DESIGNING BEHAVIOUR CHANGE

Tan Liren | Industrial Designer | Alexandra Health System

IN HEALTHCARE

Teo Ya Chih | Senior Manager | Ministry for Manpower

HELLO! And Welcome J

Joint workshop by KTPH & MOM

Innovation Behavioural Insights and Design Unit Behavioural Insights & Design

About us

Dr Wong Sweet Fun!Senior !

Consultant!

Tan Liren!AHS!

Lee Wei Chung!Designer!

Teo Ya Chih!MOM!

Sabrina Ng!AHS!

Ee Tien!MOM!

Wong Hefen!MOM!

Joycelyn Chua!MOM!

Objective of today’s session

Introduction to Behavioural Economics

Learn 2 Frameworks for Application

EASY

ATTRACTIVE

SOCIAL

TIMELY TIMELY

MINDSPACE EAST

Developed by UK, Behavioural Insights Team

Program for the day

Workshop

14:00 15:15 15:40 18:00

INTRODUCTION

TEA BREAK

APPLICATION APPLICATION

•  Activity: Redesigning S-Clinic (Develop Interventions-EAST)

•  Sharing of concepts •  Closing

16:30 15:50

•  Introduction to Behaviour Insights concepts – MINDSPACE

•  Activity: Redesigning S-Clinic (Understand-MindSpace)

NUDGE IN HEALTHCARE

•  Designing Nudge in Healthcare – EAST framework

Open to learn

Ground rules

Exchange ideas Be excited

Ice breaker

•  <<Name>> •  <<Occupation>> •  I will like to be known for __________ •  I hope to learn from this workshop __________

   

Quiz

1.  Was Mahatma Gandhi older or younger than 100 years old when he died?

2.  How old was Mahatma Gandhi when he died?

3.  Was Benjamin Sheares older or younger than 50 years old when he died?

4.  How o ld was Ben jamin Sheares when he died?

5.  Which tower is leaning more to the right?

Mei Ling is 31 years old, single, outspoken and very bright. She majored in philosophy. As a student she was deeply concerned with issues of discrimination and social justice. She drives a hybrid car and lives in Punggol waterway area.

6. Which of these two statements is more likely? A) Mei Ling is a librarian B) Mei Ling is a librarian and is active in the environmental movement

7.  Would you travel 20 minutes to get the discounted toaster?

$100

$50

8.  Would you travel 20 minutes to get the discounted television?

$3,000

$2,950

9. How many times do you floss your teeth in a day/ month*?

      0 1 2 3 4 5 6 7 8

10. How likely are you going to see the dentist if you have not done so?

      0 1 2 3 4 5 6 7 8

What is the relationship between design thinking and behaviour science?

BEHAVIOUR SCIENCE Explains the science of how our behaviour is affected by what our brains perceive

DESIGN THINKING Understand what our users need and desire through deep empathy

Design thinking and behavior science!

Understand, Explore and Affect! Examine, Explain and Test!

Behavioural insights

It turns out that the environmental effects on behaviour are a lot stronger than most people expect

Humans make predictable mistakes because of their use of heuristics, fallacies, and because of the way they are influenced by their social interactions

Use of behavioural insights in public policy

MINDSPACE – developed by UK BIT A framework for understanding behavioural

biases and effects

Messenger Incentives Norms Defaults Salience Priming Affect Commitment Ego

Messenger - We are heavily influenced by who communicates information

Expertise and trust  

Perceived authority (formal or informal)  

Peer effects  

Incentives - Our responses to incentives are shaped by mental shortcuts

Future discounting  

Loss aversion  

Overweigh small probabilities

 

24 Sep     27 Sep 29 Sep    TIME    

Banana/ Choc    

Hyperbolic discounting

Norms - We are strongly influenced by what others do

Personalise the norm  

Spread the word Beware of boomerangs

 

Defaults - We “go with the flow” of pre-set options

Defaults work because people dislike making important decisions and like to

procrastinate

 

h#p://www.youtube.com/watch?v=2lXh2n0aPyw  

Avoid choice overload

 

Highlight to people what they want/ need

to know

Salience - Our attention is drawn to what is novel and seems relevant to us

Personalisation  

Priming - Our acts are often influenced by sub-conscious cues

Size of plates and portion size effects how much we eat

Words, sights and smells influence behaviour

h#p://www.youtube.com/watch?v=2lXh2n0aPyw  

Moods can be more important than

deliberation  

Emotional responses are fast & automatic

Cannot always explain own behaviour

 

Affect - Our emotional associations can powerfully shape our actions

Commitment - We seek to be consistent with our public promises, and reciprocate acts

People can actively choose to constrain

their future self

Make commitments public

Reciprocity

Ego - We act in ways that make us feel better about ourselves

We seek to behave in a way that supports a positive and consistent

self image    

Messenger We are heavily influenced by who communicates information

Incentives Our responses to incentives are shaped by mental shortcuts

Norms We are strongly influenced by what others do

Defaults We “go with the flow” of pre-set options

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 Our 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  

Understand your persona

Programme for the day

Workshop

•  Introduction to Behaviour Insights concepts & Framework

14:00 15:00 18:00

INTRODUCTION

TEA BREAK

APPLICATION APPLICATION

16:30

TEA BREAK

15:30 15:50

NUDGE IN HEALTHCARE

•  Designing Nudge in Healthcare – EAST framework

•  Activity: Redesigning S-Clinic (Develop Interventions-EAST)

•  Sharing of concepts •  Closing

•  Activity: Redesigning S-Clinic (Understand-MindSpace)

WELCOME BACK! J Tan Liren | Industrial Designer | Alexandra Health System

Teo Ya Chih | Senior Manager | Ministry for Manpower

Overview from the 1st session A framework for understanding behavioural biases and effects

Messenger Incentives Norms Defaults Salience Priming Affect Commitment Ego

We can’t help being irrational. Our brains are wired that way.

Behavioural  Economics  helps  us  understand  many  of  the  seemingly  irraConal  behaviours  

Program for the Day

Nudge Workshop

•  Introduction to Behaviour Insights concepts & Framework

14:00 15:00 15:30 18:00

INTRODUCTION

TEA BREAK

APPLICATION NUDGE IN HEALTHCARE

APPLICATION

•  Designing Nudge in Healthcare – EAST framework

•  Activity: Redesigning S-Clinic (Develop Interventions-EAST)

•  Sharing of concepts •  Closing

•  Activity: Redesigning S-Clinic (Understand-MindSpace)

16:30 15:50

Why do you think Behavioural Economics is important in Healthcare?

As we strive to progress as a society

We are now living a more sedentary lifestyle, compared to our ancestors as we transit to a knowledge-based economy.!

http://stcommunities.straitstimes.com/sites/default/files/imagecache/bxslider_photo/capitolsg10e.jp

http://3.bp.blogspot.com/-C7CWWkHcBXc/Uld1Zco2nII/AAAAAAAAEd4/3nzjlglCymo/s1600/ncs-office.jpg    

As we strive to progress as a society

From living in a time of scarcity to one of abundance, our priorities changed. We now have easy access to convenient but unhealthy food.!

http://www.thedogood.net/wp-content/uploads/2012/05/13-donate-food-lg.jpg

h#p://i287.photobucket.com/albums/ll143/hongpeng1990/Blog%20Images/JollibeeSG02_zpse388e1d3.jpg  

As we strive to progress as a society

As a result, we now face an entirely different set of challenges, in which unhealthy lifestyles are the key to many of our chronic diseases. !

http://news.xin.msn.com/en/singapore/moh-extends-use-of-medisave-to-cover-more-chronic-diseases

Problems in Healthcare

“We don’t have a healthcare problem. We have a behaviour problem.”

-Mr Gautam Jaggi, Lead Analyst Ernst & Young

Healthcare Perspective

Patients’ Perspective

Patients’ Perspective

h#p://cdn.asiancorrespondent.com/wp-­‐content/uploads/2013/02/AsiaObesity-­‐621x297.jpg    

Patients’ Perspective

h#p://4.bp.blogspot.com/-­‐UcB68Lo5CrQ/U28nJo4LjSI/AAAAAAAAnp8/RTxBTznppMU/s1600/DSC_0047jk.jpg    

"If you look at people after coronary-artery bypass grafting two years later, 90% of them have not changed their lifestyle, even though they know they have a very bad disease and know they should change.” -Dr Edward Miller

Changing Behavior is one of the biggest and most important challenge in healthcare.

Behavioural Economics in Healthcare

How can Behavioural Economics help us?

EAST Framework

Adapted from The Behavioural Insights Team, UK

EASY

ATTRACTIVE

SOCIAL

TIMELY

The Behavioural Insights Team developed the EAST framework for practitioners to easily apply it in the design of the solution to nudge the desired behavior.

2. Simplify 3. Using Defaults

EAST Framework

EASY

ATTRACTIVE

SOCIAL

TIMELY

Make the solution easy by:

1. Reducing Hassle Factor 2. Simplifying 3. Using Defaults

Strategies for Easy

REDUCE HASSLE

Make healthy options easily accessible

SIMPLIFY

Make it simpler for people to understand healthier options

DEFAULT

Make healthy food the only choice available

HOW MIGHT WE… Make it easier for people to eat well?

EAST Framework

EASY

ATTRACTIVE

SOCIAL

TIMELY

Make the solution attractive by:

1. Attracting Attention (Appeal) 2. Rewarding and Sanctioning 3. Gamifying & Fun

Strategies for Attractive

HOW MIGHT WE… Make it attractive for people to not litter?

REWARDS & SANCTIONS

Make people own it by putting their reputation at stake

ATTRACT ATTENTION

Make recycling options obvious

GAMIFY/ FUN

Make the act of throwing trash fun

 h#p://i.dailymail.co.uk/i/pix/2009/03/19/arCcle-­‐1163132-­‐03F79CFC000005DC-­‐193_468x377.jpg  

h#p://chemistryteam.com/cms/wp-­‐content/uploads/bins21.jpg  

EAST Framework

EASY

ATTRACTIVE

SOCIAL

TIMELY

Make the solution social by:

1. Social Norms 2. Commitment Device 3. Networking

Strategies for Social

SOCIAL NORMS

Customise the desired norm to encourage usage

COMMITMENT DEVICE

Make users commit to a future decisions to ensure compliance

NETWORK

Create a network to encourage peer support

HOW MIGHT WE… Make it social for people to lead an active lifestyle?

EAST Framework

EASY

ATTRACTIVE

SOCIAL

TIMELY

Make the solution timely by:

1. Prompting 2. Planning 3. Cost of Delay

Strategies for Timely

PLAN

Bundle a service together with the product

COST OF DELAY

Bring forward consequences of not using sunscreen

PROMPTS

Place prompts at the desired context

HOW MIGHT WE… Make it timely for people to adopt the usage of sun screen to protect their skin?

http://goodoldlululemon.files.wordpress.com/2014/05/imgp8838.jpg h#p://www.ozarkoutdoors.net/wp-­‐content/uploads/2013/03/Store-­‐Layout-­‐From-­‐Dispatch.jpg  

h#p://www.reddit.com/r/SkincareAddicCon/comments/26y97f/uv_photo_with_without_sunscreen/  

Nudge in the Design Process

Understand! Explore! Prototype!Frame!Problem!

Implement!Solution!

Observe/  Interview  

Explain   Strategise   Select  Ideas   Prototype  

Nudge in the Design Process

Design Research User needs

Design Solution

Behavioural Science Attributing factors that explains one’s behavior

Social Influence Social Norms Choices

Nudge in the Design Process

“Nudges are like GPS units: they tell you the most efficient, or ‘best’, route, but you don’t have to take it; you can go your own way and choose the scenic route, if you like.” Professor Cass Sunstein

Behavioural Design Toolkit To stimulate ideas in the design process

The value in both science and design lies in what they can teach us about people.

Wai%ng  in  an  hospital    in  2013  

Thank You tan.liren@alexandrahealth.com.sg

Program for the Day

Nudge Workshop

•  Introduction to Behaviour Insights concepts & Framework

14:00 15:00 15:30 18:00

INTRODUCTION

TEA BREAK

APPLICATION NUDGE IN HEALTHCARE

APPLICATION

16:30

•  Designing Nudge in Healthcare – EAST framework

15:50

•  Activity: Redesigning S-Clinic (Develop Interventions-EAST)

•  Sharing of concepts •  Closing

•  Activity: Redesigning S-Clinic (Understand-MindSpace)

Closing

DEFINE THE OUTCOME

UNDERSTAND THE CONTEXT

BUILD YOUR INTERVENTIONS

What you’ve just been through

TEST, LEARN, ADAPT

h#p://www.clubsnap.com/forums/street-­‐candids/463876-­‐singaporean-­‐uncle.html  http://singaporeseen.stomp.com.sg/singaporeseen/sites/default/files/public/article/images/featured/2012/12/1514844.jpg  

 

Nudge in the Design Process

Understand! Explore! Prototype!Frame!Problem!

Implement!Solution!

Observe/  Interview  

Explain   Strategise   Select  Ideas   Randomised  Controlled  Trials  

MINDSPACE! EAST!

Further Reading If You are Interested

More Sources of Inspiration

A    Beginners  Guide  to  IrraConality  by  Dan  Ariely  on  Coursera    

Brains,  Behaviour  and  Design  Group,  InsCtude  of  Design    

Behaviour  Economics  and  Neuroscience  101  by  Tapestry  Works    

Thank You.