--- id: "workshop:using-behavioral-insights-to-design-effective-communications" type: "InnovateUS workshop" title: "Using Behavioral Insights to Design Effective Communications" url: "https://innovate-us.org/using-behavioral-insights-to-design-effective-communications" date: "2024-07-23" duration: "60 minutes" language: "English" instructors: ["Sheena Mirpuri","Nick Baker"] recording: "https://www.youtube.com/watch?v=nqTPi_0jBDM" transcript: "automatic, from the recording" source: "InnovateUS (innovate-us.org)" licence: "CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/), as stated on innovate-us.org" --- # Using Behavioral Insights to Design Effective Communications InnovateUS workshop · 23 July 2024 · 60 minutes Join us for this 60-minute workshop with the Behavioral Insights Team. One of the foundational findings of behavioral science is that changes to the context in which we make decisions can influence our choices. This means that even small changes to the way information is presented can have an outsized impact on human behavior. Participants in this workshop will be introduced to a concrete series of steps for applying behavioral insights to communications design. Facilitators from the Behavioral Insights Team will begin by sharing a high-level overview of the field of behavioral science before walking through best practices for applying behavioral insights to communications. Real-world case studies will be used to illustrate each lesson. By the end of the workshop, participants will be prepared to begin applying behavioral insights to their own communications. All participants will receive a checklist to begin putting the workshop lessons into practice. ## Learning goals - Receive a high-level overview of the field of behavioral science and walk through best practices for applying behavioral insights to communications - Hear real-world case studies to illustrate each lesson - Understand how to begin applying behavioral insights to your own communications - Receive a checklist to begin putting the workshop lessons into practice - Sign up [here](https://airtable.com/appdAyP4l2W9gxQdc/pagx9sXF2F53dI7kn/form)! ## Speakers - **Sheena Mirpuri**, Principal Advisor, BIT Americas - **Nick Baker**, Advisor, BIT New York Recording: https://www.youtube.com/watch?v=nqTPi_0jBDM ## Transcript Automatic transcript of the recording: names and terms can be misheard, and the times can be a few seconds off. Each time links to that moment of the video. The transcript alone: https://innovate-us.org/using-behavioral-insights-to-design-effective-communications.txt (plain text) and https://innovate-us.org/using-behavioral-insights-to-design-effective-communications.json (every segment with its start and end second). **Unknown speaker** [0:01](https://youtu.be/nqTPi_0jBDM?t=1) And hand it over to you. **Sheena Mirpuri** [0:06](https://youtu.be/nqTPi_0jBDM?t=6) Great, thank you so much. It's really lovely to be here today. I'll ask Nick to go ahead and share our slides. And then we'll get started. So welcome, everyone. Today we are talking about how we can use Behavioral Insights to Design Effective Communications. And I'll begin with just a quick introduction. And thanks so much for the introduction already done. I'm Sheena Murphori. I'm a Principal Advisor at the Behavioral Insights team. And I work with Nick Baker. Together, we lead the sustainability and transportation portfolios at BIT. And we work often with city government, with local governments, to try and better incorporate and leverage Behavioral Insights in order to make programs more effective, as well as incorporate data evaluation practices so that we can really understand what is working and what isn't working for local government. I'll go ahead and get us started today just by telling you a little bit about our company. It's a little bit of a niche company. We were established in the UK government in 2010. And we're considered the original nudge unit. So any fans of behavioral science in general will have heard of nudges. [1:27](https://youtu.be/nqTPi_0jBDM?t=87) Today, we're a social purpose consulting firm, and we're a leader in using behavioral science to improve people's lives. We partner often with government, nonprofits, as well as the private sector to apply learnings from behavioral science, design interventions for specific challenges that our clients bring to us. And we also make a priority of evaluating the results. So we've got around 250 employees around the globe now. And Nick and I are based in the New York City office. So today we're going to be talking a little bit about Behavioral Insights in general, what they are, what you can do with them. And then we're going to talk about how we might use Behavioral Insights to design communications. We'd really like this to be as interactive as possible. So definitely, please feel free to ask questions in the chat throughout, and one of us will do our best to respond to them. And then we'll save a little bit of time at the end for some discussion. So hopefully you guys can bring some questions that you have based on the conversation that we're having. [2:36](https://youtu.be/nqTPi_0jBDM?t=156) Okay, so quick introduction to Behavioral Insights. We're going to do a little bit of an interactive activity here. So I want you guys to think about what the color of the font is that you're seeing on the screen. Some of you may have already seen this before. And if you have, please don't spoil it for those that haven't. What I'm going to ask you guys to do is mute yourselves and make sure that you're not saying it out loud for everyone, but I definitely want you to say it out loud for yourself. So let's get started here. All right. So again, remember, you're saying the color of the font out loud to yourself. Okay, so we saw a couple different ones here. So on the left side, we had blue, red, green, and on the right side, we had yellow, purple, and orange. [3:49](https://youtu.be/nqTPi_0jBDM?t=229) And that was, you know, interesting. I'm very curious to hear how everyone felt about that and how they did. You could jump to the next slide, Nick. I'd really love to hear a little bit more before we dive into the two systems that are driving behavior about which of those sets was easier for you to do. The first set or the second set. **Audience** [4:12](https://youtu.be/nqTPi_0jBDM?t=252) How you felt doing it, why that might be, definitely, yeah, feel free to pop that into the chat. So folks are saying, you know, the first set was definitely easier. And so even though I knew what was coming and tried to focus on the color, my brain still went with the word first. Definitely slower on the second set. Yeah, it took a few more seconds to focus on the color. **Sheena Mirpuri** [4:43](https://youtu.be/nqTPi_0jBDM?t=283) Definitely got influenced by the words that you were seeing. **Audience** [4:48](https://youtu.be/nqTPi_0jBDM?t=288) Oh, that's clever. I placed my hand on the word to focus on the color and not the word. That's a really good strategy. **Sheena Mirpuri** [4:54](https://youtu.be/nqTPi_0jBDM?t=294) Okay, so I think clearly the first set was much faster, much easier, much more automatic to respond to, whereas the second set of colors was a little bit slower, a little bit more deliberate. You really had to think about it, use strategies potentially to help yourself, really focus in on the color that you were seeing rather than the word that you were reading. So there are two systems that drive behavior. The first system, system one, is considered a fast system. So that means it's automatic, intuitive, it's effortless. It's sort of how you respond when you think of what's two by two. It's really quick to respond to that. Here's an example of, you know, you see red on the screen and it's also the color of the font. So it's pretty easy to do. It's sort of like when you're driving or getting back on a bike, intuitively, naturally know how to do it already. [6:00](https://youtu.be/nqTPi_0jBDM?t=360) Whereas with system two, it's really something that's slow, it's reflective, deliberate, it's analytic. It's if you're, unless you're a math genius, which some of you very well might be, figuring out what 24 by 17 is takes a moment. The process of learning something new, you have to be really thoughtful about it. And then as we just saw in the little quick experiment we did, thinking about, you know, the color of the font. So here we've got purple, but it says orange. You're fighting two things there, two instincts there. So it really, it really does turn out that, you know, people are not as rational as we like to think, and that environmental effects on behavior are really quite a bit stronger than most people expect. And we'll say a little bit more about why this is important for the work that you do today. So when we're thinking, for example, about how these environmental contexts can influence major policy decisions that some of you are involved in, I want you to think a little bit about a potential scenario where you're a health advisor in your local government, and you find out that there's a new disease that's expected to kill 600 people. [7:19](https://youtu.be/nqTPi_0jBDM?t=439) I wish this was theoretical, but we all know over the last couple of years it's been, you know, not that theoretical. I'm sorry, I heard somebody just jump on, just want to see if there was a question in the group. **Unknown speaker** [7:33](https://youtu.be/nqTPi_0jBDM?t=453) I think that was accidental. **Sheena Mirpuri** [7:35](https://youtu.be/nqTPi_0jBDM?t=455) Okay, great. Okay, so a trusted advisor, jumping back in, a trusted advisor, you know, runs into your office and says, okay, Program A, there's some good news here, there's options. Program A, there's a certain outcome where 200 people will be saved. On the other hand, you've got Program B, which is a little bit of a gamble. There's a third of a chance that 600 people will be saved, and two thirds chance that zero will be saved. Which of these programs would you choose? And go ahead and put that right into the chat again. All right, so we're seeing certain outcome, outcome A, the first one, someone's asking, aren't they the same? Okay, lots of A's, a rogue B in there. [8:38](https://youtu.be/nqTPi_0jBDM?t=518) All right, some B's, some gamblers are coming out. Okay, some more A's here, so the certain outcome. All right, Nick, let's jump into it. So, if you think about the odds, it's really, you know, 72% chance, I'm sorry, 72% of people that will be saved here, and on Program A, there's a 72% chance that zero will be saved. Zero will be saved here, and on Program B, it's really that gamble there. So, a lot of folks are exactly right, sticking to Program A as the sure bet. Let's jump into another example here. So, again, you've got, you know, the same scenario, but in this case, Program C, the certain outcome is that 400 people will die. And Program D, the gamble, is that there's a two thirds chance that 600 people will die, and a third chance that zero people will die. [9:44](https://youtu.be/nqTPi_0jBDM?t=584) All right, we're seeing some C's, a D. Okay, we're seeing a really mixed bag in here. Okay, we're seeing a really mixed bag in here. All right, Nick, that's exactly right. So, it's the exact same results, Lee, as earlier choices. And if you jump to the next slide, Nick. Right. So, with certainty, the certain program options, there was a 50 percentage point swing between Program A and Program C, and again, a 50 percentage point swing between the gamble. [10:48](https://youtu.be/nqTPi_0jBDM?t=648) And choices that are framed as gains tend to promote risk aversion, whereas choices that are framed as losses tend to induce risk seeking. So, what we're learning from behavioral science in terms of how we frame things really is that ignoring the system one, that quick automatic process of thinking, really leaves policy susceptible to framing effects. And what this means for communications is that when we're trying to change behavior, how we communicate is really just as important as what we communicate. So, how we frame information for people, especially when they're thinking really fast, which a lot of folks do when they're looking at communications, it's really about how well that comes across to them and how quickly they can understand that. Now, most of you are already here, you know that. So, we'll dive in a little bit more now into the types of things that you can do to make your communications as impactful as possible. And for that, I'll pass this along to Nick. **Nick Baker** [11:58](https://youtu.be/nqTPi_0jBDM?t=718) Thanks so much, Sheena. So, behavioral science can be applied to a variety of different types of solutions. This fundamental insight that the context in which people are making decisions has a huge outsized impact on how they ultimately behave means that you as a government employee, you could look to make changes to the physical environment that people are operating in. You might want to make tweaks to the incentives that you're presenting to residents, or you might want to completely redesign processes that people go through. Fortunately, one of the easiest things you can start tweaking is communications. And so, that's why that's the topic that we're discussing today. Even small changes to how you present what you are communicating can have a meaningful impact on how residents ultimately behave. So, this is a really low hanging way that you can start incorporating behavioral science into your work today. And so, that's why we're really excited about this topic. Okay, so now that we've gone over why it's important, where should you start? And to be upfront, this can be a little bit daunting at first. [13:03](https://youtu.be/nqTPi_0jBDM?t=783) There are hundreds and hundreds of findings from behavioral science that have been condensed into what are known as biases, heuristics, effects. And just as a quick side note, when I say bias here, I'm not talking about bias as in racial bias or gender bias, but in the economic definition of tending to behave in a specific way. That's what we mean by bias in the economic sense. So, to illustrate how this can be daunting, I just pulled this graphic from Wikipedia, and this is a cognitive bias codex that lists 188 different cognitive biases that tend to drive human behavior. So, given these literal hundreds of findings from behavioral science about what tends to make us tick, what influences our behavior, where the heck should you start? Fortunately, we've done some of the work for you at the Behavioral Insights team. In order to make Behavioral Insights more approachable for new practitioners, we've developed a relatively simple framework that you can make very simple or more complicated if you're more familiar with the topic, which we call the EAST framework. [14:14](https://youtu.be/nqTPi_0jBDM?t=854) And this is an acronym for the concept that if you want to encourage somebody to engage in a behavior, broadly speaking, what you want to do is you want to make it really easy for someone to engage in that behavior. You want to make it attractive to engage in the behavior, and you want to use solutions, in this case communications, that are both social and timely. So what we're going to do for the bulk of the rest of the workshop is go through each one of these steps, easy, attractive, social, timely, and talk about how you can apply it to your own communications. And we'll do that primarily through a lens of a case study of how we've applied each of these steps to communications in our own work. Okay, first off, how can you make your communications easy for residents? So the example I'm going to use is Here is from the UK where, similar to the US, home floods are the environmental disaster that is most likely to do damage to homeowners' properties. And with climate change obviously getting significantly worse year over year, this is only becoming more and more relevant. [15:18](https://youtu.be/nqTPi_0jBDM?t=918) So what we did is we partnered with the UK's Environment Agency to run several different projects to help homeowners better prepare for future floods. And I'm going to discuss just one of those projects today. And for that specific project, what we did was we took what's called a personal flood plan. So this is a document that you can find on the Environment Agency's website. And it's a plan that residents in the UK are supposed to fill out in anticipation of a flood that hopefully won't happen. But if it does help them figure out where am I going to put my valuables if my home starts flooding? Who am I going to contact? Who are neighbors or family members I can reach out to for support? And where are my electricity, gas, and water shutoffs located so I can shut them off and make sure that there aren't any huge repercussions of the flood? And so what we wanted to do was help the Environment Agency try redesigning this plan to make it easier for folks to use. We created four different versions of the plan, but I'm going to focus on what we call the simplified plan since that's most relevant to easy, the topic that we're going over right now. On the left-hand side of the slide, you can see the pre-existing version. And on the right-hand side, you'll see our new and improved version. [16:32](https://youtu.be/nqTPi_0jBDM?t=992) And here are a couple of the design features that I wanted to call out. This communication is a great example of reducing friction. So this is a term that some of you might already be familiar with, but this is the behavioral science finding that even small decreases in the effort required to complete a behavior, that is the friction to engage in a behavior, can significantly increase how likely we are to follow through. So that essentially means if you make it easy to engage in a behavior, people are much more likely to do it. So here are three different ways that we made the flood plan easier for folks to fill out. Near the top of the plan, you have a call to action for people to sign up for flood warnings so that they can be alerted if there's likely going to be a flood in their area. What we did was we added three checkboxes for, hey, here are the three pieces of information you're going to want to have at hand to make it easier and less painful to sign up for those alerts. The second thing we did is that in that section, encouraging people to go shut off their electricity, gas, and water, we told them where they might be able to find those shutoffs. And on the pre-existing version, folks were essentially left to fend for themselves. And we didn't provide any guidance on that. So here we provided one sentence for each of those where you might be able to find these shutoffs. [17:53](https://youtu.be/nqTPi_0jBDM?t=1073) Lastly, there's a section on the plan encouraging people to write down phone numbers for various utility providers that they might want to get in touch with in case of a flood. We've gone ahead and pre-populated some of those phone numbers to make it easier for people to access that information. Okay. So what effect did these changes have? Again, we created four different plans, and then we conducted an online experiment where people were presented with a hypothetical scenario, hey, you're preparing for a flood, and you need to fill out one of these flood plans. And we found that people who saw our flood plans, the new and improved versions, were much more likely to say that they were useful, that they found these flood plans something that they actually got value out of. Specifically, the simplified plan, which we just went over, people were 7.62 percentage points more likely to say they found this plan useful compared to the status quo version. So what I'm going to do at the end of each section is give you a couple of essential steps to apply this topic to your own communications. [19:00](https://youtu.be/nqTPi_0jBDM?t=1140) So there are a ton of ways that you can make your communications easier, but there are three essential steps that I would recommend you take with every single communication that you design. First thing, focus on a single target behavior. We oftentimes work with folks who want to send out a letter and get recipients of a letter to change their behavior in five or ten different ways. And I understand the inclination, you want to get everything done all at once, but we find that when you try to do too many things at once, when you try to change too many behaviors at once, you water down your message, and people are less likely to change their behavior in any way. So stay ruthless, stay targeted, and just pick one specific behavior for each communication. Next, make your call to action, that is what you want people to do, very clear and easy to execute. When you're making this mental shift to writing communications for behavior change, you always want to have that target behavior you want people to engage in crystal clear in your mind, and then you want to very simply communicate it to people. Tell them what you want them to do. [20:04](https://youtu.be/nqTPi_0jBDM?t=1204) Lastly, make it easy to execute, that is getting at reducing friction. If you want people to follow through on a behavior, give them everything that they need in order to follow through. And then our third point, minimize the amount of text. We find this in experiment after experiment after experiment, that shorter letters and shorter emails and shorter text messages get more engagement than their longer counterparts. So be ruthless when it comes to cutting out text. Moving on to attractive. This is essentially getting at two different things. First, attract people's attention to your communication. You can't change anyone's behavior without getting them to open and read your communication. And the second thing that attractive is getting at is make the behavior that you want people to engage in as attractive as possible. Whether that's making it look like something that other people do, offering people some kind of incentive to engage in the behavior, incentive to engage in the behavior, motivate them to engage in the behavior, or else they're not going to do it. So for our example here, we're going to look at a real estate policy actually. So traveling to Northern Ireland at the end of the early aughts in 2008, there was a huge housing boom followed by a bust in Northern Ireland, very similar to the US. [21:20](https://youtu.be/nqTPi_0jBDM?t=1280) And unfortunately, many homeowners became super far behind on their mortgage payments. And we partnered with a housing authority in Northern Ireland to develop and evaluate solutions to help homeowners get back up to speed on their home payments. And the project that I'm going to focus on specifically here today is one where we partnered with a home lender. So partnership both with this housing authority and then with a specific home lender. And we worked with them to redesign their communications and see if we could encourage lenders to be more likely to get in, sorry, borrowers to be more likely to get in touch with their lender. And for our purposes, talking about making communications attractive, the most relevant things that we did were first, we use a colored envelope for our trial. You'll see a teal envelope here on the left. And that was to help our letters cut through all the noise. I mean, I'm sure you understand you probably yourself get more mail than you probably like to read on any given day. And to cut through that noise of all the different mail that participants were getting, we use these colored envelopes. The second thing that we did and potentially more interesting, in my opinion, is that we included handwritten post-it notes inside each of the letter. And so somebody who's literally taking the time to like tear off a post-it note and then write a handwritten note to personalize each recipient. And this probably functioned on two levels. First is obviously personalizing the letter to that individual recipient. It uses the person's name and calls out that, hey, we're taking the time to address this specifically to you. We over and over again find that personalized communications are much more likely to attract people's attention. The second level that this is probably functioning on, and this starts to get ahead a little bit to social, is that it activates what is known as reciprocity in the behavioral science world. And this is the finding that if somebody does a favor or a kindness for us, even if it's unsolicited and we don't ask for it, we tend to feel a social debt [23:25](https://youtu.be/nqTPi_0jBDM?t=1405) to kind of pay that back. Somebody has done something nice for us. I want to do a kindness for them so I'm not seen as kind of being a freeloader who lets other people do nice things for me. So in this case, somebody's taking the time to write a personalized note to you, to use a relatively gentle tone. It might elicit reciprocity and make you more likely to respond to that communication. A couple other things that I want to quickly point out which aren't quite as relevant to attractive but are still interesting aspects of the communications materials are, first off, we changed the tone of the letter. Here's one key sentence. These fees are avoidable, referring to fees that people are getting for falling behind on their mortgage payments. But if you do nothing, they will continue to be charged. There's a good chance I can help you avoid these fees. So these two sentences are specifically trying to avoid what is known as the ostrich effect. This is aptly named because, similar to ostriches who hide their head in the sand, there's a finding that people, when they're faced with pretty dire news or unpleasant news, such as, hey, you're behind on your mortgage payment, you're getting these huge fees, instead of doing the, quote unquote, rational thing of taking steps to avoid the dire consequences, people sometimes become overwhelmed, hide their head in the sand like an ostrich, and do nothing. So to avoid that possibility of people being like, ah, I'm overwhelmed by being behind on my mortgage payments. I'm not going to do anything about it. [24:52](https://youtu.be/nqTPi_0jBDM?t=1492) We assured people these fees are avoidable. We can likely help you. Last thing that I want to point out about these communications materials is, in addition to the letter, we also sent people a text message. This is great in case people, A, might have not opened the letter in the first place, and B, maybe they opened it, but we're all human. We're fallible. We have short memories, short attention spans. Maybe someone opened the letter, wanted to pay attention to it, but forgot about it. So sending reminder messages is a great way to attract people's attention in case you didn't get it in the first place. Okay, so what did we find about our kind of new and improved updated communication materials? On the left, you have the percentage of people who received a business as usual existing communication materials, who got in touch with their lender, 45.9%. And on the right, you have the proportion of people who received our new communications materials, who got in touch with their lender. You'll see there's a huge jump there, and that means that 16.3 percentage points, people were more likely to get in touch with their lender if they received the new communications materials. So an example where we were more successfully able to attract people's attention and get them to read these materials. And super quickly, I just want to mention that in addition to encouraging people to follow through on your target behavior, incorporating insights like this into your communications can improve outcomes for residents and improve your relationship with residents. This is a real note that we got back from somebody who received one of those handwritten post-it notes. And just quickly, a couple of highlights. I really appreciate the approach that you have used to get in touch with us and wanted to let you know how much it has helped that you did this rather than start threatening or action, something obviously much more serious. Thank you for making my life just a little bit easier. [26:42](https://youtu.be/nqTPi_0jBDM?t=1602) So there can be a real human impact to redesigning communications in this way. Okay, so what are my key kind of essential steps for how to make communications attractive anytime you're designing communication? First, you want to draw attention to key information using color and bolding. Even if you're writing a really short letter, you always want to, like, if there are two or three key sentences, use very simple design features to make sure that you're drawing people's attention to those specific bits. Next, personalized communications to the recipients. As we just went over in this example, you're much more likely to get people's attention if the communication is personalized to that. Lastly, do not forget to design your envelope or subject line. This is what we're going back to what we were saying about those teal envelopes. Don't make the mistake of spending a ton of time designing a perfect letter, designing your perfect email, and then forgetting to design an appealing envelope or subject line that's going to get people to actually open your communication and engage with it. Your communication won't do anything if people don't open it. Okay, moving on to social. What we're getting at here is the ways in which the behavior of people around us and how they expect us to behave often has a huge impact on our resulting behavior. There's essentially a huge academic field called social psychology, which is the study of peer pressure and how the behavior of others ends up influencing us. So what does this mean for communications? The example I'm going to go over here is related to reducing the overprescription of antibiotics. This is a huge issue because the overprescription of antibiotics is one of the leading causes of antimicrobial resistance. I imagine most of y'all are already familiar with antimicrobial resistance, but just to make sure we're on the same page, this is the idea that bacteria, viruses, etc. are increasingly [28:44](https://youtu.be/nqTPi_0jBDM?t=1724) becoming resistant to the medications that we use, and eventually there's the possibility that our existing medications will no longer be effective. Hopefully I won't be eliciting the ostrich effect myself here, but there could be some pretty dire outcomes of this. For example, antimicrobial resistance could result in up to 10 million deaths and $100 trillion in unrealized gross domestic product by 2050. So obviously a huge issue that we were really eager to tackle and try to do something about. So again, traveling back to the UK, we partnered with the Department of Health, and while you might not think communications would be able to address an issue as kind of big and as dire as antimicrobial resistance, we had a go at it. So what we did was we sent letters to general practitioners, GPs who were prescribing antibiotics at a higher rate than their peers, specifically folks who prescribe more antibiotics than 80% of their peers. There are two aspects of the letter that I want to call out here. The first one is this sentence that I pulled out, the great majority, 80% of practices in Birmingham or whatever the location. [30:00](https://youtu.be/nqTPi_0jBDM?t=1800) The second thing is looking down at the bottom of the communication is who it's signed by. Chief Medical Officer, I've got to say they do titles in the UK much better than we do them here, Professor Dame Sally C. Davies. I know she sounds very impressive. I would change my behavior if I got a letter from her. This is leveraging the finding from the behavioral sciences that's known as the messenger effect. This is the idea that who distributes the communication and who it's addressed from can have a meaningful impact in whether we ultimately change our behavior in response to the communication. Research has routinely found that we are more likely to change our behavior in response to communications that are addressed from people in positions of authority, such as Professor Dame Sally C. Davies, people who are perceived as experts, and people who we perceive to be similar to ourselves. So last thing on this case study that I want to show is what I personally think is a pretty interesting graph about what results these letters had. So here you're seeing a chart of the rate of antibiotic prescription over time, over a six-month period, and the blue line represents doctors who received our letters, and the gray line represents doctors who did not receive any letter at all and who kind of continued business as usual. [31:25](https://youtu.be/nqTPi_0jBDM?t=1885) So in September, when the treatment doctors started receiving our letters, treatment simply referring to the doctors who were assigned to receive the letters, you'll see that immediately those two lines diverge, and that's doctors who received our letters, while overall prescription rates are varying and peaking and balling month over month, every single month, doctors in the blue line in our treatment group are prescribing lower levels of antibiotics, suggesting that our letters are having an impact. Now the really interesting thing is come April, the end of this six-month period, when we decided to send the letters to all doctors, and what we found is that those two lines converged and that the gap in prescribing rates closed again, providing us much stronger evidence that it was literally these letters that was causing the difference in prescription rates, and that just a couple of sentences here and there was capable of changing doctors' prescribing behaviors and hopefully having a knock-on effect on antimicrobial resistance. [32:27](https://youtu.be/nqTPi_0jBDM?t=1947) So what were the real-world impacts of this letter? This one letter saved over 73,000 doses across 791 practices and resulted in direct public savings of over $112,000 in public sector prescription costs. The total cost of printing and mailing these letters were a little bit over $5,300, so obviously the benefits much outweighing the costs, and if you get down to how much it cost to prevent each individual dose of antibiotics, it was just seven cents per dose prevented. So huge impacts for a very, very simple solution. Okay, so my essential steps for making communication social, we only have one step here because making communication social is more of a nice-to-have. It's not something that you have to do in every single case. My essential step here is that if you are going to include a social norm, that is, if you're going to tell recipients how other people are behaving, make sure that it communicates that many other people are engaging in your desired behavior, and what this is going to do is it's going to help you avoid backfires where you actually make people less likely to engage in your target behavior. So let me dig into that just a little bit more. The idea here is that if you tell people that most people are not engaging in the behavior that you want them to, whether it's medication prescribing or flood-improving their homes or paying back their mortgage, you're giving people license to behave badly and to just go with the flow. [34:04](https://youtu.be/nqTPi_0jBDM?t=2044) You're telling them, hey, most other people aren't doing the behavior we want you to, so it's okay for you to not do it as well. An example that I came across recently just browsing the internet that maybe you've come across as well is little banner messages on Wikipedia asking you to donate one or five dollars, and those messages pop up. They ask you to donate money, and then right after that, they tell you that 99% of people reading that message don't donate, and what they're doing by that is they are giving you moral license to join the 99% of other people who aren't donating, and they're saying it's okay, most other people don't do this. So when you include social norms in your communications, don't be Wikipedia. Don't communicate an undesirable social norm. Okay, last thing. Sorry, I realize I have been blabbering for a while. We will open it up to discussion. We want to hear your questions. I do want to go over timely first, and what we mean by timely is send your communications to people at a time when they are willing and able to change their behavior. It's not going to have any effect if you send it to them at a time when they're not motivated to change their behavior. So for our example for timely, finally we're traveling to the U.S. We're going to talk about a project that we did with the city of Portland, and specifically related to the city of Portland's bike share program. The bike share program for the city of Portland is called BikeTown, sponsored by Nike, since Nike's based out of Portland. And what we did was we partnered with the city to design these little coupons or brochures that gave people a free ride on the BikeTown program to see if we could get more people to start using it. We tested in two different messaging framings that were kind of similar to that public health example that Sheena went over at the beginning of our workshop, where there were two framings, but you know what? They communicated the same thing. The first one offered residents of Portland a free ride on BikeTown. [36:06](https://youtu.be/nqTPi_0jBDM?t=2166) The other one offered residents $12 off a ride on BikeTown. And you know what? It cost $12 to ride BikeTown, and so it was essentially offering a free ride. But for our purposes, the more interesting thing that we did here was we sent some of these brochures or coupons to residents who had just moved to an address near an existing bike station. And the other thing we tried was sending these communications to residents who didn't move to a new address, but where a new bike station had just been developed near their existing address. And we found a pretty stark difference, as you can see from this bar chart, that residents who had recently moved to a new address were more than four times as likely to try BikeTown compared to those people who had simply had a new BikeTown location constructed near them. And what this is doing is it's illustrating this finding that's often used in behavioral science called the fresh start effect, and it's a super powerful one that you should all be aware of and you should all leverage in your communications. And this is the idea that the beginning of quote-unquote new chapters in our lives, we're much more likely to be willing to change our behavior. The idea here is that we tend to think of our behavior in chapters. [37:22](https://youtu.be/nqTPi_0jBDM?t=2242) And so in the case of maybe like I'm Nick in Portland and pre-move, I'm Nick in Portland who commutes to the office by driving my own car. I've always wanted to try public transit, but I have this identity as being Nick who commutes to the office driving his car. Then I move to a new address and actually start to think of this as a new chapter of my life. I'm now Nick who lives in this new neighborhood within Portland, and I feel more removed from my past failures to try to use public transportation. And this distancing from our past selves gives us more motivation and more confidence that we'll be able to successfully change our behavior in the future. And so that's the mechanism underlying the fresh start effect. Okay, this is another simple one where I only have one essential step for how to make your communications timely, and that is send your communications to people at a time when they're willing and able to change their behavior. In practice, this means leverage the fresh start effect. Frequently, this can be send your communications right when a program is being launched at the beginning of a new year, at the beginning of spring, which people generally think of as a time for new beginnings, spring cleaning, for example. The other way that you can put this into practice is by sending communications to people at a time when they're going to feel relevant. So say that you want to send people a healthcare communication, send it to them just a couple of weeks before open enrollment starts so that they're likely to see that communication as relevant and timely and more likely to pay attention to it. So with that, I'm going to turn it back to Sheena, who's going to discuss some next steps for just concrete ways that you **Sheena Mirpuri** [39:10](https://youtu.be/nqTPi_0jBDM?t=2350) can start applying this in your own work. Excellent. Thank you, Nick. So we wanted to give you a couple of really clear action steps that you could take. The first one is downloading the EAST report. So everything that Nick talked about, you can find on our website. You can download this report that talks a little bit about how you can make your communications easy, attractive, social, and timely. We're also going to be sharing out with everyone with Innovate US, who will share out a communications essential checklist. And that way you have some of these sort of distilled principles that you can be applying into your communications. And then if you have any additional support that you need, please definitely feel free to get in touch with us. We are always happy to help and always happy to have conversations about the best way to incorporate behavioral science into your work. [40:14](https://youtu.be/nqTPi_0jBDM?t=2414) So a couple of key essentials that are important to remember is thinking about what the behavior that you most want your audience to do is. And really thinking, as Nick said, about that one specific behavior. And the more specific you can get, the better it is. So really focusing in on that single target behavior. The second thing you want to do is show your draft to someone who has never seen it before. So think about your grandmother, your mother, a parent, a spouse, a friend, anyone who's not a colleague and doesn't have any idea what you do or what context it is. You really want them to be able to find the call to action as quickly as possible and understand the key messages that you're trying to share out. So think of this as like very rapid user testing. And really what you're trying to do here is make your call to action extremely clear and easy to execute. So if they have any trouble, that's your way of sort of troubleshooting and figuring out what steps might be missing. The next thing you want to do is zoom your page out. So think about how much black space, how much black versus white space you see. You really want to maximize your blank space and cut content as much as possible. When we write, we tend to be quite wordy, and that's really not helpful for folks who are reading quickly, which is almost everyone. [41:42](https://youtu.be/nqTPi_0jBDM?t=2502) You also want to chunk your information as much as possible. So think about bullet points, chunking information sort of together, putting it in specific sections. And that helps people retain information because it's whatever relevant information they need is chunked up together. So really that's boiling down to minimizing the amount of text. And there's lots of good ways to do this online, lots of apps that you can use to sort of cut down your text. The next thing you want to do is think about where the most colorful or darkest part of your page might be and think about whether this is the most important content. So thinking about drawing people's attention to key information using color and bolding. Really if something is standing out because it's highlighted, it's in a really bright color, that should be the most important thing that you want to convey. The next thing you want to do is try and personalize the recipient. So Nick gave some really wonderful examples there. Think about ways that you might be able to include the recipient's name and any information that could tailor it to them. It doesn't obviously have to be per person. We imagine you guys are sending communications out to loads of people, but anything you can do to tailor it, to personalize it, really makes a difference. You also want to be thinking about the behavior that the in-group emphasizes. So what are the social norms that you're really trying to emphasize here? [43:13](https://youtu.be/nqTPi_0jBDM?t=2593) Make sure that the social norms that you're emphasizing are supporting your target behavior rather than encouraging the behavior that you don't want to happen. So say it's in action, you really don't want to encourage people to do that if that's not actually what you want. And lastly, think about what your audience needs to do to perform the call to action. And when and how will they get these things? Make sure you time your communication so that people really see it when they're able to change their behavior. So hearkening back to the fresh start effect that Nick talked about, really thinking about if people are in the right moment for the message. And as much as you can tailor that to them, the better. So again, we'll share these out and make sure that you guys have them so they're top of mind. It's something that I think we do, we always kind of keep this checklist out whenever we're helping folks edit out their communications and really think about, have we hit all these points? And it seems really simple. It seems like things you might do anyway, but it really helps to double check that. All right, we'll open it up to questions and Nick and I are definitely happy to **Unknown speaker** [44:28](https://youtu.be/nqTPi_0jBDM?t=2668) answer. Thank you so much, Sheena and Nick. That was fantastic. Let me just take us off recording as promised. * * * Original page: https://innovate-us.org/using-behavioral-insights-to-design-effective-communications · Licence: CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/), as stated on innovate-us.org