River Thames flows through London. People come to the London Bridge to enjoy the river.
When I visited the London Bridge, there was a pink public litter bin in the beginning of the bridge. Many visitors stopped in front of it momentarily and threw litter away before crossing the bridge.
Although adding human faces or adding controversial messages encourages our prosocial behaviors, adding an opportunity to vote could be another effective intervention. Asking people to vote by splitting a litter bin into two sub bins looks more effective than designing a gigantic litter bin like a disposable coffee cup. I believe libertarian paternalism proposed by behavioral economists could help people behave in a better way.
Governments are increasingly adopting behavioral science techniques for changing individual behavior in pursuit of policy objectives. The types of “nudge” interventions that governments are now adopting alter people’s decisions without coercion or significant changes to economic incentives. We calculated ratios of impact to cost for nudge interventions and for traditional policy tools, such as tax incentives and other financial inducements, and we found that nudge interventions often compare favorably with traditional interventions. We conclude that nudging is a valuable approach that should be used more often in conjunction with traditional policies, but more calculations are needed to determine the relative effectiveness of nudging.
Antibiotic prescription rate differs across countries. It is two times greater in Korea than in Norway (27.9 vs. 15.8: Defined Daily Doses (DDDs) per 1000 people per day, 2015 OECD report). Why are antibiotics over prescribed in Korea?
One reason might be that it is difficult to find traditional medicines in Korean market. In contrast, Norwegians can buy a FLU SHOT at convenience stores. It is a bitter version of Jamba Juice. It is filled with traditional medicines such as ginger, turmeric, garlic, and cayenne pepper.
If I can buy the same FLU SHOT in Korea, I may not need to see doctors often. My thought provides fresh insights into behavioral economists. In the past, how to nudge doctors not to prescribe antibiotics was studied. Now, how to nudge patients not to see doctors may need to be studied.
IMPORTANCE: Interventions based on behavioral science might reduce inappropriate antibiotic prescribing.
OBJECTIVE: To assess effects of behavioral interventions and rates of inappropriate (not guideline-concordant) antibiotic prescribing during ambulatory visits for acute respiratory tract infections.
DESIGN, SETTING, AND PARTICIPANTS: Cluster randomized clinical trial conducted among 47 primary care practices in Boston and Los Angeles. Participants were 248 enrolled clinicians randomized to receive 0, 1, 2, or 3 interventions for 18 months. All clinicians received education on antibiotic prescribing guidelines on enrollment. Interventions began between November 1, 2011, and October 1, 2012. Follow-up for the latest-starting sites ended on April 1, 2014. Adult patients with comorbidities and concomitant infections were excluded.
INTERVENTIONS: Three behavioral interventions, implemented alone or in combination: suggested alternatives presented electronic order sets suggesting nonantibiotic treatments; accountable justification prompted clinicians to enter free-text justifications for prescribing antibiotics into patients’ electronic health records; peer comparison sent emails to clinicians that compared their antibiotic prescribing rates with those of “top performers” (those with the lowest inappropriate prescribing rates).
MAIN OUTCOMES AND MEASURES: Antibiotic prescribing rates for visits with antibiotic-inappropriate diagnoses (nonspecific upper respiratory tract infections, acute bronchitis, and influenza) from 18 months preintervention to 18 months afterward, adjusting each intervention’s effects for co-occurring interventions and preintervention trends, with random effects for practices and clinicians.
RESULTS: There were 14,753 visits (mean patient age, 47 years; 69% women) for antibiotic-inappropriate acute respiratory tract infections during the baseline period and 16,959 visits (mean patient age, 48 years; 67% women) during the intervention period. Mean antibiotic prescribing rates decreased from 24.1% at intervention start to 13.1% at intervention month 18 (absolute difference, -11.0%) for control practices; from 22.1% to 6.1% (absolute difference, -16.0%) for suggested alternatives (difference in differences, -5.0% [95% CI, -7.8% to 0.1%]; P = .66 for differences in trajectories); from 23.2% to 5.2% (absolute difference, -18.1%) for accountable justification (difference in differences, -7.0% [95% CI, -9.1% to -2.9%]; P < .001); and from 19.9% to 3.7% (absolute difference, -16.3%) for peer comparison (difference in differences, -5.2% [95% CI, -6.9% to -1.6%]; P < .001). There were no statistically significant interactions (neither synergy nor interference) between interventions.
CONCLUSIONS AND RELEVANCE: Among primary care practices, the use of accountable justification and peer comparison as behavioral interventions resulted in lower rates of inappropriate antibiotic prescribing for acute respiratory tract infections.
Flam is a small village in Norway. Tourists who take the Norway in a Nutshell tours switch ferry boats here. A cozy restaurant called Bakkastova Cafe is located up on the hill.
This restaurant had a note at the cash register. It says, statistics say that women are tipping better than men. I added coins to the tip jar labeled men because I wanted to oppose this questionable argument. Others might tip if they support it.
This suggests that scientifically proven or well supported arguments may fail to motivate people to behave in a certain way. Rather, incomplete, controversial arguments trigger people’s willingness to speak out and may lead them to make an action. From the behavioral economics’ perspective, people’s avoidance for perfection seems to be a better nudge compared to either putting on some lipsticks to make something look like a human or painting foot prints on the street.
Taipei is hot in summer. After sweating an hour, I ordered an iced coffee at 羊毛與花 Youmoutoohana Coffee. To my surprise, it served me a glass of coffee with a metal straw. After sipping coffee through it, I became a huge fan of metal straw. This summer, I will buy and bring a few metal straws to office with me to enjoy coffee more and consume plastics less.
I keep these in my tote bag (if you are worried about them getting dirty, I suggest a pencil pouch), and whip them up out whenever I’m at a coffee shop. Once at Starbucks, a talkative barista commented on my straw. “Hey, I’m with you,” he told me. “You’d hate to work here. You see how wasteful people are from behind this counter.” I’ll be gifting them to all of my friends for World Oceans Day on June 8.
Henckell is my favorite cafe in Frederiksberg, Copenhagen. It is a local place with great coffee and sandwich. I feel cozy inside. It has only four small tables.
There is a tip jar next to the credit card machine on the counter table. Interestingly, it has a smiley face, two arms, and two legs. One day out of curiosity, I kept watching how many guests tipped in this human-looking tip jar. Afterwards, I also asked a server whether guests liked it. Surprisingly, I noticed that a few guests hesitated putting coins into this jar for an unknown reason. The server even told me that not few guests complained about the tip jar because its mouth is too small to insert coins.
When human flavor is added to an object, people like the object. It is supported by academic studies about anthropomorphism. For instance, when a car is anthropomorphized and its characteristics are congruent with the proposed human schema, people evaluate it positively (Aggarwal and McGill 2007). When a garbage bin is anthropomorphized (e.g., “feed me”), people follow the message and show prosocial behaviors (Ahn, Kim, Aggarwal 2013). When an innovative, uncertain product is anthropomorphized (e.g., “this little guy”), people tend to adopt this product (Jiang, Hoegg, and Dahl 2011).
However, anthropomorphism might backfire if the usefulness of the product is sacrificed. When I come back to this cafe, I want to draw a different character with a bigger mouth and see what happens.
People are often reluctant to comply with social causes because doing so may involve personal sacrifices of time, money, and effort for benefits that are shared by other members of society. In an effort to increase compliance, government agencies and public institutions sometimes employ financial tools to promote social causes. However, employing financial tools to induce prosocial behavior is expensive and often ineffective. We propose that anthropomorphizing a social cause is a practical and inexpensive tool for increasing compliance with it. Across three prosocial contexts, we found that individuals exposed to a message from an anthropomorphized social cause, compared with individuals exposed to a message relating to a nonanthropomorphized social cause, were more willing to comply with the message. This effect was mediated by feelings of anticipatory guilt experienced when they considered the likely consequences of not complying with the cause. The theoretical and practical implications of these findings are discussed.
In this study, we adopted a food-waste composting campaign. A total of 104 undergraduates (54% female and 46% male; mean age = 19.8 years) participated in return for course credit. Participants in the anthropomorphism condition were exposed to a campaign poster showing a garbage bin with humanlike features of eyes, a nose, and a mouth alongside the caption, “Please feed me food waste only!” Participants in the nonanthropomorphism condition were shown a campaign poster in which the garbage bin lacked humanlike features and was accompanied by the caption, “Please put food waste in only!”. Participants completed a measure of expected compliance with the campaign (α = .89) using response scales from 1 (very unlikely) to 9 (very likely). In addition, we employed a 4-item measure of anticipatory guilt adapted from Cotte, Coulter, and Moore (2005). The four items assessed the degree of guilt, shame, responsibility, and accountability, respectively, that participants would feel if they did not comply with the campaign and were administered with 9-point scales (α = .89).
As expected, we found increased compliance in the anthropomorphism condition (M = 6.99, SD = 1.62) compared with the nonanthropomorphism condition (M = 6.24, SD = 1.80), β = 0.22, SE = 0.34, p < .05. Moreover, anticipatory guilt was higher in the anthropomorphism condition (M = 5.16, SD = 1.39) compared with the nonanthropomorphism condition (M = 4.49, SD = 1.64), β = 0.22, SE = 0.30, p < .05, which in turn resulted in an increased level of compliance, β = 0.45, SE = 0.10, p < .001. When we controlled for anticipatory guilt, the direct effect of anthropomorphism on compliance was no longer significant, β = 0.12, SE = 0.32, p = .17, Sobel z = 2.04, p < .05, which suggests that anticipatory guilt mediated the effect of anthropomorphism on compliance.
Chinese government tries hard to reduce plastic waste. Recently, it banned plastic waste import. According to financial times, half of the UK plastic waste need to find alternative places desperately.
In contrast, Chinese people seem to overuse plastics. In Shenzhen, for instance, plates are often wrapped with plastic packages. We should tear it down and throw it away. Sometimes, plastic gloves are provided at the restaurants. We wear the gloves when eating bread.
I suspect Chinese people are addicted to plastics probably because they consider plastics cleaner and safer than water or napkins. If we aim to reduce plastic consumption in China, we should consider the Chinese psychology about plastics seriously.
We now see a wide variety of floor signage. In Singapore, there is a yellow-painted footstep on the right side of the paved road at the Marina Bay. Since this road is crowded by runners, this signage probably helps them run on the right side of the road.
In Shenzhen, China, there are orange-colored lines at the subway stations. Since many people are in a hurry, these lines help them not to rush forward when the train is coming, and wait for the next train if they cannot get on.
Although floor signage is visually salient, I wonder whether this is needed to change our behavior, because we learn rules naturally. We learn how to avoid bumping into other runners when running on a narrow road and we also learn how to navigate a huge crowd to get on a train. Although I am a strong supporter of behavior economics and nudge, I believe some nudges interfere with learning. Not surprisingly, some people argue that behavioral economics are not always as effective as thought (Why nudges hardly help)(The dark side of nudging). We need to study more about which specific nudges are ineffective and how we can modify these nudges.
In Copenhagen, Denmark, many people use bicycles. Many Danes I met have more than three bicycles; one for commuting between home and train station, another for commuting between train station and workplace, and the other for weekend. Some trash cans are even angled in this city so that bicycle riders can throw away their empty water bottles on the wheel.
In Singapore, we should pay fine when behaving inappropriately in subway: S$500 when eating or drinking, S$1000 when smoking, and S$5000 when using flammable goods. Interestingly, eating durians is also inappropriate but the fine amount of doing so is not clarified. I suspect that Singapore government seems to know intuitively that people follow rules if they see a set of three escalating numbers.
People often use verbal signs to give instructions to others. The store owner posts a sign on the window saying, “This is a window, please use the door.” Government officers paint “Look Right” at the pedestrian crossing. However, I have observed numerous store visitors and pedestrians mistakenly push or slide the window and look left before crossing the road. In these cases, a visual signage might work better to attract their attention and guide their behavior.
