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This post originally appeared on the Envolve Blog.

In a world filled with misinformation, it’s tempting to design health campaigns that correct false beliefs. Many educational campaigns attempt to do so by first stating and then debunking the common myth. For example, a typical ad campaign might say:

“The flu vaccine causes the flu. FALSE! Thousands of studies have proven that you cannot get the flu from the flu vaccine.”

Unfortunately, research shows that these myth-correcting strategies don’t actually work. In today’s blog post, we’ll explain why you should avoid myth-busting in your health campaigns and use a social norms approach instead.

Myth-busting is not effective and can backfire.

Numerous studies have shown that debunking common myths can actually backfire. For example, after being told that the flu vaccine cannot cause the flu, people who were highly concerned about vaccine side effects actually became less likely to vaccinate.^[1]When individuals are exposed to information that disconfirms strongly-held beliefs, particularly beliefs tied to their identities, they are motivated to cling to their original beliefs due to consistency bias. As a result, they dismiss the new information as irrelevant, thereby further reinforcing their existing belief.

In another study to test myth-busting effectiveness, participants were presented with four true statements paired with supporting evidence, along with four false statements paired with a correction and supporting evidence.^[2] When surveyed a few days later, participants tended to incorrectly remember one of the four false statements as true. The more false statements someone misremembered as true, the more their attitudes shifted to align with the false statements. “Myth-busting” thus not only damaged recall, but also shifted initially neutral attitudes towards false beliefs!

Try social norms instead!

If you’ve stayed in a hotel recently, you may have noticed a card in your room asking you to reuse your towels. Perhaps they tried bribing you with a credit at the coffee shop or guilting you about the environmental impact. We’re susceptible to both caffeine and guilt trips, but there’s an even more effective route: telling people about the behaviors of others. As social creatures, we want to fit in, and one of the best ways to fit in is to do what everyone else is doing. (Sorry, Mom, if everyone is doing it, over the cliff it is!) People rely on group norms to guide their behavior; changing perceptions of norms can nudge people toward new, desirable behaviors.

Researchers^[3] partnered with a hotel to test whether changing the message on the towel card could increase towel reuse. Rooms were randomly assigned to receive a neutral message, simply asking people to reuse their towels to help the environment, or they were asked to join their fellow guests in reusing towels to save the environment. The standard message resulted in about one-third of guests reusing towels, while the message establishing a group norm resulted in about half of guests reusing their towels. Follow-up work in this domain has found smaller but reliable effects,^[4] and an energy efficiency company, Opower, has applied this finding to increase conservation among their users.^[5]

Social norms can also be deployed in a health context. For example, colleges are a hotbed of health social norms campaigns, trying to give students accurate information about the way their peers study, eat, drink and exercise. In our research partnership with Envolve and Centene Corporation, we tested the concept of social norms and their impact on our members as it pertains to flu vaccination-seeking behavior. The new flu vaccination campaigns found that a social norms framing increased the percentage of Centene members who said that they were likely to get a flu shot after viewing the campaign (46 percent) when compared to the percentage who viewed a myth-busting frame (41percent). Based on this research, Centene is implementing its flu vaccine campaign for health plan members in the 2018-2019 flu season using social norms.

Social norm campaigns seem to be most effective when the message is:

• Relevant: College students want to know the drinking norms of their peers, not their parents!
• Relatively specific: “Hotel guests in this room” may be stronger than “hotel guests” at large.
• Doable: Don’t ask people to give up electricity altogether!

With these guidelines in mind, you can build stronger, more effective campaigns no matter the target behavior.

About the Authors

Lindsay Juarez is a senior behavioral scientist in the Center for Advanced Hindsight at Duke University. She has a Ph.D. in social psychology and specializes in goal pursuit and self-control. She works with the Envolve Center’s Behavioral Economics (BE) team, which incorporates BE and social science into health-related behavioral modification programs.

Rachel Kahn is a behavioral researcher on the Better Living and Health Group at the Center for Advanced Hindsight at Duke University. She has a BS in biomedical engineering and a strong background in social psychology. She works with the Envolve Center’s Behavioral Economics (BE) team, which incorporates BE and social science into health-related behavioral modification programs.

About the Envolve Center for Health Behavior Change™

The Envolve Center for Health Behavior Change™ is a partnership between the Brown School at Washington University in St. Louis, The Center for Advanced Hindsight at Duke University and Centene Corporation. The Envolve Center advances life-centric health research to improve lives so that communities can thrive.

^[1] Nyhan, B., Reifler, J., & Ubel, P. A. (2013). The hazards of correcting myths about health care reform. Medical care, 51(2), 127-132.

^[2] Peter, C., & Koch, T. (2016). When Debunking Scientific Myths Fails (and When It Does Not) The Backfire Effect in the Context of Journalistic Coverage and Immediate Judgments as Prevention Strategy. Science Communication, 38(1), 3-25.

^[3] Goldstein, N. J., Cialdini, R. B., & Griskevicius, V. (2008). A room with a viewpoint: Using social norms to motivate environmental conservation in hotels. Journal of Consumer Research, 35(3), 472-482.

^[4] Scheibehenne, B., Jamil, T., & Wagenmakers, E. J. (2016). Bayesian evidence synthesis can reconcile seemingly inconsistent results: The case of hotel towel reuse. Psychological Science, 27(7), 1043-1046.

^[5] Allcott, H., & Rogers, T. (2014). The short-run and long-run effects of behavioral interventions: Experimental evidence from energy conservation. American Economic Review, 104(10), 3003-37.

The post Using Social Norm Marketing Tactics for Effective Health Communications appeared first on Center for Advanced Hindsight.

This post originally appeared on the Envolve PeopleCare Blog

We’ve all heard the phrase, “Everyone has a price.” But paying someone to do what we want doesn’t always work. We know now that human beings are far more complicated; sometimes, we do things for no money at all, and other times no amount of remuneration will budge us.

A great example of ineffective incentive use was found by Gneezy and Rustichini (2000). Israeli daycare providers began charging a small fee to parents who showed up more than ten minutes late to pick up their children. However, the rate of late pickups actually doubled following the fine’s implementation. Even more interesting: When the fine was removed altogether, instead of returning to baseline, parents were even tardier picking up their kids than they had been before! In this case, it seems that a small incentive made the situation worse.

On the other hand, Volpp et al. (2006, 2009) were successful at getting individuals to quit smoking for practically pennies on the dollar. Health risks aside, smoking can cost over a thousand dollars a year for a light smoker, and over two thousand for someone with a pack-a-day habit in America. This adds up to between $42,000 and $84,000 over 20 years. Quitting on one’s own, therefore, makes economic sense, but Volpp et al. found that significantly more smokers were able to stick with their cessation if they were offered relatively small, incremental incentives. How could incentives be effective in one case but not the other?

The answer to this puzzle is, of course, that people respond to incentives other than money. For example, in the United States, a woman who agrees to be a surrogate mother can be compensated from $35,000 to $45,000 and upwards. However, just north of the border in Canada, it is actually illegal to pay a surrogate for her services, making “altruistic surrogacy” the only option. Nonetheless, one estimate claims a 400 percent increase in Canadian surrogacy in the last decade. In this case, the incentive for potential surrogates isn’t money; it’s a moral calling.

In our daycare example, parents originally felt bad for picking up their children late. However, once a relatively low price for this behavior had been set, they understood that it wasn’t “that bad,” and maybe even saw it as a fair price for extended care. Even after the fee had been removed, it was impossible to revert to feeling as bad as they originally felt about arriving late; thus, the tardiness continued. What made the intervention ineffective was the alleviation of guilt by setting a price on it.

The smoking intervention’s success may have had little to do with the amount of money offered. Although smokers might know that smoking is expensive, giving them salient rewards, i.e., cold, hard cash for achieving small subgoals ($100 for completing the educational program, $250 for six months and $400 for six months after that), was much more effective than working toward an abstract amount of money saved over time with cessation. Additionally, the program itself served as a commitment device, and participants understood they had someone to whom they could report their failures or successes.

The findings of these and other studies help us to understand that financial incentives aren’t straightforward. We can get more bang for our buck (pun intended) depending on when and how they are delivered. Lotteries have been particularly popular because, overall, people prefer a small chance at a big prize over a big chance at a small prize. Lottery incentives have been used to try to improve adherence to blood thinners, antiretrovirals and even gym attendance. One famous example from Glasgow’s 1957 anti-tuberculosis campaign increased expected tuberculosis screening threefold by implementing a weekly prize.

The Envolve Center for Health Behavior Change™ is currently working on finding out what kind of incentives, under what circumstances, work best to help people achieve their health goals. One of these studies, which works with the Healthy Solutions for Life program, has set out to determine whether the right kind of incentive can motivate parents of children with asthma to adhere to a telephonically delivered health coaching program.

Overall, it is important not to underestimate the complexity behind monetary incentives. Not only do people respond differently to how monetary reward schemes are structured, but other drivers – such as values, norms and personal goals – may override the perceived value of money altogether.

Ruth Shach is a researcher at the Envolve Center for Behavior Change. Prior to this, she has worked at the Gertner Institute for Epidemiology and Health Policy Research, and the Jerusalem College of Technology in Israel, focusing on contexts for decision making in health policy, overuse of and disinvestment in health services, and patient engagement. She received her MPH from Tel Aviv University, Israel, and her BA (Hons) in psychology from York University, Canada. Her interests include health and economic policy, specifically utilizing behavioral insights to structure interventions in order to achieve greater effectiveness and efficiency.

Lynn Zhao is a Master of Social Work student at the Brown School at Washington University in St. Louis. She works with the Envolve Center as a research fellow and focuses on behavioral economics and health behavior change.

References

Gneezy, U., & Rustichini, A. (2000). A fine is a price. The Journal of Legal Studies, 29(1), 1-17.

Volpp, K. G., Levy, A. G., Asch, D. A., Berlin, J. A., Murphy, J. J., Gomez, A., … & Lerman, C. (2006). A randomized controlled trial of financial incentives for smoking cessation. Cancer Epidemiology and Prevention Biomarkers, 15(1), 12-18.

Volpp, K. G., Troxel, A. B., Pauly, M. V., Glick, H. A., Puig, A., Asch, D. A., … & Corbett, E. (2009). A randomized, controlled trial of financial incentives for smoking cessation. New England Journal of Medicine, 360(7), 699-709.

Walque, D. (2015, April 8). Risk, Sex and Lotteries. Can lotteries be used as incentives to prevent risky behaviors? | Impact Evaluations. Retrieved from https://blogs.worldbank.org/impactevaluations/risk-sex-and-lotteries-can-lotteries-be-used-incentives-prevent-risky-behaviors

http://www.nejm.org/doi/full/10.1056/nejmsa0806819#t=article

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If you are like most people, there is a good chance your behavior is based on what you think others are doing. College students consume more alcohol if they think their classmates are drinking heavily. If you tell college students their classmates don’t drink as much as they might think, these students drink less alcohol. Similarly, if you tell someone their neighbor doesn’t consume lots of energy, this person makes an effort to consume less energy. This is decision-making based on social norms and can be leveraged to increase donations.

We wanted to explore social norms marketing when the social norm is bad. We looked more specifically at organ donation. How does an organization use social norms marketing to boost organ donations when not a lot of people are organ donors?

BACKGROUND

We started from the idea that social norms influence people in two ways. First, people want to do what other people do. Second, people want to do what other people think is the good thing to do. To sound smart, we academics call the first kind of social norm the “descriptive norm” – think of it as the “description” of what people do. We call the second kind of social norm the “injunctive norm” – it’s an “injunction,” an instruction on how to behave well, or what we should do.

At the time of our experiment, only 45% of Americans were organ donors, so the “descriptive norm” was bad and would likely backfire if used in marketing. But we also knew from surveys that 95% of Americans supported organ donation. That was something we could work with. So we decided to use the injunctive norm in social norms marketing.

RESEARCH

We partnered up with ORGANIZE, a non-profit that has made it easy for people to register as an organ donor. On ORGANIZE’s website, people can register in less than a minute, and the information becomes available in a central registry. We ran an experiment with them on Giving Tuesday, after Black Friday, in 2015. We sent out emails to 719 employees of a large firm to invite them to register to become an organ donor. Our test was very simple. We had the standard email, and then we created a second email which was exactly the same except for one line in the header of the email that read: “95% of Americans support organ donation.” That is, we included information about the injunctive norm. What effect would that have?

Standard header

Header with “injunctive norm”

We found that, of the employees who received our standard email, only 1.3% registered as an organ donor. In contrast, of the employees who received the email with the injunctive norm, 4.9% registered as an organ donor. Of course, these registration rates are pretty low, because generally people tend to ignore these types of emails. But our social norms message almost quadrupled registrations.

OTHER APPLICATIONS

Our experiment shows that you can still do social norms marketing even when the descriptive norm isn’t positive (i.e. most people are doing the bad thing). So, say you’re trying to do social norms marketing in a school where many of the students truly are perpetually sloshed, or a neighborhood where most people really consider it too arduous to flip the light switch off. Don’t yet despair. Try asking people what they think should ideally be done. Chances are that, even though behaviors are bad, opinions aren’t. That’s a start that you can build on.

There are many behaviors that many people approve of although few do it:

• bring your own bags to the supermarket,
• turn down the AC and just wear a T-shirt,
• visit Aunt Cornelia (nobody goes anymore),
• eat less meat,
• give regularly to charity,
• do courtesy flushes in public bathrooms,
• …

The last thing you want to do is to complain about how few people do these things, because it will only justify not doing it. Try the injunctive norm: What do people think should be done? Talk about that, and suddenly you can use social forces to your advantage.

Dr. Jan Willem Lindemans is senior researcher in the Global Team at the Center for Advanced Hindsight. Distract him from important work by emailing janwillem.lindemans@gmail.com.

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Twenty years ago, the city of Alpine, Wyoming had an E.colioutbreak that made 61 people ill, sent 19 to the hospital, and left a further 159 people suspected of being infected. Faced with an outbreak of this size, local authorities reached out to the Centers for Disease Control (the CDC) and their Epidemic Intelligence Service; and I was the “disease detective” leading the three-member team sent to help. At the time, it was the USA’s largest water-borne outbreak of E.coli O157:H7 and for those curious to learn more, Time Magazine covered the story in-depth.

By revisiting my experience in Wyoming, I want to describe four steps I followed as a disease detective and show how these same basic principles can be extended to other fields. Specifically, I will make a parallel to the spread of information around real or perceived issues related to vaccines, the risk this poses to public health, and what we can do about it.

Step One: Confirm that an outbreak is occurring

In the case of Wyoming, it was a local doctor who first noticed something was going wrong. After a patient displayed worrying symptoms similar to an E.coli infection, he called other doctors in the area and confirmed that they had seen similar cases. By the time the CDC was contacted, critical information about the scale of the outbreak and pathogen involved were already known, allowing my team to work swiftly and efficiently when we arrived.

We live in a society where information and misinformation travels at the speed of a tweet, so it is more important than ever to have the facts straight before we raise any alarms or take action. This applies to all individuals, but especially those active on social media, journalists, public health officials and leaders in the industry. In the case of measles vaccinations, we have learned the hard way that once false information starts to spread, it is difficult to correct and this can have devastating consequences (in 2017, there were 14732 reported cases of measles and more than 30 deaths in Europe alone).

Step Two: Dig deeper, listen, and form a hypothesis

Upon arriving in Wyoming, the three of us began by speaking to as many people as we could in the community. We needed to determine what all of the victims in the outbreak had in common, and how they differed from those who were unaffected. Based on critical leads, we started to suspect the water supply as the source of the infection.

The power of going into a community, asking questions, and listening carefully to people’s observations, worries, and perceptions, cannot be overstated. For this reason, I strongly advocate spending more time talking to communities in order to better understand reasons why vaccination rates in some areas might be low, as well as learning from the regions where they are high.

Step Three: Test the hypothesis

With a hypothesis established, the team performed a rapid case-control study, i.e. compared behaviours of people affected by E.coli (cases) with healthy individuals (controls) and ran the numbers using statistical tools. As we suspected, the local water supply was to blame for the outbreak.

Using the right tools to test theories on human behaviour in the context of vaccination fatigue or hesitancy is of great importance. For this, we can turn to emerging disciplines, such as behavioural economics, to test assumptions regarding intentions vs behaviours. For instance, studies have revealed that myth-busting –a popular public health communication tactic – may have been backfiring all of these years, a fact which should be a reason for pause and re-evaluating how to communicate public health messages to the public.

Step Four: Take action!

In the case of Wyoming, by simply mending a fence, the town was able to keep livestock away from the source of their water and prevent further outbreaks. Meanwhile, other E.colioutbreaks led to massive food recalls and resulted in stricter standards in food processing and handling. When it comes to public health, it is never enough to just diagnose the source of contamination; you also need to do all you can to prevent outbreaks from happening again.

I have seen many myths and false perceptions around vaccines emerge over the years and when these have triggered lower vaccination rates, the result has been outbreaks and the re-emergence of diseases. Public health officials, governments and industry are eager to help put science around vaccines and vaccination into a digestible and understandable context and have done this with varying degrees of success in the past. However, more needs to be done. Over the coming months, I aim to highlight approaches being taken to improve understanding around both the benefits and risks of vaccination, especially those that lead to positive behavioural changes and improved public health.

The post Stopping Disease Outbreaks in 4 Steps, Lessons from a Former Disease Detective appeared first on Center for Advanced Hindsight.

Using Behavioral Economics to Change Behavior

This post originally appeared on the Envolve People Care Blog.

Have you ever wondered why, when you open your phone to search a query, Google is the engine that runs your search? It is just “one click away” to switch to Yahoo, Bing or Amazon, but most people don’t. A recent New York Times article showed that Google is “investing heavily to be the default choice on web browsers and mobile phones,” paying $100 million each year to become the default search engine on the Firefox web browser. One may argue that it is not worthwhile to pay that much to get just one click ahead of competitors. However, it turns out that although other choices are one click away, very few people bother with that single click, so Google remains the default.

This tendency to stay in the default choice is called default bias (or status quo bias) and encompasses people’s tendency to choose inaction over action as well as their preference to stick with previously made decisions. Researchers concluded there are four main reasons for this. Firstly, changing the default requires mental effort or a “cognitive cost.” Thus, people tend to “save their cognitive investment” of making a choice, or, simply, be lazy. Secondly, inertia is a strong force keeping many people in status quo, no matter what that means. Thirdly, people are twice as sensitive to a loss as they are to an equivalent gain, meaning that they tend to stick to the default choice to avoid the possible losses that might result from their behavior change. Finally, there is an implicit perception that when something is a default, it should be a good choice, causing more people to stick with it.

(…) Inertia is a strong force keeping many people in status quo, no matter what that means

Recently, both governments and organizations have begun taking advantage of default rules and the related concept of opt-out design to advance social outcomes. This includes having people automatically enroll in retirement plans unless they actively opt out, or nudging households towards purchasing “green” energy from sustainable sources. Opt-out policy design produces significantly higher participation rates than opt-in policy design, and its applications in the sphere of healthcare are only growing.

A pivotal opt-out policy sprung from the reality that, although most people approve of organ donation, only a minor fraction carry out the process of signing a donor card. Thus, some version of the opt-out policy for organ donation exists in 25 European countries, with France and the U.K. also in the planning process. Individual states have considered implementing the program as well. Countries that follow the opt-out design have reached donation rates as high as 90 percent and above, while opt-in countries fail to reach even 15 percent.

OPT-OUT POLICY PRODUCES SIGNIFICANTLY HIGHER PARTICIPATION THAN OPT-IN POLICY.

An example from the provider healthcare side involves generic prescriptions. Although most generic equivalents of brand name medications work just as well as their counterparts and are markedly less expensive for patients and the healthcare system, physicians often stick with prescribing brand names. Realizing this, researchers changed the physicians’ computer display to include an opt-out checkbox labeled “dispense as written,” which, if left unchecked, would dispense the generic instead of the brand name medication. The overall rate of generic prescriptions rose 23.1 percentage points to a whopping 98.4 percent, saving patients out-of-pocket expenses, and improving overall adherence.
The Envolve Center for Health Behavior Change™ has also been using default bias and opt-out features to see if they can improve health outcomes in Medicaid members. One example is testing whether automatic enrollment increases participation in the Healthy Solutions for Life pediatric asthma program. The program pairs health coaches with members, providing ongoing guidance and health education to help members gain and maintain control of their health.

The moral here is if we want people to have healthier behavior, don’t make them choose “doing.” Make them choose “not doing!”

Ruth Shach is a researcher at the Evolve Center for Behavior Change. Prior to this, she has worked at the Gertner Institute for Epidemiology and Health Policy Research and the Jerusalem College of Technology in Israel, focusing on contexts for decision making in health policy, overuse of and disinvestment in health services, and patient engagement. She received her MPH from Tel Aviv University, Israel, and her BA (Hons) in psychology from York University, Canada. Her interests include health and economic policy, specifically utilizing behavioral insights to structure interventions in order to achieve greater effectiveness and efficiency.

Lynn Zhao is a Master of Social Work student at the Brown School at Washington University in St. Louis. She works with the Envolve Center as a research fellow and focuses on behavioral economics and health behavior change.

References
Ariely, D. (2008, May 5). 3 main lessons of Psychology. Retrieved from http://danariely.com/2008/05/05/3-main-lessons-of-psychology/

Behavioral economics.com. (2017). Behavioral Concepts: Status quo bias | Behavioraleconomics.com | The BE Hub. Retrieved July 5, 2017, from https://www.behavioraleconomics.com/mini-encyclopedia-of-be/status-quo-bias/

Johnson, E. J., & Goldstein, D. (2003). Do defaults save lives?

Lohr, S. (2011, May 15). Default Choices Are Hard to Resist, Online or Not – The New York Times. Retrieved from https://www.nytimes.com/2011/10/16/technology/default-choices-are-hard-to-resist-online-or-not.html

Madrian, B. C., & Shea, D. F. (2001). The power of suggestion: Inertia in 401 (k) participation and savings behavior. The Quarterly Journal of Economics, 116(4), 1149-1187.

Sunstein, C. R. (2017). Default Rules Are Better Than Active Choosing (Often). Trends in Cognitive Sciences. doi:10.1016/j.tics.2017.05.003

The post By the Power of Default appeared first on Center for Advanced Hindsight.

Despite the United States being the only advanced economy in the world that does not guarantee its workers any paid vacation or holiday days, Americans often fail to use the few days of paid time off they do get. In 2015, 55% of Americans left a total 658 million vacation days unused – an equivalent to $61.4 billion in forfeited benefits (an average of $604 per person!)

Does this mean that Americans just don’t like vacations? Unsurprisingly, that’s not the case. When people are asked about their attitudes towards holidays, almost none say that they would want less time off. In fact, 95% of employees say that using their paid time off is very important to them. And, quite remarkably, a large survey found that no one thought their vacation was a waste of time or that they’d rather be working.

The lesson of this is clear: There is a gap between people’s intentions and behavior when it comes to planning and taking their holidays.

If vacation is so important, why do Americans still leave so many of their paid days off on the table?

In a nationally representative survey of 7,331 Americans, researchers at Project Time Off set out to figure out why people weren’t using their vacation days. The three most common reasons study participants gave were:

They fear that they’ll return to a mountain of work.

The most prominent reservation people have towards taking time off is the dreaded feeling of what awaits you when you get back. 43% of surveyed participants said that this fear was the biggest barrier to taking time off. And this may also be a problem even for those who do take time off; with the advent of technology, there is often an expectation that we should be reachable at all times, including when we are away from the office. In fact, more than 60% of people say they keep working remotely while on vacation – which often leads to disagreements with spouses.

They feel like no one else can do the work while they’re gone.

As people get more seniority in a company, 33% say that their position becomes the largest barrier to time off. Many fear that no one else can do the work for them while they’re gone.

We often fail to accurately account for how we will feel in the future. This appears to be no less true in the case of vacations. A study by Ed O’Brien and Ellen Roney found that people often prefer “saving” trips for when they’ve finished work, believing that they would be distracted otherwise. Of course, if you wait for work to end, you may be waiting for a very long time. Regardless, this intuition appears to be mistaken. Vacations can be just as enjoyable with work left behind. It turns out people fail to account for how absorbed they will be when they are doing something enjoyable.

They feel like their superiors will think less of them.

Another significant barrier to taking a vacation is that many feel like it may jeopardize their job security. Survey respondents fear that time off makes them look less dedicated at work, that it may make them lose consideration for a promotion or raise, or that they will be seen as replaceable.

The opposite appears to be true when we look at what actually happens. People who took fewer than 10 of their vacation days per year had a 34.6% likelihood of receiving a raise or bonus in a three-year period, while those who took more than 10 of their vacation days had a 65.4% chance. These “work martyrs” tend to be more stressed and less productive than their vacationing colleagues, and it doesn’t appear to be serving them well.

To fix it, plan ahead.

Some of the reasons Americans don’t take enough holidays are structural and should be addressed on a policy level or by employers. For example, U.S. policymakers could follow the example of their OECD counterparts and mandate paid vacation days. Or employers can make sure to model the behavior they want from employees, including explicitly encouraging them to use their vacation. However, as an employee, there are still things you can do yourself.

An effective way of ensuring your vacation days is to plan ahead. Among surveyed workers, 52% of those who say they set aside time each year to plan out their vacations use all of their days off, compared to just 40% of non-planners. We also tend to get a boost in happiness just from going through the motions of planning a vacation. One word of caution, however: Scheduling all activities on your trip can take the joy and spontaneity out of them. Instead, maintaining the free-flowing nature of the trip by “roughly scheduling” activities without pre-specified times increases enjoyment.

So, what are you waiting for? Now is as good a time as any to book your next vacation.

The post Here’s Why You Need a Vacation appeared first on Center for Advanced Hindsight.

If your office is like ours, someone is out with the flu. And yet, we all got vaccinated! We diligently trooped downstairs, rolled up our sleeves, and received our flu shots in October. As a lab full of behavioral scientists, we know there are few things more demoralizing than doing all the right things and not getting the outcome promised (shout-out to anyone who’s ever #nailedit on a Pinterest craft).

Bodies are notorious for not giving you immediate positive reinforcement for healthy behaviors. If this year’s intense flu season has you feeling skeptical about getting the flu shot in the future, let’s talk.

Below, we discuss the benefits of flu vaccination for those around you as well as the direct benefit to you—sometimes it’s okay to be selfish!

Vaccinations to protect the vulnerable

We all want to stay flu-free, but what we sometimes forget is that avoiding the flu is not just great for ourselves – it can be the difference between life and death for others. So, even if you don’t care about your own health, remember that when you catch the flu you can spread it – and not everyone’s immune system is as strong as yours. People with compromised immune systems die from the flu all the time. This season, one in every 10 American deaths is due to the complications from the flu or pneumonia).

Do it for the grandparents, do it for the babies!

Shorter, milder symptoms

This year’s flu strain, H3N2, is a particularly tough virus to pin down, which can make the vaccine seemingly less effective. Because the resulting immunity might not be 100%, a person who got the flu shot could still get the flu, or they might get a different, less common strain that wasn’t included in the vaccine.

However, even if you ultimately contract the flu, you will still have a better experience than someone who catches the flu without having been vaccinated. Even though you can’t see it, the immune response a vaccine triggers is your body’s version of a fire drill, getting prepared for a real emergency. Lucky for you, those drills pay off.

Getting a flu shot reduces the likelihood of getting the flu, but if you do contract the flu, having been vaccinated also reduces the likelihood that you’ll be hospitalized for complications from the flu. And, even if you end up hospitalized from flu complications, patients who had received the flu shot were able to leave the hospital earlier and were much less likely to die of those complications.

Do it for yourself!

So what do I do next?

Get vaccinated! Flu season is still ongoing, and the flu shot improves your health and the health of people you care about. We’ve tackled two important motivations here: a self-focused, make your own life better rationale, as well as a more altruistic, helping others explanation.

Whether you’re looking out for others or you’re looking out for yourself, a flu shot makes sense.

Lindsay Juarez is a senior behavioral researcher at the Center for Advanced Hindsight, an applied behavioral science lab that helps people be happier, healthier, and wealthier, at home and abroad.

Aline Holzwarth is a senior behavioral researcher and Principal of the Center for Advanced Hindsight.

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In a new, 12-lesson online course, we have teamed up once again with Academy Award-winning producer and director Yael Melamede to create the Medical Professionalism Project, in collaboration with Duke Health.

We are bringing together experts in behavioral science and medicine to address some of the pressing issues facing healthcare providers today, including conflicts of interest, burnout, shared decision-making and social norms. By starting an ongoing conversation about the role of ethics and professionalism, we can create more honesty and accountability, inspiring medical institutions we are proud to be a part of.

This course addresses questions such as:

• What are the behavioral biases we need to take into account when we design our healthcare institutions?
• How can we use insights from behavioral science to help ourselves and our colleagues behave professionally?
• What are the systemic or cultural ‘fudge factors’ that work against doing the right thing?
• How should we think and talk about medical ethics and professionalism?

Who is it for?

This course is ideal for medical students and health care professionals at all levels, but anyone with an interest in the topic can register.  

The Medical Professionalism Project is a continuing education program, accredited through the Duke University Health System Clinical Education and Professional Development.

Sign Up Here

The post Creating Medical Institutions We Are Proud to Be a Part Of appeared first on Center for Advanced Hindsight.

Vaccination is one of the most effective public health interventions of our time. Each year, vaccination prevents 2.5 million deaths in children under age five. For older adults, vaccines reduce heart attack, pneumonia, ICU admissions, and death. Beyond disease prevention, vaccination leads to increased school attendance, reduced work absenteeism, a better-educated population, and decreased antimicrobial resistance.

Despite the wide availability of vaccines, vaccine-preventable diseases are still leading causes of death globally. In many cases, the problem of undervaccination is not simply a problem of access, but rather a problem of behavior.

Although media attention overwhelmingly focuses on ‘anti-vaxxers,’ false beliefs are only a small part of the problem. In many cases, the context and our psychology lead us to take actions not in our favor. For instance, barriers of time, convenience, the complexity of vaccine schedules, and the psychological experience of pain all pose obstacles. As a society, we simply haven’t designed systems that make vaccination easy or that address these barriers.

To learn more about our approach, research hypotheses, and potential experiments, download our white paper, Increasing Vaccination: A Behavioral Science Approach. Check back on our website for more updates about this project.

The post Why Vaccinations Are Underutilized – and How Behavioral Science Can Help appeared first on Center for Advanced Hindsight.