Rio Mata Centrer for Cognitive and Decision Sciences - University of Basel - Presentation at DayOne Experts event on digital nudges and behavioral economics in healthcare in Basel 11 April 2018

1. Introduction to Behavioral Economics
Rui Mata
Center for Cognitive and Decision Sciences
University of Basel

2. Behavioral and life style factors are key determinants of health
http://thelancet.com/gbd/gbd-compare-visualisation
Wang, H., Naghavi, M., Allen, C., Barber, R. M., Bhutta, Z. A., Carter, A., et al. (2016). Global, regional, and national life
expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: A systematic analysis for
the Global Burden of Disease Study 2015. The Lancet, 388(10053), 1459–1544.

3. Behavioral sciences as a potential solution
Daniel Kahneman Richard Thaler
20082011
2002 Nobel Memorial Prize
in Economic Sciences
2017 Nobel Memorial Prize
in Economic Sciences

6. Nudges
1. help decision makers achieve a desired goal
2. exploit known cognitive/motivational shortcomings
3. affect features over which people claim not to care
about (e.g., position in a list, defaults, framing)
4. are in principle reversible, allowing the chooser to
decide freely
Grüne-Yanoff, T., & Hertwig, R. (2015). Nudge versus Boost: How coherent are policy and theory?
Minds and Machines, 1–35.

8. A taxonomy of behavioral change techniques
Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: A new method for
characterising and designing behaviour change interventions. Implementation Science, 6(1), 42.
Education
Persuasion IncentivisationCoercion
Restriction Training
Restructuring
Modeling
Enablement

9. Evaluation is key but evidence is lacking

10. Incentivisation can work but lacks sustainability and long-term impact
John, L. K., Loewenstein, G., Troxel, A. B., Norton, L., Fassbender, J. E., & Volpp, K. G. (2011). Financial incentives for
extended weight loss: A randomized, controlled trial. Journal of General Internal Medicine, 26(6), 621–626.

11. Incentivisation may not work for everyone
Kupferschmidt, K. (2017). The science of persuasion. Science, 356(6336), 366–369.

12. Betsch, C., Böhm, R., & Chapman, G. B. (2015). Using behavioral insights to increase vaccination policy effectiveness.
Policy Insights From the Behavioral and Brain Sciences, 2(1), 61–73.
Brewer, N. T., Chapman, G. B., Rothman, A. J., Leask, J., & Kempe, A. (2017). Increasing vaccination: Putting psychological
science into action. Psychological Science in the Public Interest, 18(3), 149–207.
Incentivisation may not work for everyone
Different reasons for non-vaccination
Confidence Complacency Convenience Calculation
Incentivisation ✔ ✔ ✔
Debunking ✔
Reminders ✔

13. Betsch, C., Böhm, R., & Chapman, G. B. (2015). Using behavioral insights to increase vaccination policy effectiveness.
Policy Insights From the Behavioral and Brain Sciences, 2(1), 61–73.
Brewer, N. T., Chapman, G. B., Rothman, A. J., Leask, J., & Kempe, A. (2017). Increasing vaccination: Putting psychological
science into action. Psychological Science in the Public Interest, 18(3), 149–207.
Incentivisation may not work for everyone
Different reasons for non-vaccination
Confidence Complacency Convenience Calculation
Incentivisation ✔ ✔ ✔
Debunking ✔
Reminders ✔

14. Future directions
Michie, S., Thomas, J., Johnston, M., Mac Aonghusa, P., Shawe-Taylor, J., Kelly, M. P., et al. (2017). The Human
Behaviour-Change Project: Harnessing the power of artificial intelligence and machine learning for evidence synthesis
and interpretation, 1–12. http://doi.org/10.1186/s13012-017-0641-5
Digitalisation and automatisation of experimentation and research synthesis
http://www.ucl.ac.uk/human-behaviour-change
Human Behaviour-Change Project

15. Take Home Message
Nudges are a promising but only one of several tools in the
behavioral-change toolkit
Promise of digital deployment and automated evaluations
Challenges regarding the use of nudges in healthcare
- few studies and research syntheses so far
- limited sustainability and long-term impact
- heterogeneity of target populations