Cases

A pink litter bin on the London Bridge

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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.

Benartzi, Shlomo, John Beshears, Katherine L. Milkman, Cass R. Sunstein, Richard H. Thaler, Maya Shankar, Will Tucker-Ray, William J. Congdon, and Steven Galing (2017), “Should Governments Invest More in Nudging?,” Psychological Science, 28 (8), 1–15.

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.

Cases

Why are antibiotics over prescribed in some countries?

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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.

Reference

Meeker, Daniella, Jeffrey A. Linder, Craig R. Fox, Mark W. Friedberg, Stephen D. Persell, Noah J. Goldstein, Tara K. Knight, Joel W. Hay, Jason N. Doctor (2016), “Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices: A Randomized Clinical Trial,” Journal of the American Medical Association, 315 (6), 562-570.

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.

Cases

Is Iron Man banned in Denmark?

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There is a Ninjago World at the Legoland in Denmark. In front of a flying dragon brick, I met an unfamiliar sign.

 

 

At first, I questioned why Lego hates Marvel so that pushing hand out like Iron Man was banned. Very soon, I realized it means “do not touch.” Later, I found the same sign at a construction site in downtown. It says “No entry for unauthorized people (Adgang forbudt for uvedkommende).”

 

 

Are these dynamic signs more effective than static ones? According to marketing research, people pay more attention to road signs when they are dynamic. We may need more “Iron Men” signs on the road.

Cian, L., Krishna, A., & Elder, R. S. (2015). A Sign of Things to Come: Behavioral Change through Dynamic Iconography. Journal of Consumer Research, 41(6), 1426–1446.

We propose that features of static visuals can lead to perceived movement (via dynamic imagery) and prepare the observer for action. We operationalize our research within the context of warning sign icons and show how subtle differences in iconography can affect human behavioral response. Across five studies incorporating multiple methodologies and technologies (click-data heat maps, driving simulations, surveys, reaction time, and eye tracking), we show that warning sign icons that evoke more (vs. less) perceived movement lead to a quicker propensity to act because they suggest greater risk to oneself or others and increase attentional vigilance. Icons used in our studies include children crossing signs near schools, wet floor signs in store settings, and shopping cart crossings near malls. Our findings highlight the importance of incorporating dynamic elements into icon design to promote imagery and thereby elicit desired and responsible consumer behavior.

 

 

Cases

How crowded is crowded?

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Copenhagen differs from Seoul. In Copenhagen, I have ample opportunities to feel emptiness. When I go to a shopping mall (Kronen Vanlose) at 5PM on a weekday, it is literally vacant. Only few are spotted.

 

 

In Seoul, people constantly bump into people on street. By default, I feel crowdedness. When I go to Costco Wholesale at 8PM on any weekday, I should stand in line more than 10 minutes to meet cashiers.

 

 

Feeling emptiness or feeling crowdedness affects us. According to marketing research, social density shapes how we value products in a space. I find this research interesting and insightful, but it does not say much about how (objectively) crowded is (subjectively) crowded. While Koreans find a store or mall empty, Danes may find the same space crowded.

 

 

This article is about social space and material objects for sale within that space. We draw primarily on Goffman’s (1971) concepts of use space and possession territories to predict that as the social density of a given space increases, inferences of the subjective social class and income of people in that space fall. Eight studies confirm that this is indeed the case, with the result holding even for stick figures, thus controlling for typical visual indicators of social class such as clothing or jewelry. Furthermore, these social class inferences mediate a relationship between social density and product valuation, with individuals assessing both higher prices and a greater willingness to pay for products presented in less crowded contexts. This effect of inferred class on product valuation is explained by status-motivated individuals’ desire to associate with higher-status people. To the best of our knowledge, this research is the first to reveal the link between social density, status inferences, and object valuations. As such, it makes a novel contribution to what has come to be known in sociology as the topological turn: a renewed focus on social space.

 

 

 

Cases

People tip more when they disagree with a statement

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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.

 

 

Cases

Food tastes different at rooftop bar

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Vertigo offers a Bangkok’s ultimate rooftop dining experience. Sixty one floors above the city, people dine on premium steaks while feasting eyes on the skyline. When I visited this rooftop terrace, it was neither windy nor noisy, a perfect place to enjoy dish under the completely dark black sky.

 

 

However, food they served had very little flavor to me. It surprised me because Thai is one of my favorite cuisines. At first, I suspected that I over-enjoyed the street food that had been heavily seasoned with basil, garlic, ginger, and red chili. Alternatively, the level of spiciness and flavor might have been calibrated for cautious people.

 

 

However, I also thought food might taste different at high altitude as in-flight meals are dull and unpleasant. Katia Moskvitch wrote an article about why food tastes different on planes.

… as the plane gets higher, the air pressure drops while humidity levels in the cabin plummet. At about 30,000 feet, humidity is less than 12% – drier than most deserts. The combination of dryness and low pressure reduces the sensitivity of your taste buds to sweet and salty foods by around 30%…

 

 

 

Cases

Hibi lights like a match and burns like incense

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Songshan Cultural and Creative Park is a creative hub in Taipei, Taiwan. It organizes art events, displays creative goods, and sells design items.

An incense attracted my attention. Although I like candles and incenses (e.g., red rose scents of Jo Malone and burning sound of Wood Wick), lighting them is a headache. I found a creative solution at the park. A Japanese incense called Hibi is a match itself and produces fragrance for about 10 minutes. According to the website, this 10 minutes aroma has an interesting behind story.

It all started with the encounter of two traditional industries: incense of Awaji Island and matches of Harima. These two traditional industries of Hyogo Prefecture first encountered each other in 2011. The collaboration started with the idea of an incense that could be lit like striking a match and was followed by 3 years of trial and error, an aromatic product with properties of strength and fragrance was developed, which did not break even when struck like a match… The name of products and packaging were developed to convey the sensibility of today’s Japan. All those things were ‘designed’ to create a new way of enjoying fragrance.

Cases

Women-only train car vs. all gender toilet

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Women only subway cars are available in Shenzhen, China. They are also found in Cairo, Rio de Janeiro, Mexico city, Tokyo, Delhi, Jakarta, and Kuala Lumpur. However, priority carriages for women receive mixed reactions. According to the Wikipedia,

… Women cited safety from gropers, as well as not having to tolerate various smells. Men cited not having to worry about false accusations of being a groper. However, passengers complained about further overcrowding in mixed cars, and feared that women who ride mixed cars would be putting themselves at more risk than before (Japan)

… Women-only compartments were introduced on the Leipzig-to-Chemnitz regional train in 2016. Reactions from passengers were mixed. While some welcomed the measure as it made women feel safer, others thought that separating genders was “something from the past” and a “backward solution” (Germany)

To quarantine women from men aims to protect female passengers from male criminals. However, to do so *accentuates* gender differences. Claire Cohen wrote at Telegraph,

… Women-only carriages are an admission of defeat; they normalise sexual assault and tell the world that, rather than tackling sex offenders, the answer is to simply remove women from the equation – as if it is somehow our fault… It sounded ridiculous because it is, and it is exactly the same mentality that thinks hiding women away is a solution to sexual assault – not just plain sexism.

Nordic countries address gender issues differently. They attempt to *mitigate* gender differences. One example is all gender toilet widely available in Copenhagen, Denmark. Women and men equally wait in queue outside the toilets.

Cases

Self service kiosks are everywhere

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The Frankfurt airport in Germany has Nespresso Coffee kiosks. They brew coffee.

The canteen at Copenhagen Business School in Denmark has a self-checkout system. It tells how much I should pay.

The Max, a fast food restaurant in Stockholm, Sweden, has a do-it-yourself kiosk stand. It receives orders.

A hotel in Oslo, Norway, has a self service kiosk reception. Doors open only when reservation information is entered.

Indeed, self service kiosks are everywhere in Europe. They benefit managers and customers. Managers lower labor cost and customers avoid unnecessary relationships companies hoped for. 

However, self service kiosks have two weaknesses. Gretchen Gavett elaborated them in his article titled How Self-Service Kiosks Are Changing Customer Behavior.

… Technology lacks flexibility. When we’re interacting with a person and we’re having trouble understanding something, the person can adjust to us. If we’re having a misunderstanding, they can help clarify it. Technology really can’t do either of these things.

… A person has the ability to delight us or disappoint us. It’s really hard for a technology to ever delight, however, because it’s standardized and is built on a set of rules. But it is possible for technologies to disappoint us.

I have met a good example about how to overcome the above mentioned two weaknesses. This is Neal’s Yard Dairy, a cheese store at the Borough market in London, UK. In this store, customers should talk to the person over the counter to buy cheese. While having conversation with another human being over the counter, they learn what to buy and are relieved or excited. Only people can educate AND delight us at the same time. Kiosks cannot.

***

Reference

Gavett, G. (2015). How self-service kiosks are changing customer behavior. Harvard Business Review, 3(1), 1-6.

Cases

Man-made sky – Do you feel like you are in Italy?

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Macau has many tourist spots including Senado Square and Ruins of St. Pauls. However, I enjoyed a shopping district at The Venetian Macau the most. As the name suggests, a man-made Italian city exists in the hotel.

 

 

When I first entered this district, something unnatural grabbed my attention; canal is narrow, floor is shiny, and lights are bright. These are clearly different from what I saw or expected in Venice.

However, about 30 minutes later, I saw myself paying attention to something good: cool air, blue sky, and sailor’s singing a song. Then, it did not take more than an hour to feel like I was in Venice. I was surprised by how soon I became immersed with a fake world or, more precisely, a human-made store environment (probably because some people took a ride on the gondola?).

 

 

As many of us live in cities, we are often surrounded by human-made environments. What if our thoughts and behaviors are dictated by artificial environment?

 

 

 

Jaewoo Joo | design thinking, behavioral economics, field experiment, customer experience