Forced to adopt new habits

This article first appeared in The Hindu on 14th May 2020.

Starting new habits is tough and requires overcoming inertia. Most of the time humans like maintaining the status quo. The majority of us don’t change the default settings when we buy a new mobile phone. Nor we do change the default settings of any new app we download. The tendency to stick with defaults happens across different aspects of our lives, from personal to social to office work. But this pandemic has jolted us out of our inertia.

We’re now doing new things that we haven’t done before. Those not used to cleaning their own dishes or homes are doing so now. Those not used to working from home are forced to do so now. Managers who wouldn’t allow their teammates to work from home have no choice but to ask them to work from home now. The pandemic has forced us to start new habits.

One habit that we Indians are not used to is maintaining sufficient physical distance from one another in public spaces. There are many reasons for this. Urban cities are densely packed with people. Houses in slums are cramped. Few roads have footpaths, forcing pedestrians to take up a portion of the road. Lanes are narrow; even main roads are narrow. Trains and buses are always packed. Queues are long. The population is overwhelming.

Environmental factors

Behavioural science studies are showing evidence that a large part of human behaviour is led by environmental factors. In normal times we don’t pay much attention to our environment because we don’t need to. If one has to take a crowded train to work because of lack of better choice, we get used to it because the goal is to get to office, in time. The environment becomes part of our sub-conscious. We navigate through life, lanes, stations, etc. without paying much attention to our surroundings. But the pandemic is now making us aware of our surroundings. Besides behaviours like hand washing, sanitising and wearing masks to prevent contracting COVID-19, the pandemic is driving another big behavioural change — keeping safe distance.

Merely informing people that they need to maintain at least six-feet distance from one another is not enough. People tend to forget about distancing while talking to one another. Maintaining distance is an alien concept for us.

That’s why we’re now seeing examples of behavioural design nudges in our environment that help us in maintaining distance in public spaces. Markings in the form of circles and squares are being painted outside grocery stores and pharmacies to help people maintain distance. People are now standing in these circles and squares while waiting in queues. I hope relevant authorities implement this rule, wherever crowds need to be managed.

Maintaining physical distancing

Around the world behavioural design nudges are being implemented to help people keep safe distance from one another. Restaurants in Hong Kong are putting tapes over alternate tables so that people do not occupy tables next to each other. A bus station in Thailand has put stickers on alternate seats so that people sit leaving one seat empty. Schoolchildren in Hangzhou, China are being made to wear caps with fan-like blades so that they cannot come close to other children. A police station in Thailand has placed transparent protective shields on desks creating a barrier between the police inspector and civilians. 

We are likely to see many more examples of such behavioural design in the near future that help us keep safe distance, because the lockdown will eventually be lifted.

To see examples of Behavioural Design for keeping safe distance, click here – Instagram

Making doctors wash hands

This article first appeared in The Hindu on 24th April, 2020

Ignaz Philipp Semmelweis, a Hungarian-born doctor came to Vienna in 1846 to work at the city’s General Hospital. Dr. Semmelweis noticed that women delivered by doctors had three times higher mortality rate than women delivered by midwives. He spotted a link between the lack of hygiene of the doctors and the mortality rate of the mothers. After he initiated a mandatory hand-washing policy, the mortality rate for women delivered by doctors fell from 18 percent to about 1 percent. Despite such a brilliant outcome, the idea of hand washing was rejected by the medical community. Doctors were offended by the suggestion that they could be causing infections. Semmelweis’s practice earned widespread acceptance only two decades after his death, when Louis Pasteur, of pasteurization fame, raised awareness of pathogens.

From 1850s to 2020, hand washing has been advocated as a simple way of reducing the risk of infection. But even after 170 years, studies find that doctors still do not wash their hands often. A systematic review of studies on compliance with hand hygiene in hospitals, done by researchers Vicki Erasmus et al, found that only 32% of doctors and 48% of nurses wash their hands between seeing patients. Another study by researcher Didier Pittet, an infection control expert with the University of Geneva Hospitals, Switzerland found that compliance rates for hand washing amongst doctors and nurses was only 57 percent, and years of awareness programs urging doctors to wash up or use disinfectant gels have had little effect. A study of hand hygiene compliance amongst Indian doctors by researchers S. K. Ansari et al, found only 49% of doctors and 56% of nurses washed their hands with soap between patients.

If India needs to contain the spread of Covid-19, everybody ought to be washing our hands, especially doctors and nurses. But how can we change their hand washing behaviour?

The traditional approach of changing behaviour is to educate doctors and nurses on the importance of hand washing. It seems like the rational and logical thing to do, but even though doctors and nurses know that they should be washing their hands, they forget to do so. That’s why we need to apply behavioural design. Behavioural design is about creating subconscious nudges right at the moment where the desired action is to be performed, in our case where hand washing needs to happen.

Behavioural scientists piloted a low-cost experiment in rural schools in Bangladesh where behavioural design nudges were used to guide hand washing with soap after toilet use. Hand washing stations were built in visible and easy‐to‐reach locations, brightly colored paths were painted from toilets to the hand washing station, and footprints and handprints were painted on the path and at the hand washing station. Hand washing with soap after using the toilet went from 4% before these behavioural design nudges nudges were created, to 74% six weeks after they were introduced. No other hygiene education was communicated as part of the study.

Similarly, in hospitals where wash basins and hand sanitizers are placed, stickers of brightly colored footsteps should be placed so that doctors and nurses get attracted by them, which subconsciously directs them to the wash basin or the hand sanitizer. Such behavioural design nudges influence doctors and nurses to wash their hands with soap or sanitizer without making a conscious decision to do so. Hand washing is often done as a relatively subconscious habitual action, and can be easily triggered by contextual cues, so hand washing lends itself well to such behavioural design nudging. An experiment done at the Gentofte Hospital in Denmark has found that hand sanitizer usage increased from 3% to 67% when the hand sanitizer was placed in a prominent location with bright signage that caught people’s attention. Not bad for such a simple and low cost intervention.

Creating social bonds while physical distancing

This article first appeared in Mint on 6th April 2020

Till a few weeks ago almost nobody in the world knew what social distancing meant. But since the spread of Covid-19, the term ‘social distancing’ has gone viral too. It implies steps that need to be taken to prevent the spread of coronavirus by maintaining a physical distance between people and reducing the number of times people come into close contact with each other. It involves keeping a distance of six feet from others and avoiding gathering together in large groups. It is critical in curbing the spread of the virus and must be followed as far as humanly possible.

But the term ‘social distancing’ means to avoid being social. That’s unnatural for most humans. Humans are a social and emotional beings. We survive and thrive being social. Children are attached to their parents. Grandparents love spending time with grandchildren. Siblings are emotionally close to each other. We all have friends who are our life supports. In India, house helps are like extended family. But now because of Covid-19 we suddenly need to follow social distancing from the people who are always there for us precisely in times like these. It goes against human nature. That makes using the term ‘social distancing’ inappropriate.

Matthew Liebermann, a social neuroscientist, has conducted several studies on how our brains processes social pain. He finds that to the brain, social pain feels a lot like physical pain. The more rejected the participant felt, the more activity there was in the part of the brain, that processes the distress of physical pain. What’s surprising is that studies show that drugs that treat physical pain, like paracetemol, can also reduce emotional pain like social rejection, because similar brain circuitry is engaged when we feel physical pain. That’s perhaps why we express social pain in terms of physical pain, like “she broke my heart”, “he hurt my feelings”. Social pain is real pain. Social pain is associated with decreased cognitive functioning, increased aggression and engagement in self-defeating behaviors, like excessive risk taking and procrastination. So its safe to assume that social distancing in today’s times must be causing real pain too.

Over the past few days we’ve been seeing people in various countries come out in their balconies and sing songs, play music and cheer the people who have been dedicating their time, risking their lives serving patients and delivering essential supplies. Prime Minister Narendra Modi has addressed the nation twice requesting we all stand in solidarity. It may not mean much for people who can easily take care of themselves during these times. But for the rest of us, his aim is to boost morale, because levels of stress and anxiety are rising. We humans don’t like uncertainty. We don’t know how long it may take for the vaccine to be made available for most of our population. We don’t like being caged in our little homes away from our social bonds. These times call for social bonding, not social distancing. Thankfully social bonding is possible today because of being able to stay connected over voice and video calling. We can talk to each other about how we are feeling, what we cooked, the jokes our children are cracking, the dreams we’re getting at night and details about the quarrels between couples.

On March 20, the World Health Organization officially changed its language. “We’re changing to say ‘physical distancing,’ and that’s on purpose because we want people to still remain connected,” said WHO epidemiologist Maria Van Kerkhove. Language matters. Just like how ‘climate change’ is now refered to as ‘climate crisis’ by media, ‘social distancing’ needs to be refered to as ‘physical distancing’. So start exercising physical distancing and social bonding, because this pandemic is going to last quite some time.

Get rid of that tricky habit of touching your face

This article first appeared in Mint as an opinion editorial on 31st March 2020.

Few days back Dr. Sara Cody, director of the Santa Clara County’s Public Health Department, US was speaking at a press conference about a simple, yet vital, way on how people can stop coronavirus from spreading: Don’t touch your face. “Today, start working on not touching your face — because one main way viruses spread is when you touch your own mouth, nose, or eyes,” Dr. Cody, said at the press conference. Less than a minute later, Dr. Cody brought her hand to her mouth and licked her finger to turn a page in her notes.

It’s not just Dr. Cody, millions have the habit of touching their tongue before turning the page of a document, especially the elders, who are at the highest risk of catching coronavirus. This is just one of the instances of touching a part of the face. The bigger problem is that almost every human being in the world has a habit of touching their face, including me and probably you too. A study by scientists in New South Wales, Australia, Kwok, Gralton and McLaws, found that on average people touch their faces 23 times an hour. What makes this behaviour tricky is that it’s a habit.

Habits are automatic behaviours that are done sub-consciously. They are actions that we perform frequently on auto-pilot. That’s precisely why they go unnoticed. This makes habits tricky because we aren’t even aware of it. Honestly this is the first time, being a behavioural scientist, that I’m even thinking about touching my face. I must be doing it all the time everyday without any realization whatsoever. But now we’re finding that coronavirus can spread easily, by touching surfaces that may be infected with the virus, and then touching any part of the face like mouth, nose or eyes – where the body’s mucous membranes are vulnerable to infection. That’s bringing up our habit of touching our face and making us aware of it. But even after being aware of it, I can’t help touching my face.

Ironically, the more you want to consciously avoid something, the more you think about it. So the more one thinks about not touching the face, the more it makes you want to touch your face. You are probably wanting to touch your face right now. That’s because you’ve been momentarily made conscious of your face, eyes, nose and mouth. This simple fact makes you want to touch it, perhaps as simple as scratch your cheeks a little or adjust your eyebrows or itch your nose. The other reason is psychological reactance. People cannot resist indulging in precisely what they’ve been told to avoid. It’s like being on a diet. When people are on particular diets and forbidden to eat certain foods, it makes them want to eat those foods even more.

Touching the face is an instinctive response. A recent study by behavioural scientists Mueller, Martin and Grunwald show that face touching is involved with coping with stress, regulating emotions and stimulating memory. Other researchers have established it’s an instinct we share with monkeys and apes. Gorillas, orangutans and chimpanzees all exhibit similar face-touching behaviour. But what can we humans do to prevent touching our faces and prevent getting infected this way by coronavirus?

Washing hands is the need of the hour. But we also need to use our hands often to open doors, press lift buttons, use keyboards, drink from glasses, use pens, open and shut taps, and a hundred other things that  we don’t think about. How often can one wash hands or even use the hand sanitizer. It can be overwhelming if we have to wash hands after touching everything. I’m not recommending we don’t do it. I’m simply saying that it’s not practical to keep washing hands after each and every interaction.

Keeping our hands away from our face requires a lot of willpower. But willpower has been shown in behavioural science studies to always be limited in supply. Willpower works temporarily in the moment when one is conscious but wears out quickly as we slip back into doing things subconscious i.e. habits. Willpower is a bit like our muscles. The stronger our muscles are, the more we can work them out. But eventually they tire out. Similarly, the stronger our willpower is the more we can work them out but eventually we tire out. So willpower is not a dependable way of avoiding to touch our faces, while touching our face is going to be unavoidable.

That’s why we need to rely on behavioural design to help us not touch our face. Behavioural design is about tweaking our environment, right at the time and place our behaviour takes place, to achieve the desired action. For example, to reduce the quantity of food intake, instead of relying on willpower, if we reduce the size of the plate we eat from as well as the size of the spoon, we’re likely to eat less. Similarly, to avoid touching our face with our hands, we could try keeping a clean tissue at a close distance. By using clean disposable tissue we could prevent our bare hands from touching our eyes, nose and mouth. You can use a small portion instead of one whole piece to conserve paper. Small things make a big difference.

Do you spend enough time analyzing the problem?

I used to hear the words ‘the client wants it yesterday’ a lot when I used to be in advertising. And for various reasons people in advertising succumbed to the pressure. This in turn led to clients crunching the timelines even shorter as years passed, while the ad industry diligently kept working harder at keeping deadlines, lowering the quality of strategic thinking, thereby positioning ad agencies as short-term ad campaign makers.

Though you may not be from the ad industry you may find yourself in a similar situation. Unfortunately, the temptation in such time-pressured situations is to use habitual responses to get started on the solution immediately. Since problem-construction feels like a waste of time, it’s the phase that gets sacrificed most often. In reality, it is the most important part of the creative process.

In the classic study on creative preparation conducted by behavioural scientists Jacob W. Getzels and Mihaly Csikszentmihalyi, they asked art students to create a still-life painting of an object, which was later evaluated professionally. The study found that students judged to have created the best work were those who spent the longest preparing – thinking about the object itself and how they were going to use it. When Mihaly returned to the same people 7 and 18 years later, he found that it was these measures of problem identification and construction that predicted the artists’ long-term success. Even 18 years later, artists who spent longer constructing the problem were more successful.

Says Jeremy Dean of www.psyblog.co.uk, “The choices made in the early stages have a massive impact later. That’s why spending longer thinking about the problem before you dive in is likely to lead to higher levels of creativity in the final product. Fools rush in where the more creative dare to tread.”

Needless to say, deadlines are part and parcel of constraints in any commercial work. Constraints bring out the best in us, but we need to give ourselves adequate time to analyze the problem well enough. That’s why before identifying the Behavioural Design principles to be applied to the challenge, we spend a substantial amount of time analyzing the product and customer data and map out the customer journey, whether the customer is a consumer, employee, investor or simply put, the user.

Source: Jacob W. Getzels and Mihaly Csikszentmihalyi – The creative vision: A longitudinal study of problem finding in art – Wiley New York 1976

S.M. Rostan – Problem finding, problem solving and cognitive controls: An empirical investigation of critically acclaimed productivity – Creative research journal 7, no. 2 (1994): 97-110

Behavioural Design for Urban Planning

We were happy to be invited to speak at Milano Arch Week 2019 on applying Behavioural Design to urban planning or as they liked to refer to it ‘Urban Regeneration’. We are happy that architects are opening up to our practice of Behavioural Design to build cities that work for people living in it and to use architecture to modify public behaviour.

Our talk included Behavioural Design examples from my Instagram feed. Some of the examples we referred to were the Ballot Bin that gets cigarette smokers to stub their cigarette buds at the Ballot Bin because they are motivated to vote for their choice, whether the choice is about your favourite football player or some other topical question. We were asked about Bleep horn reduction system as a Behavioural Design nudge to reduce drivers’ honking. We spoke about how the Bureau of Energy Efficiency (BEE) in India has made it mandatory for appliances to come with star ratings and how it’s nudging people to choose higher star rated appliances so that people can save money and in doing so also consume lower power and contribute towards climate crisis in a positive manner. Some of the other examples we spoke about were Behavioural Design nudges to reduce overspeeding, getting people to – use trash bins in the outdoor, use sanitizers in hospitals, use stairs instead of escalators, and many more. If you’re curious to know more, click here.

To change the habit, change the environment

Habits get automatically activated by our environment, especially so in stressful situations like when you get home hungry and tired – that time our habits are in full control of us. An effective way to change the habit is to change the environment.

Behavioural scientists Neal and colleagues had participants sit in a cinema watching trailers while others sat in a meeting room watching music videos. None were aware that the study was about eating habits; they were told it was about attitudes and personality.

When sitting in the cinema, strong habits cued by familiar circumstances had their familiar effect – people ate popcorn like robots. In the cinema, it didn’t matter whether the popcorn was stale or fresh or whether the person was starving or had a full stomach. Liking for popcorn had very little effect on how much they ate. Those with weaker popcorn eating habit did eat less of the stale popcorn.

In contrast, participants in the meeting room, all behaved, more thoughtful, whether or not they had a strong habit of eating popcorn at the cinema. They ate less of the stale popcorn, and less overall if they weren’t hungry. Even for those with strong popcorn eating habit, the change of environment was enough to disrupt their automatic behaviour. Overall, in the meeting room, people ate 50% less popcorn than those in the cinema.

Then some people in the cinema were told to eat with their non-dominant hand. If they were right-handed, they were told to eat with the left hand. This jolted them out of their habitual behaviour and brought the conscious mind back into action.

Take a close look at your kitchen. Is the first thing you see healthy or unhealthy? What’s easily accessible – fruits or packaged snacks? How big are the containers in which food is stored? How big are the plates you eat out of?

Source: D.T. Neal, W. Wood, M. Wu, D. Kurlander – The pull of the past – personality and social psychology bulletin 37, no. 11 (2011): 1428-1437

The journey from taking the lift to walking the stairs

The journey from taking the lift to walking the stairs

How often have we heard that we must take the stairs especially if we need to go to Floor nos. 1/2/3, yet how many times do we take it? It’s an exercise that can be so easily incorporated into everyday life, but awareness yet again doesn’t translate into action.

So a few behavioral scientists put a sign at the bottom of the stairs telling us that walking up the stairs burns about five times as many calories as taking the lift. Sixteen studies analyzed this intervention and found that on average, stair use increased by 50%. Sure this is from a low baseline, because not many people generally use the stairs in the first place, but it does demonstrate that a small nudge can do more than any big-budget-ad-campaign to change behavior. Few stations in Tokyo, Japan like Tamachi station have implemented it by mentioning the number calories burned with each step. And a friend of ours says he feels better while walking up the stairs because he can see how many calories he’s burning with each step.

Of course there’s a way of making climbing stairs fun like the Volkswagen piano staircase, but putting signs is probably a thousand times cheaper.

Source: R.E. Soler, K.D. Leeks, L.R. Buchanan, R.C. Brownson, G.W. Heath and D.H. Hopkins – Point-of-decision prompts to increase stair use: A systematic review update – American Journal of Preventive Medicine 38, no.2 (2010): S 292 – S 300

Behavioural Design for safer public spaces (Mint)

Behavioural Design for public spaces

This article first appeared in Mint on 24th Sep, 2018.

Recently it was reported that a 9W 697 Mumbai-Jaipur flight was turned back to Mumbai after take off as, during the climb the crew forgot to select the bleed switch to maintain cabin pressure. This resulted in the oxygen masks dropping. Thirty out of 166 passengers experienced nose and ear bleeding, some also complained of headache.

Aviation safety experts say such an incident was “extremely rare” as turning on the bleed switch is part of a check-list that pilots are expected to mandatorily adhere to. If turning on a switch that regulated cabin pressure is part of standard protocol, how could the pilots make such a simple, common-sensical error. And more importantly how can such errors be avoided in the future?

Traditional thinking suggests increasing the training of the pilots so that it makes them better and thereby avoid such errors. But training is not a full-proof method of ensuring human errors don’t get repeated. That’s because as long as humans need to rely on their memory to ensure the cabin pressure switch is turned on, errors are bound to happen. Sure check lists work. But that’s still a manual method of ensuring that the switch is turned on. And after repeatedly performing the tasks on the checklists over multiple flights, checklists themselves become routine habitual tasks done without much thinking. Also given that there are multiple tasks pilots need to perform in the 3-4 minutes after taking off, the chance of errors happening during those critical moments becomes high.

So instead of the pilot having to rely on their memory or routine check-lists, the answer to avoid such human errors lies in implementing simple behavioural design nudges. For example, if there was a continuous audio-visual reminder that the bleed switch had not been turned on, it would draw the pilot’s attention and it would be highly likely they would have turned it on. Such an audio-visual reminder was not present in this kind of an older generation of aircraft, and therefore the chance of human error increased.

The Japanese have a term for such error-proofing – poka yoke. This Japanese word means mistake proofing of equipment or processes to make them safe and reliable. These are simple, yet effective behavioural design features that make it almost impossible for errors to occur. The aim of error-proofing is to remove the need for people to think about the products or processes they are using. Some examples of behaviourally designed products used in everyday life are the microwave oven that doesn’t work until the door is shut or washing machines that start only when the door is shut and remains shut till the cycle is over. Elevator doors now have sensors that cause them to not close when there is an obstruction. This prevents injury to someone trying to enter as the doors are closing.

Human behaviour cannot be trusted to be as reliable as a machine. In fact, human behaviour is far from perfect. Yes, the people who operate expensive and complicated machines may be the best trained, but human errors in the form of simple error, lapse of judgment or failure to exercise due diligence are inevitable. According to Boeing, in the early days of flight, approximately 80 percent of accidents were caused by the machine and 20 percent were caused by human error. Today that statistic has reversed. Approximately 80 percent of airplane accidents are due to human error (pilots, air traffic controllers, mechanics, etc.) and 20 percent are due to machine (equipment) failures.

Another instance of how systems could be made safe by applying behavioural design is of airplane emergency evacuations. During the emergency landing of the Emirates flight EK521 at the Dubai airport in 2016, passengers were running to get their bags from the overhead cabins, instead of evacuating the plane. Only when the airplane staff began yelling at them to leave their bags and run, did the passengers finally pay heed to their calls and evacuate. Just a few minutes after the evacuation, the plane caught fire. It was a near miss situation. Had even a few passengers waited to get their bags from the overhead cabins, many of them would have got engulfed in fire. Again the natural instinct to correct such a situation would be to train people to evacuate and get them to listen to the flight’s safety instructions. But behavioural science studies have proven that such efforts are time-consuming, money-draining, unscalable and most importantly ineffective at changing human behaviour. In such an emergency situation, if the overhead cabins were automatically locked, with a label “Locked due to emergency”, passengers would not waste time trying to open them. That would in turn get passengers to behave in the desired manner and evacuate faster.

Sometimes behavioural design nudges are intuitive. Other times they are counter-intuitive. In a fire-drill experiment by behavioural scientist Daniel Pink, he found that placing an obstacle like pillar in the middle of a doorway got people to exit a hall 18% faster than without the pillar. The pillar was an obstacle but it split up people into two streams at the exit. That got people to use each side of the door, which in turn made the flow of people exiting the hall a lot smoother and faster. When the pillar wasn’t there to separate them at the exit, people bottle-necked at the door making the exit slower. Likewise, behavioural design could go a long way to design safer buildings, machines and systems and reduce human errors.



Related Posts Plugin for WordPress, Blogger...