BEHAVIORAL SCIENCE & WIC: SMALL TWEAKS TO MAKE A BIG ... · ideas42 Poverty Interrupted: Applying...

BEHAVIORAL SCIENCE & WIC: SMALL TWEAKS TO MAKE A BIG DIFFERENCE Jonathan Hayes, Senior Associate

Dani Grodsky, Senior Associate

Thursday, April 20, 2017

AGENDA

•  What is ideas42 and behavioral science?

•  The influence of context

•  Application to public benefits programs

•  Recommendations for WIC

•  Q&A

AGENDA

•  Q&A

FIRST, A GAME…

YOU HAVE ONE JOB…

Say out loud the color of the shape you see on the screen.

STANDARD DECISION MAKING MODEL Decision Action Outcome

Do I want outcome X? What action must I take?

Outcome X occurs or not.

BEHAVIORAL DECISION MAKING MODEL

I don’t know

How hard is it?

Will it take long?

Am I in the mood?

Can I put it off?

Do I want outcome X? What action must I take? Outcome X occurs or not.

Decision Action Outcome

EXCELLENT AIRMEN COMMIT NO ERRORS

CONTEXT MATTERS

WHO ARE WE, REALLY?

A nonprofit that uses the theories of behavioral science and psychology to design solutions to some of the world’s

most persistent social problems.

WE WORK ACROSS SEVERAL DOMAINS

consumer finance

economic mobility

energy

government

international development education criminal justice

health

PROJECT METHODOLOGY

Disentangle presumptions to

arrive at a behavioral problem

Study the context and identify key bottlenecks

Create and refine a

workable solution

Test our solution and learning

from the process

DEFINE DIAGNOSE DESIGN TEST SCALE

Spread successful

interventions more widely

AGENDA

•  Q&A

THOUGHT EXPERIMENT A mother using WIC arrives over 20 minutes late for her appointment and you recall that she has been late multiple times before. What does this say about about her?

Fundamental Attribution Error

•  She does not value punctuality

•  She does not appreciate her WIC benefits

•  She is forgetful and irresponsible

•  She can only leave once her husband returns from work to drive her

•  She relies on friends or family to arrive on time to watch her children

•  She must run multiple errands in the small window of time she’s off of work

The Person The Situation

CONTEXT HAS MULTIPLE MEANINGS

Milkman, Katherine L., et al. (2011) "Using implementation intentions prompts to enhance influenza vaccination rates." Proceedings of the National Academy of Sciences 108(26): 10415-10420.

CONTEXT AS COMMUNICATIONS

27% increase in vaccine uptake

Wansink, B., Painter, J.E., North, J. Bottomless bowls: why visual cues of portion size may influence intake. (2005) Obesity Research & Clinical Practice,13(1): 93-100.

Regular Bowl vs. Refilling Bowl

Those who ate from the refilling bowl had 73% more soup…

Predicted that they ate 140 fewer calories than they actually did…

And were no more likely to report being more full after the meal.

CONTEXT AS VISUAL CUES

CONTEXT OF SCARCITY

•  Scarcity of any resource (e.g. time, money, food) takes up mental capacity and causes “tunneling” of the mind

•  This can be adaptive in the short term

•  But dangerous when chronic

YOUR BRAIN UNDER SCARCITY

QUANTIFYING THE BANDWIDTH TAX

Mani, Mullainathan, Shafir, and Zhao, Science, 2013

COGNITIVE CONTROL

Rich" Poor"

Easy"(cheap)"

Hard"(Expensive)"

RAVEN’S MATRICES

High Income High Income Low Income Low Income

$3,000

Mani, A., Mullainathan, S., Shafir, E., Zhao, J. (2013) Poverty Impedes Cognitive Function, Science, 341 (6149), 976-980.

POVERTY ≠ PERSONAL FAILING

POVERTY ≠ CULTURAL PATHOLOGY

POVERTY =CHRONIC SCARCITY

AGENDA

•  Q&A

POVERTY INTERRUPTED

HOW TO CHANGE THE CONTEXT OF SCARCITY

3 design principals and

15 recommendations for reducing the bandwidth

tax and addressing the context of poverty

DESIGN PRINCIPAL 1: CUT THE COSTS

Cut the costs

The high costs of poverty

Poverty is expensive, in more ways than one. Families with low incomes

face significant financial, temporal, and cognitive costs on a daily basis.

Providing families additional resources can help (see “Create slack” below), but

individuals and organizations serving people in poverty should first focus on

reducing the costs they themselves impose.

Poverty Interrupted: Applying Behavioral Science to the Context of Chronic Scarcity | 17i d e a s 4 2

Design Principles:Cut the costs

A BENEFITS COMMON APP

DESIGN PRINCIPAL 2: CREATE SLACK

VALUE TIME AS MONEY

DESIGN PRINCIPAL 3: REFRAME AND EMPOWER

Reframe and empower

The toxic environment of poverty

Thus far, we’ve focused on ways to reduce the complexities, hassles,

and lack of slack that drive up the bandwidth tax for families with

limited incomes. Poverty also affects individuals and families in a way that

is less visible, and perhaps more insidious: by shaping their understanding

of who they are, where they fit in society, and what’s possible for their

future. These perceptions in turn shape decisions and actions, often in

negative ways. To improve outcomes for families

with low incomes, we must work to

de-stigmatize services and ben-

efits, promote more constructive

interpersonal interactions,

and put decision making

back in the hands

of families.

Design Principles: Reframe and empower

USE INTENTIONAL LANGUAGE

DEFINE

DIAGNOSE

DESIGN

32% of SNAP recipients lose benefits for failing to submit recertification forms or complete phone interviews

Ambiguous process, many small hassles, easy to forget, underestimation of time required for tasks

Clarify action steps, icons to visually communicate required steps, frame in terms of losses, call for immediate action

Randomized controlled trial on 22,000 SNAP recipients up for recertification. Final results anticipated by summer 2017

INCREASING SNAP RECERTIFICATION Design Principal 1: Cut the Costs

Original Letter Behavioral Letter

Clear action steps

Loss frame

Icons communicate action steps

Call to immediate

action

INCREASING SNAP RECERTIFICATION Design Principal 1: Cut the Costs

AGENDA

•  Q&A

WHAT CAN YOU DO TO IMPROVE WIC FOR THOSE IN THE CONTEXT OF

CHRONIC SCARCITY?

OUR WORK WITH CALIFORNIA WIC

•  3 WIC agencies in San Jose, CA

•  Expert interviews with over a dozen people in government, academia, nutrition and community outreach

•  Over 60 interviews with staff, current and past participants

•  Site visit observations

THE THREE DESIGN PRINCIPALS

Cut the costs

The high costs of poverty

Poverty is expensive, in more ways than one. Families with low incomes

face significant financial, temporal, and cognitive costs on a daily basis.

Providing families additional resources can help (see “Create slack” below), but

individuals and organizations serving people in poverty should first focus on

reducing the costs they themselves impose.

Design Principles:Cut the costs

Cut the Costs

Create Slack

Reframe and empower

The toxic environment of poverty

Thus far, we’ve focused on ways to reduce the complexities, hassles,

and lack of slack that drive up the bandwidth tax for families with

limited incomes. Poverty also affects individuals and families in a way that

is less visible, and perhaps more insidious: by shaping their understanding

of who they are, where they fit in society, and what’s possible for their

future. These perceptions in turn shape decisions and actions, often in

negative ways. To improve outcomes for families

with low incomes, we must work to

de-stigmatize services and ben-

efits, promote more constructive

interpersonal interactions,

and put decision making

back in the hands

of families.

Design Principles: Reframe and empowerReframe and

Empower

SUPPORTING COMPLEX DECISIONS

Upfront, provide clients with information about…

WIC vendor locations Education options

Design Principal 1: Cut the Costs

Design Principal 2: Create Slack Appointment: May 2nd

THE POWER OF REMINDERS

April 11th April 27th May 22nd

MAKING EDUCATION STICK Design Principal 2: Create Slack

Would a time on Monday or Wednesday morning works for you?

What day and time in the week are best for

RETURNING AGENCY TO THE CLIENT Design Principal 3: Reframe and Empower

•  Have you ever looked for WIC labels in the grocery?

•  In your everyday life, when do you forget appointments or deadline? Have you ever needed to rely on others for transportation?

•  Do you have friends or family using WIC?

•  When is this the easiest to forget and how can you remind yourself to shift perspectives?

SHIFTING PERSPECTIVE Design Principal 3: Reframe and Empower

NEXT STEPS IN OUR WIC WORK

2017 •  Partnering with two WIC agencies in Northern and Southern CA •  Co-design and process evaluation of 2 behaviorally-informed solutions

2018 •  Potential for full implementation and testing

Opportunity for partnership, continued research and insight sharing nationally

LEARN MORE

VISIT: www.ideas42.org

EMAIL: JHayes@ideas42.org DGrodsky@ideas42.org

FOLLOW: @ideas42

READ: Poverty Interrupted White Paper

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