Abstract
We test the main predictions of the rational addiction model, reconceptualized as rational habit formation, in the context of handwashing. To track habit formation, we design soap dispensers with timed sensors. We test for rational habit formation by informing some households about a future change in the returns to daily handwashing. Child weight and height increase for all households with dispensers. Monitoring and incentives raise handwashing contemporaneously, and effects persist well after they end. Anticipation of future monitoring further raises handwashing: individuals internalize handwashing's habitual nature and accumulate stock. Our results inform policy design around the adoption of healthy behaviors.
Highlights
Bacterial and viral contamination, resulting in anemia, diarrheal disease, and acute respiratory infection, end the lives of nearly three million children per year and contribute to the severe stunting of millions more
Children in households that received a dispenser and soap report 39.5% fewer days of loose stool and 23% fewer days of acute respiratory infection (ARI) eight months after the distribution of the dispensers.2. These effects rise to 74% fewer days of loose stool and 28% fewer days of ARI when we examine the impact of the treatment on the treated, where ‘treated’ is defined as those who self-report regularly washing their hands at the eight month mark
Perhaps the term “monitoring” makes the act of handwashing more salient today than the term “tripling of tickets.” (Note that this is distinct from a salience argument in which being monitored in the future makes handwashing more salient today than receiving triple tickets in the future: if salience from future activity were the mechanism, responding to such salience would fall within the realm of rational habit formation.) there is little one can do to ensure equal salience of handwashing across related terminology, we offer the following test: on the days of surveyor visits, it is likely that the salience of handwashing is maximized regardless of what treatment arm one is in
Summary
Bacterial and viral contamination, resulting in anemia, diarrheal disease, and acute respiratory infection, end the lives of nearly three million children per year and contribute to the severe stunting of millions more. Agents can benefit from these behaviors becoming matters of habit Most of these preventive health behaviors suffer low rates of takeup in the developing world despite their affordability, and neither information provision nor materials and/or infrastructure provision appear to generate sustained improvements in such practices (Dupas and Miguel 2016, Clasen et al 2014, Kremer and Zwane 2007, Banerjee et al 2010, WSP 2012, WSP 2013). Given their repetitive, reflexive nature and ties to contextual cues, the psychology literature highlights such behaviors as ideal candidates for habit formation (Wood and Neal 2007)
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