayin’ Alive campaign successfully uses Behaviour Economics to achieve its goal. 'Hands-only CPR Vinnie TVC' shows how simple it is to perform CPR when instructed in an emotionally tangible way using the beat from the Bee Gee's classic song.

Enjoy the ad:

Why less is more

Once, when I was suffering a fit of depression, I walked into a supermarket to buy a packet of washing powder. Confronted by a shelf full of different possibilities, I stood there for 15 minutes staring at them, then walked out without buying any washing powder at all.
I still feel echoes of that sensation of helplessness. If I just want to buy one item but discover that if I buy three of the items I will save myself half the item price, I find myself assailed by choice paralysis.


I hate making consumer choices at the best of times, because I have this uncomfortable suspicion that big companies are trying to gull me out of as much money as possible, using sophisticated techniques designed by people who are smarter than I am.
For instance, when I buy an insurance product, how can I decide whether I should just buy the cheapest, or the best? The best is the one most likely to pay out without penalty or fuss, but that information is much harder to find out than factors such as cost, extent of cover, etc. It’s complicated. So I often try not to make choices – by just putting my payments for insurance with my usual insurers on direct debit, for example, which means I don’t have to think about shopping around.

This issue of choice and complexity lies at the heart of the experience of being modern. It penetrates commerce, politics and our personal lives. It may even be connected to the fact that there are higher levels of depression in society than ever before.
This idea was suggested by Barry Schwartz in his book The Paradox of Choice. Choice oppresses us. Why? Because there are too many choices and they are often too complex for us to be confident that we are making the right one.


When you might have 200 potential choices to make of a particular style of camera, it is difficult to feel sure you have chosen the right one – even if you spend an inordinate amount of time trying to make a rational decision. Or you may see the same model two weeks after you’ve bought it being sold more cheaply. When there was less choice and fewer types of camera, this kind of experience was rare. Our capacity for hindsight has become a means of punishing ourselves.


Complexity is not entirely accidental. Late capitalism solves the dilemma of competition (for the producer) through complexity. To try to choose a mortgage, or a pension, or a computer, requires a tremendous amount of application, so we become relatively easy to gull. Whether it is a power company or a loan company, we struggle to understand tariffs, terms and the small print. Exhausted, we just take a stab and hope for the best, or we succumb to inertia; choose what we have always chosen. Consumers are thrown back on simple cues that are advantageous to the producers, such as brand recognition.

https://www.theguardian.com/commentisfree/2015/may/18/choose-less-choice-shopping-around?CMP=share_btn_link#sthash.UJmYoE8J.dpuf


Complexity also impacts on politics. Once it was pretty clear who to vote for – your class position, on the whole, made it a simple matter of self-interest for most voters. Now we have become closer to what is ironically the democratic ideal – ie choice-making actors – voting is more of a challenge than it once was. Do you really have a good enough grasp of economic theory to judge whether it is best to spend or save in a recession? Do you understand the complexities of private provision in the NHS enough to rule it out? Do you know enough about international affairs to support a reduction in defence spending, or a retreat from the EU? Most people don’t – so, again, they make snap judgments based on loyalty and sentiment.

How behaviour economics prevents food waste

Fruits and vegetables don't always grow into the perfect shapes like we see in supermarket. The 'ugly' ones normally get thrown out, which creates a massive problem with food waste. 

However, Intermarche launched the Inglorious Fruits & Vegetables, which shows us it is not abnormal to enjoy 'ugly' fruits and vegetables because they are as great as the normal ones, just in different shapes. 

Behaviour Change is contagious!

Telling people what to do is often ineffective. However, by changing what people think of as socially acceptable we can 'nudge' them in a certain direction. Here is an article that talks about how the reduction in drink driving is more about what is socially acceptable rather than more severe punishment. Every marketer should ask themselves; 'what are the norms that shape my category and how can I influence these?'

http://www.bbc.co.uk/news/magazine-24745784