This document discusses evidence-based behavior change principles that can be applied to communications and marketing. It summarizes research showing that traditional economic theories that view people as rational are inaccurate, and that unconscious behaviors drive most decisions. It then outlines several principles supported by research, including: leveraging loss aversion over potential gains, using social norms to show popular behaviors, "chunking" large tasks, employing reciprocity, focusing on current rather than future events, and using these principles in marketing contexts like healthcare and government initiatives. The document argues for an approach grounded in behavioral science instead of only providing information.

1. Increasing Communications Success
By Thinking Differently
Denise Aube, Vice President, Health Care Practice Leader
Joel Machak, Executive Creative Director

2. What should I wear?
Which doctor
should I choose?

3. Traditional economic
theory portrays
people as rational.

4. Traditional healthcare
communications
provide consumers
with education.

5. Trends in Current Cigarette Smoking
Among High School Students
34.8% 36.4% 34.8%
30.5%
27.5% 28.5%
21.9% 23%
20% 19.5%
1991 1993 1995 1997 1999 2001 2003 2005 2007 2009
Source: Centers for Disease Control and Prevention.

6. Knowledge is not enough.

7. Brain science
tells us that the
unconscious mind
controls
95% of behavior.

8. People actually
behave in
predictably
irrational ways.

9. A few principles…. and some applications.

10. Loss Aversion
The possibility of loss
motivates people to
action more than the
idea of gain.

11. If you insulate your home fully If you fail to insulate your home
you will save 50 cents a day. you will lose 50 cents a day.
4% response 10% response
Source: Robert B. Cialdini, Influence: The Psychology of Persuasion, 1993.

12. Regional Hospital
Women’s Heart Center
Outpatient Services
• “Fact-based” campaign, 1 appointment
scheduled over the course of several
weeks.
• Current campaign, 12 appointments in
week 1.

13. Social Norming
People do what they think other people
like them are doing.

14. NO
SIGN your fellow guests in helping
Join
Help save the environment. save the environment
Reuse your towels during your stay. (75% are participating).
Reuse your towels during your stay.
44% reuse
35% reuse
- 49% reuse
Source: Study published in Journal of Consumer Research (2008), authored by Noah J. Goldstein, Robert B. Cialdini, Vladas Griskevicius.

15. County Government Department of Health
Cancer Prevention Program Made breast cancer
screening the norm –
“8 in10 women right
here in AA Cty.”
2010 Postcard – I mail drop 2011 Postcard – 1 mail drop
Traditional Health Education Focus Utilizes “Social Norming”
< 100 county residents respond Nearly 600 county residents respond
4.5% response rate
(DMA benchmark 2.5%)
15

16. Chunking
People are more likely to embark
on a difficult task if it’s presented
in bite-sized stages, rather than
one continuous act.

17. Survey with 96 questions
Survey with 96 questions.
divided into 8 sections, 12
Q1 – Q96
questions in each.
6% response 26% response
61% of responders 87% of responders
complete the entire complete the entire
form form
Source: Richard Storey, AAAA, Behavioral Economics: Small Change, Big Difference, 2010.

19. Reciprocity
People are more likely to give if they
receive something first.

20. Physician Surveys
National sample, 2,147 physicians
Mailed survey – 25 minutes to complete
½ sample was promised a check ½ sample was sent a check with
upon completion of survey the survey (pre-payment)
66% completion 78% completion
Only 26% of respondents who did not complete
survey cashed checks.
Source: Study published in Public Opinion Quarterly (2001), authored by Sandra Berry and David Kanouse, funded by NIH.

21. The Power of Now
We engage more strongly with
current events than future ones.

22. What is the most effective way to stop speeding?

23. Photo taken and fine incurred.
No photo taken, no fine incurred.
Prevents 2.2
accidents
Prevents 3.1
accidents
Source: United Kingdom, Department of Transport Study, 2008, Angela Watkinson’s Report to House of Commons.

24. Regional Hospital
Emergency Services
• Digital platforms provide ER wait
times in “real time”
• ER services up 2%
Mobile Application
shorterERwait.com: updated every 30 minutes
24

25. • Drive awareness and traffic through
online, outdoor, social media
25

26. Smoking causes cancer, lung
disease, heart disease….
sometime in the future.

27. Bar coasters engage the target when
message is most relevant.
27

28. Gas pump toppers send messages
when smokers are likely to
purchase cigarettes.
28

29. QR codes drive traffic to a
mobile site to download or
order a quit kit by phone.
29

30. Elevator or stairs?

31. Stair use increased immediately
from 9.2% to 34.7%.
Source: New York City Department of Health and Mental Hygiene.

32. I don’t know… those
cookies on the
counter smell good.
How do we get people to make
healthier decisions?

33. How do we get more people
to participate in our events?

34. I just want to
go home.
How do we get more
people who have been
waiting for hours at
DMV to register to
become organ donors?

35. Evidence-based
behavior change
principles.

36. Thank you.
Denise Aube
Vice President, Health Care Practice Leader
daube@crosbymarketing.com
@deniseaube
301-261-1570
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