Background

This fall, the Center for Advanced Hindsight (CAH) at Duke University partnered with five North Carolina Counties–Cabarrus, Catawba, Gaston, Haywood, and Union–and the North Carolina State College of Design to integrate behavioral science solutions into COVID-19 response efforts.

After prioritizing the areas of risk for each county, the project team decided to pursue intervention opportunities within faith and religious communities around North Carolina, as one area of focus. First, we conducted a comprehensive literature review of religious participation during COVID-19. Afterwards, we engaged in qualitative interviews with faith leaders to better understand the barriers faced by congregations hoping to prevent further spread of the virus. 

Below, we list general recommendations for the integration of behavioral science into religious communities to promote safety during the ongoing pandemic. Implementing such practices presents considerable upside by encouraging COVID-19 preventative behavior while preserving the traditional role of religion in a community. 

Ways to Mitigate Risk Among Faith Groups

Emphasize safe substitutes for typical tradition, such as greeting someone.

The interaction that church provides is a form of socialization for many, and a crucial part of the community. However, continued engagement with traditional norms such as physical greetings, communion, and community meals, can increase the risk of infection among members. Many resort to traditional habits out of misinformation regarding the virus, or a lack of awareness for available substitutes – and habits tend to be automatic unless they are acted upon. Providing congregation members with clear and healthy alternatives can mitigate any ambiguity bias present, and promote safe behavior while maintaining the social atmosphere of religion. 

Create main modes of communicating safe practices (posters, flyers, vinyls, etc.) that relate directly to religious texts and scriptures.

For many, religion is an integral part of their identity. Likewise, those who dismiss wearing masks often do so citing limitations on their individual identity and liberties. Encouraging faith leaders to relate religious scriptures to preventative behaviors can encourage collectivism, a belief that is core to all religious worship. Promoting healthy measures in religious sermons holds significant substance and can build identity while preserving the role of worship to individuals.

Break COVID-19 related messages down by religious sect. Allow for individual congregations to customize their own messages in ways compliant with safe behavior. 

Despite ethics and morals being somewhat uniform across religious groups, values can change depending on each individual sect. Customizing messages at the group and congregation level can further establish the importance of safe behavior within specific religious identities. As humans often make choices based on their identity, publicizing messages in specific ways can create a framing effect that makes compliance with guidelines more appealing to individuals. 

Leverage the upcoming holidays by creating themed messaging campaigns.

Clearly, this holiday season will be unlike any witnessed before. Given the heavy foot traffic and close proximity of people that celebrations generally produce, leveraging the true themes of holidays (generosity, sacrifice, gratitude) can encourage those celebrating to do so safely. Moreover, labeling the risk level of alternative ways to celebrate the holidays based on criteria (size of group, location, age of participants) is a nudge effective in encouraging safe behavior while maintaining a sense of individual control.  

Encourage faith leaders to publicize why it is important to engage in preventative behavior and how it betters the entire community. 

Finally, humans tend to suffer from an authority bias which can strongly influence individual decisions. Faith leaders are oftentimes people of respect and stature in their respective communities. As such, having faith leaders promote preventative behavior for the sake of the community can have lasting effects on the mitigation of the virus.  

Conclusion

Faith groups are organizations vital to many communities around the world and now face significant barriers due to COVID-19. The role religion plays is critical to many people–especially during hard times–but safe worship is imperative to mitigate the risk for congregation members. The use of behavioral science in addressing safety and compliance can provide significant insights helpful in promoting healthy worship among faith communities this holiday season and beyond. 

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By Dan Rosica

The Center for Advanced Hindsight at Duke University has partnered with the NC State College of Design and five North Carolina counties to form a multidisciplinary collaboration aiming to use behavioral science and design to improve county COVID responses.

The Idea

On May 14, the World Health Organization published the following message: “Behavioural insights are valuable to inform the planning of appropriate pandemic response measures.”(1) With that in mind, and knowing that much of the available funding in the United States is reserved for cities, the Center for Advanced Hindsight (CAH) proposed forming a working group of various counties across North Carolina to provide policy briefs, webinars, lab testing, and field testing with regards to public COVID-19 response efforts. The group acts as a forum to cross-pollinate effective strategies region to region and to share materials, solutions, and evidence.

The Execution

After several months of planning and organization, this collaborative project officially launched on August 27th with five participating counties—Cabarrus, Catawba, Gaston, Haywood, and Union—as well as significant support from the state of North Carolina. The cities of Concord and Kannapolis have also joined in partnership with Cabarrus County. Each county has formed a project team that spans multiple departments including public health, communications, marketing, public information, and county manager’s offices. Additionally, we partnered with the NC State College of Design to combine behavioral science and human-centered design in order to tackle applied problems centered around COVID-19 responses. With the inclusion of the CAH Government and CAH Health teams, the project brings together more than 60 individuals working towards a common goal.

Over the first month of this six-month partnership, we accomplished the following:

• Launched an exploratory survey designed to help the internal project team gain an understanding of past, present, and future COVID-19 navigation efforts from the perspective of county employees.
• Held initial assessments with each county to determine the desired direction of this project and align expectations.  
• Conducted a comprehensive literature review of key COVID-19 behaviors and interventions.
• Launched a lab study to assess the effectiveness of different messages and designs on people’s perceptions of and behavior toward the SlowCOVIDNC contact tracing app released by the NC Department of Health and Human Services.
• Narrowed into three primary workstreams focused on addressing (i) Continued Distancing and Mask Compliance, (ii) Vaccine Adoption (regarding current flu vaccines and future COVID-19 vaccines), and (iii) Combating Misinformation.
• Developed a fourth umbrella workstream dedicated specifically to addressing county COVID-19 responses in underserved and marginalized communities.

Each of these counties is unique, but they share many of the same challenges. With this collaboration, we hope to avoid the duplication of effort that has slowed COVID-19 responses worldwide by learning from past approaches and sharing successful strategies. As a project team, we will place an emphasis on equipping counties with the tools, strategies, and methods necessary for achieving sustainable behavior change—not only for the duration of this six-month engagement, but for continued efforts moving forward. The COVID-19 pandemic is a public health crisis and the focus on technological advancements (e.g. vaccine development, contact tracing apps, etc.) is fully warranted. In addition to these advancements, however, we must also place a heavy emphasis on the fundamental understanding of the effectiveness of social and behavioral strategies.

Stay tuned for updates regarding the progress of this partnership!

This project would not be possible without the consistent engagement and effort of all county stakeholders. We also want to extend our gratitude to NC State Department Head of Graphic Design & Industrial Design Tsailu Liu, Design Lead Kahren Kersten, and their team of talented design students for sharing our vision for this project. Lastly, we would like to acknowledge the creativity and academic rigor of Taylor Newton, Associate Professor of Psychology at Lenoir-Rhyne University.

1) Kluge, Hans Henri P. (May 14, 2020). “Statement – Behavioural insights are valuable to inform the planning of appropriate pandemic response measures.” WHO Europe. Accessed July 21, 2020. https://www.euro.who.int/en/media-centre/sections/statements/2020/statement-behavioural-insi ghts-are-valuable-to-inform-the-planning-of-appropriate-pandemic-response-measures.

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By Anson Tong, Liz Tracy, and Joseph Sherlock

On September 21, today, the United Nations is celebrating its 75th anniversary with the theme of “The Future We Want, the UN We Need: Reaffirming our Collective Commitment to Multilateralism.” The goal of the UN is to improve the quality of life for people all over the world, whether through peacekeeping efforts, humanitarian aid, international law, or other avenues. In order to help people, we must be able to understand their psychology and behavior, which is why the UN has partnered with Duke University’s Center for Advanced Hindsight (CAH) in a variety of ways to apply behavioral science. As we look back and celebrate a truly remarkable and impossible institution, we also look forward. Forward to the future of the UN and the role behavioral science can play in its ambitious mission.

In the wake of the COVID-19 pandemic, we as individuals, communities, nations, and a world have a lot of reevaluation, reform, and rebuilding to do. Many inequalities have been exacerbated and broken systems have been exposed. Together, we can envision a brighter future. From a behavioral perspective, we know temporal landmarks offer us an opportunity for a fresh start, a new beginning. These landmarks can be the start of the new year, new month, new week or a new semester. For instance, Google searches for “diet” increase significantly at the start of a new week, month, and year (Milkman et al., 2014). They can also be personal landmarks or shifts like a birthday or moving to a new place. A 2012 study in Copenhagen found that providing car commuters with a free public transportation card for a month only caused a switch to public transportation commuting among drivers who had changed residence or workplace in the last 3 months (Thøgersen, 2012). As a society this year, we have been forced out of our habits ranging from daily work commutes to hugging friends. It is a large-scale reset no one wanted, but we shouldn’t let it go to waste. We ought to treat this as the pivotal opportunity it is. How we attend school, do our work, interact with our loved ones, move around, and spend our free time has changed. Our institutions and organizations should reflect that, both in the medium-term during the pandemic  and in the longer-term. So to the UN, on your 75th birthday, what comes next – don’t waste the silver lining opportunities a pandemic brings.

Behavioral science is by no means the end-all solution. Rather, it is an interdisciplinary approach to understanding how and why people make the choices they do. We work to collect evidence, test hypotheses, and evaluate interventions. For example, in collaboration with the UN on polio eradication, behavioral insights can be applied to encourage individuals to attend all their appointments for immunizations. Issues such as limited public infrastructure or vaccine supply, however, require other policy solutions. Behavioral insights are one tool to address the challenges we face and should be used appropriately in conjunction with other tools. For the UN to use behavioral science to its full impact, it will be essential to recognize where this tool is most useful, and where it isn’t.

Some of the standout behavioral science implementations have been as simple as just wording changes, such as the Behavioural Insights Team’s work on encouraging people to pay their taxes with social norms. However, we can also look at the larger picture to understand how processes work (or don’t work) for people. One aspect of applied behavioral science is about how we craft the messaging surrounding positive behaviors like eating healthier. Another is about making those choices more convenient by making the healthy option prominent (e.g. at eye level in the grocery store), affordable, and accessible (e.g. available in general supermarkets). A very relevant COVID-19 example is promoting self-isolation if someone exhibits symptoms. It is important to publicize and frame this message correctly, but potentially more important to assess and reduce barriers to self-isolation like fear of losing one’s job or having a living situation that makes self-isolation challenging. There are many behavioral barriers that must be addressed further upstream. So our challenge here for the UN is to be bold with behavioral science. See it as more than just changing copy in a letter, but as a tool that will help in the design of policy and strategy from the start. Give behavioral science a seat at this table and allow it the time and space to demonstrate value.

A particularly vital change to make within behavioral science is to diversify teams and better understand local contexts, beyond those just in the United States. We must build a more comprehensive and inclusive body of literature and evidence that comes from a diverse set of contexts. We need a wider variety of researchers doing this work. The UN’s work championing behavioral insights, through the UN Behavioral Insights Network and other partnerships, is an excellent start. Currently, CAH is collaborating with UNICEF on projects in a variety of workstreams including: polio, HIV/AIDS, COVID-19, water, sanitation, and hygiene. We are also working with the UN Institute for Training and Research (UNITAR), helping the United Nations Capital Development Fund (UNCDF) examine financial decision making, and running sessions with the UN Behavioral Insights Network. Behavioral science is an expanding and maturing field. In the coming years, we are sure to see many more exciting insights, partnerships, and applications from all over the world and across a variety of domains. Our birthday wish for the UN here is to use its unique position to help behavioral science embrace diversity.

Behavioral science, as a field, and the UN, as an institution, are both young with plenty to learn in the years to come. We at CAH tremendously value our UN partnership and hope our paths continue to wind together while we strive for a connected, diverse and impactful future. The United Nations may be 75 years old, but it is still constantly innovating, adapting, and changing to be the UN we need. And we appreciate this.

Authors
Anson Tong – Research Assistant
Liz Trazy – Project Manager
Joseph Sherlock – Senior Behavioral Advisor 

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A survey conducted by our Government team at the Center for Advanced Hindsight contributed to a major policy change that will impact more than 600,000 public employees of the Brazilian Federal Government. The change is being recognized as a step to modernize people management and increase efficiency in the provision of public services in the country.

The survey was a partnership between Duke University, Enap – The School of Public Administration,  and SGP – Secretariat of People Management and Performance. Both Enap and SGP are part of the Ministry of Economy of the Brazilian Federal Government. “Enap has been an advocate of evidence-based policy and this project is one of its many examples of how data and research can add to the design of public policies” says Diogo Costa, president of Enap.

According to data collected by the Ministry of Economy, 357,767 federal civil servants are working at home, including institutions of the Federal Education System. This number represents 63% of the total workforce of the Federal Public Administration. The survey was opened to participation in May of 2020 with the intent of learning about people’s experience with teleworking and/or managing teleworkers both before and in light of COVID-19.

82% of public employees reported that they would like to spend at least one day of the week in remote work and that 65% reported that they “totally agree” or “agree” with the phrase: In the future, I will ask for permission to telework.

More than 40,000 responses were gathered from public employees all over Brazil. “The survey conducted by CAH had a surprising number of participants and brought important insights that contributed to the design of our new policy” says Wagner Lenhart, Secretary for People Management and Performance at the Ministry of Economy.

The previous policy did not allow part-time remote work, but the results of the survey supported the idea that most of public employees feel more productive in dividing themselves between the office and their homes. Results collected from the survey showed that 82% of public employees reported that they would like to spend at least one day of the week in remote work and that 65% reported that they “totally agree” or “agree” with the phrase: In the future, I will ask for permission to telework.

According to the Secretary Lenhart, teleworking has the potential to contribute to the reduction of costs in the public sector – it has saved at least $21 million USD during these last four months due to the pandemic – as well as generated gains and benefits for the public employees that adhere to the program. “This program will directly impact the quality of life of the participants and will contribute to the motivation of professionals and the retention of talents” explained the secretary.

Considering the benefits that remote work can bring to public entities, the objective of the new policy is to simplify the rules of the management program and expand the adoption of telework. “We are reversing the process, making it simpler and less bureaucratic. With the authorization of the minister, the director of each unit defines how teleworking will work. The process will be transparent and can be followed up by citizens, with effective control over all deliveries” says Lenhart.

Results from the teleworking survey will also be used to help identify what kind of tasks could benefit from public employees working from home since each agency will have autonomy to define what activities can be performed in remote work. The new policy was also based on the experiences of public agencies of the Executive, Judiciary and private organizations. “We learned about experiences that were already being practiced in public administration and outside it to build a model based on transparency, monitoring productivity, and the effectiveness of the program” informs Lenhart. To contribute to the success of the teleworking policy, “Enap plans to use the survey results as a source of valuable information for servants’ skills development programs and training in technologies,” explained Costa. 

Joseph Sherlock, senior behavior researcher and the head of the Center for Advanced Hindsight Government team acknowledges the importance of having such projects: “We have a big mission to use science to create change in big social issues with Government partners. Teleworking has become an important topic all over the world and we are happy to have contributed to the process of building a new policy that will impact so many public employees and may benefit the Brazilian Society.”

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