Behavioral Science Interventions Research Articles

Efficiently exploring the causal role of contextual moderators in behavioral science

Behavioral science interventions have the potential to address longstanding policy problems, but their effects are typically heterogeneous across contexts (e.g., teachers, schools, and geographic regions). This contextual heterogeneity is poorly understood, however, which reduces the field's impact and its understanding of mechanisms. Here, we present an efficient way to interrogate heterogeneity and address these gaps in knowledge. This method a) presents scenarios that vividly represent different moderating contexts, b) measures a short-term behavioral outcome (e.g., an academic choice) that is known to relate to typical intervention outcomes (e.g., academic achievement), and c) assesses the causal effect of the moderating context on the link between the psychological variable typically targeted by interventions and this short-term outcome. We illustrated the utility of this approach across four experiments (total n = 3,235) that directly tested contextual moderators of the links between growth mindset, which is the belief that ability can be developed, and students' academic choices. The present results showed that teachers' growth mindset-supportive messages and the structural opportunities they provide moderated the link between students' mindsets and their choices (studies 1 to 3). This pattern was replicated in a nationally representative sample of adolescents and did not vary across demographic subgroups (study 2), nor was this pattern the result of several possible confounds (studies 3 to 4). Discussion centers on how this method of interrogating contextual heterogeneity can be applied to other behavioral science interventions and broaden their impact in other policy domains.

The effectiveness of a behavioral science and design intervention for family savings on use of maternal health services and male involvement: study protocol for a randomized controlled trial

BackgroundLack of financial preparedness for pregnancy can lead to adverse outcomes during childbirth. Behavioral science interventions have been shown to influence savings behavior. Financial savings interventions can be adapted for the purpose of encouraging individuals to save towards maternal healthcare costs. This article describes a protocol to assess the effectiveness of an intervention formulated with a behavioral science approach for encouraging use of maternal health services through increased financial savings for birth preparedness and maternal healthcare costs among pregnant women or their partners in Uganda.MethodsA randomized controlled trial will be conducted to assess the effectiveness of the intervention among pregnant women or their partners in Uganda’s central region, including the capital of Kampala. Seven hundred pregnant women (12–35 gestational weeks) or their partners will be recruited. All participants will receive access to a committed mobile money health savings account provided by a local organization that also offers savings targets and reminders for antenatal care appointments and health tips as part of a “Mamas Program” offered to expectant mothers. The time period in the intervention is from the day of enrollment until two weeks after the delivery date. The control group will receive the standard Mama Program offering. The intervention group will receive the standard Mama Program offering plus behavioral designs encouraging savings behavior through short-message service (SMS) text messages. The primary outcome is usage of maternal health services measured by level of birth preparedness and delivery at a health facility. Secondary outcomes include male involvement in maternal healthcare, measured by financial support, as well as total savings for healthcare, assessed using the validated amount of savings accrued in participants’ clinicPesa accounts from the day of enrollment plus any withdrawals for healthcare expenditures during the intervention period.DiscussionThe study will contribute to a better understanding of the effectiveness of behavioral designs encouraging financial savings during pregnancy into committed mobile money health savings accounts. The study could contribute to demonstrating the effectiveness of savings on birth preparedness, usage of maternal health services, and male involvement in maternal healthcare.Trial registrationUMIN-CTR Clinical Trial, UMIN000046472. Registered on 19 January 2022. https://center6.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000053008

Nudging Emergency Department-Initiated Addiction Treatment.

When initiated in the Emergency Department (ED), medication for addiction treatment (MAT) with buprenorphine improves outcomes, increases engagement in addiction treatment and decreases the use of inpatient addiction treatment services. Unfortunately, initiating MAT in the ED is not yet standard practice. We assessed the impact of the addition of a multipart behavioral science-based intervention to increase opioid use disorder (OUD)-related treatments prescribed in the ED. Our ED initiated a campaign to help ED faculty obtain their DEA-X waiver required to prescribe buprenorphine. In parallel, we implemented 2 ED-initiated buprenorphine treatment pathways. We then conducted a two-stage qualitative process informed by behavioral science to identify key barriers to physician use of the MAT protocol. Using these insights, we developed 4 behavioral science-based interventions. To assess the impact of the interventions on the number of OUD-related treatments per day among patients meeting the inclusion criteria we compared the number of OUD-related treatments per day before versus after the interventions began using t tests. Then, in our primary model, we estimated the causal effect of the behavioral interventions using a regression discontinuity in time approach. Across the entire year study period, there is an increase in OUD-related treatment after the interventions begin, driven by greater use of ambulatory referral orders. The unadjusted mean difference in any OUD treatments per day pre- versus post-intervention increased by 0.80 (95% confidence interval [CI]: 0.04, 1.56; P = 0.039) whereas the number of ambulatory referral orders placed increased by 0.82 (95% CI: 0.48,1.16; P < 0.001). Using the 120-day study window and an ordinary least squares regression discontinuity in time model, the 4-part intervention increased the number of patients receiving any opioid treatment in the ED by 1.6 additional treatments per day (95% CI: 0.04, 3.19; P = 0.045). To support our protocol and increase the provision of ED-MAT, we implemented 1 patient-facing and 3 provider-facing interventions rooted in behavioral science principles. Our results show that this pack of behavioral science interventions increased the likelihood that ED providers offer MAT to patients with OUD.

Psychological ownership interventions increase interest in claiming government benefits

Each year, eligible individuals forgo billions of dollars in financial assistance in the form of government benefits. To address this participation gap, we identify psychological ownership of government benefits as a factor that significantly influences individuals' interest in applying for government benefits. Psychological ownership refers to how much an individual feels that a target is their own. We propose that the more individuals feel that government benefits are their own, the less likely they are to perceive applying for them as an aversive ask for help, and thus, the more likely they are to pursue them. Three large-scale field experiments among low-income individuals demonstrate that higher psychological ownership framing of government benefits significantly increases participants' pursuit of benefits and outperforms other common psychological interventions. An additional experiment shows that this effect occurs because greater psychological ownership reduces people's general aversion to asking for assistance. Relative to control messages, these psychological ownership interventions increased interest in claiming government benefits by 20% to 128%. These results suggest that psychological ownership framing is an effective tool in the portfolio of potential behavioral science interventions and a simple way to stimulate interest in claiming benefits.

Planet or pocketbook? Environmental motives complement financial motives for energy efficiency across the political spectrum in the United States

While policies to encourage low-cost energy saving behaviors have increasingly incorporated nonfinancial behavioral science interventions to motivate behavioral change, policies to encourage large structural energy efficiency upgrades have been slow to adopt such tools to motivate consumers, relying instead on economic incentives to reduce upfront cost and targeting financial and comfort motivations. This research examines whether adding an emphasis on environmental benefits can increase interest in these upgrades and explores whether political ideology moderates the effectiveness of different environmental benefits frames. In Study 1, we explore how homeowners rate the importance of financial and nonfinancial decision factors of weatherization, a large energy efficiency upgrade, including the financial, informational, environmental, material, and social benefits and costs. We find that social factors and environmental benefits explain the most variance of any decision factor in reported likelihood to upgrade. In Study 2, we examine whether adding a description of environmental benefits of upgrades to their financial benefits can increase upgrade likelihood across political ideologies. We find that adding environmental benefits framed as mitigation of climate change increases liberals’ likelihood to upgrade but has no effect on conservatives; however, adding benefits framed as an increase in environmental stewardship and energy independence increases both liberals and conservatives’ likelihood to upgrade. This research demonstrates that, contrary to existing practice, adding environmental messages after characterizing financial benefits may increase investment likelihood for energy efficiency upgrades across the political spectrum.

Behavioral science interventions: Integrating the decision task, context, and individual differences to inform policy.

Behavioral science interventions: Integrating the decision task, context, and individual differences to inform policy.

ELLEN G. WHITE PERSPECTIVE ON POLITICS AMONG SEVENTH DAY ADVENTIST LEADERS

ELLEN G. WHITE PERSPECTIVE ON POLITICS AMONG SEVENTH DAY ADVENTIST LEADERS

Understanding Antimicrobial Use Contexts in the Poultry Sector: Challenges for Small-Scale Layer Farms in Kenya.

The poultry sector contributes significantly to Kenya’s food and economic security. This contribution is expected to rise dramatically with a growing population, urbanization, and preferences for animal-source foods. Antimicrobial resistance is putting the poultry sector in Kenya—and worldwide—at risk of production losses due to the failure of medicines for animal (and human) health. The emergence and spread of antimicrobial resistance has been linked to overuse and misuse of antimicrobials in poultry and other sectors. Previous studies have documented poultry farmer antimicrobial use but without systematic consideration of the contexts (i.e., drivers) as important targets for behavior change, particularly in low- and middle-income countries. To improve understanding of antimicrobial use patterns in poultry systems, we conducted a mixed-methods knowledge, attitudes, and practices study of 76 layer farms in Kiambu County; Kenya. We found that commonly used antibiotics were often labeled for prophylactic, growth promotion, and egg production improvement purposes. Antimicrobial use was also motivated by the presence of diseases/disease symptoms, most of which could instead be managed through infection prevention measures. The results suggest that improving vaccination and biosecurity practices on farms and engaging with drug-makers to ensure proper labeling and marketing of antimicrobial drugs may represent important areas of opportunity for social behavior change communication and/or behavioral science interventions (i.e., nudges) to reduce disease burdens and promote prudent antimicrobial use. We conclude our findings with suggestions for further research into the behavioral insights at play in these scenarios to fuel future intervention development.

Scaling up behavioral science interventions in online education.

Online education is rapidly expanding in response to rising demand for higher and continuing education, but many online students struggle to achieve their educational goals. Several behavioral science interventions have shown promise in raising student persistence and completion rates in a handful of courses, but evidence of their effectiveness across diverse educational contexts is limited. In this study, we test a set of established interventions over 2.5 y, with one-quarter million students, from nearly every country, across 247 online courses offered by Harvard, the Massachusetts Institute of Technology, and Stanford. We hypothesized that the interventions would produce medium-to-large effects as in prior studies, but this is not supported by our results. Instead, using an iterative scientific process of cyclically preregistering new hypotheses in between waves of data collection, we identified individual, contextual, and temporal conditions under which the interventions benefit students. Self-regulation interventions raised student engagement in the first few weeks but not final completion rates. Value-relevance interventions raised completion rates in developing countries to close the global achievement gap, but only in courses with a global gap. We found minimal evidence that state-of-the-art machine learning methods can forecast the occurrence of a global gap or learn effective individualized intervention policies. Scaling behavioral science interventions across various online learning contexts can reduce their average effectiveness by an order-of-magnitude. However, iterative scientific investigations can uncover what works where for whom.

Testing local descriptive norms and salience of enforcement action: A field experiment to increase tax collection

The use of behavioral science interventions, and particularly social norms, in tax compliance is a growing industry for scholars and practitioners alike in recent years. However, the causal mechanism of these interventions is unknown, where effects could be explained by a pro-social desire to support one’s community, conditional cooperation, desire to conform, or fear of reprisals. We conduct a field experiment in local government taxation in the United Kingdom which tests the effectiveness of a social (descriptive) norm against a control condition and against messages that highlight the enforcement process. The social norm outperforms enforcement salience, suggesting that this explanation, although more powerful than the control, does not fully explain compliance effects. This study further provides evidence that social norm type interventions can be effective at the subnational level, a context where previous work has shown they may produce null effects.

Community-Engaged Learning in Public Health: An Evaluation of Utilization and Value of Student Projects for Community Partners

Schools and programs of public health must equip public health professionals to conduct community health assessments that can be subsequently used by community partners to inform programs, policies, and interventions. Measuring health outcomes, identifying behavioral risk and protective factors, and mapping community assets for social and behavioral science interventions is a key competency for departments of social and behavioral sciences. Community-engaged learning is one approach to build student competency while developing mutually beneficial relationships between academic settings and community organizations. This mixed-methods evaluation explores the value of community-engaged learning to community partners who collaborate with courses on community assessment in public health. Data were collected through interviews with community partners and a quantitative survey. Data analysis involved thematic analysis and descriptive statistics. Results suggest that community partners value community-engaged learning in several ways: (a) students provided quality data and reports that informed program development and revision, (b) students offered increased human capacity and the skills needed to conduct community assessments, and (c) organizations benefitted from the prestige of sustained relationships with an academic partner. Challenges of community-engaged learning included difficult timelines and demands from students based on the semester schedule. Organizations recommended additional interaction with faculty members to clarify project goals and student responsibilities. Lessons from the evaluation are beneficial to other colleges and universities and community organizations invested in successful and valuable academic–community relationships.

How Can We Improve Retention of the First-Time Donor? A Systematic Review of the Current Evidence.

Blood products are critical to health systems and donations by voluntary nonremunerated donors are recommended. Worldwide, however, only around 5% of those eligible to donate do so and around half of those never return to donate again. This review focuses on what deters first-time donors, what predicts their retention, and what interventions may promote retention of this group. A comprehensive search of relevant databases identified 9 studies investigating motives and deterrents of first-time donors, 14 studies investigating predictors for first-time donors (13 whole blood [WB] and 2 plasmapheresis), and 15 studies (in 14 published articles) detailing interventions conducted on first-time donors. Drawing on an established blood donation taxonomy, studies were classified by 2 independent raters. Interventions were also classified into traditional, behavioral, or social science interventions. With only 2 eligible studies among first-time plasmapheresis donors, analyses focused on WB donors. First-time WB donors reported benevolent and collectivistic motivations, as well as personal benefits to commence WB donation. Self-reported deterrents have typically not been examined. Intention predicted first-time donor retention with intention determined by attitudes and a sense of (perceived behavioral) control. However, anxiety, adverse events, and deferrals all deterred retention. Traditional interventions, such as reminders and incentives, are widespread yet had only a small effect on return of first-time donors. Although behavioral science interventions such as fluid loading are effective, the strongest effect for the return of first-time donors was found when individual psychological support was provided. The purpose of this analysis was to identify the factors associated with the commencement and continuation of first WB donations. The current review revealed that self-reported motivators are typically not effective, and most successful predictive factors identified have not been translated into interventions. Future work would do well to identify, manage, and meet donors' expectations along with developing more individualized donation experiences. Blood donor research should delineate donor career stages; addressing first-time donor retention will support stable panels for blood collection agencies.

Reducing the cancer burden of lifestyle factors: opportunities and challenges of the Internet.

This paper focuses on the Internet as a tool for enhancing behavior and lifestyle changes to reduce the burden of cancer at a population level. The premise of this paper is that the Internet can and should be leveraged to bridge the chasm between basic science, clinical trials, and public health. Our focus is specifically on the opportunity to disseminate effective behavioral science interventions via the Internet in order to decrease the prevalence of behavioral risk factors for cancer. The examples herein are primarily drawn from tobacco use to illustrate issues that can be applied more generally to other behavioral risk factors for cancer. Four areas will be addressed: (1) the scientific basis and rationale for delivering lifestyle behavior change interventions via the Internet; (2) the need to determine the quality of Internet interventions; (3) methodological considerations in conducting evaluations of Internet interventions; and (4) recommendations for a transdisciplinary approach to Internet intervention development and evaluation.

Observations from a Long-Term, Survey-Guided Consultation with a Mining Company

During a nine-year period, consultants conducted four attitude surveys with increasing levels of employee involvement in making feedback-guided behavioral science interventions with a large underground mining company. This consultation pattern emerged not from a conscious plan by the organization or its consultants but from a step-wise progression based on the successes and failures of previous interventions. The consultants derived models for the consultation process and survey-guided development from an adaptation of action research to OD interventions and from Argyris's perspectives on intervention, including his more recent analysis of "theories in action." This article describes the activities and progress that occurred during the period of the consultation, and the author discusses the changing organizational processes and the plausibility of linking them to organizational effectiveness and health criteria.

Book Review Section

Book reviewed in this article:Steers, Richard M. and Porter, Lyman W. (Editors) Motivation and Work Behavior.Jones, John E. and Pfeiffer, J. William. (Editors) The 1979 Annual Handbook for Group Facilitators.Natemeyer, Walter E. (Editor) Classics of Organizational Behavior.Shafritz, Jay M. and Whitbeck, Philip H. (Editors) Classics of Organization Theory.French, Wendell L. and Bell, Cecil H. Organization Development: Behavioral Science Interventions and Organization Improvement.Trice, Harrison M. and Roman, Paul M. Spirits and Demons at Work: Alcohol and Other Drugs on the Job.Staw, Barry M. (Ed.) Research in Organizational Behavior: An Annual Series of Analytical Essays and Critical Reviews. Volume 1‐1979.Pollard, Harold R. Trends in Management Thinking 1960‐1970.Greenlaw, Paul S.and Biggs, William D. Modern Personnel Management.Glueck, William F. Foundations of Personnel.Quinn, Robert P. and Staines, Graham L. The 1977 Quality of Employment Survey: Descriptive Statistics with Comparative Data from the 1969‐70 and the 1972‐73 Surveys.Ash, Philip and Cates, Judith N. No Sacrifice Too Great: Technical Report for State Trooper Selection Procedure.Singleton, W. T. (Editor) The Analysis of Practical Skills.Miller, Lawrence M. Behavior Management: The New Science of Management People at Work.Brown, Paul L. and Presbie, Robert J. Behavior Modification in Business Industry, and Government.Greenman, Russell L. and Schmertz, Eric J. Personnel Administration and the Law.Merrell, V. Dallas. Huddling: The Informal Way to Management Success.Deutsch, Arnold R. The Human Resources Revolution: Communicate or Litigate.Filley, Alan C. The Compleat Manager: What Works When.

Book Review: Organizational Behavior: Organization Development: Behavioral Science Interventions for Organization Improvement

Book Review: Organizational Behavior: Organization Development: Behavioral Science Interventions for Organization Improvement

Organization Development: Behavioral Science Interventions for Organization Improvement.

Organization Development: Behavioral Science Interventions for Organization Improvement.

System Intervention in a School-Community Conflict

During the New York City school strike of 1968, staff members of a community mental health center, along with members of a local community group, helped plan and execute a Forum* in school-community relations intended to channel existing conflicts toward the long-term benefit of the community the center serves. The significance of this report stems from several factors that are not typical of applied behavioral science interventions. First, entry took place at the height of a community conflict situation, in the face of warnings from various parties to the conflict that the most constructive course was to do nothing. Second, the relationship between a community mental health center and its catchment area differs in important respects from that involved in either the external or internal change-agent models, and thus limits action alternatives in such a crisis. Third, turnout at the Forum was strikingly high and quite representative of the community population. Fourth, the design of the Forum itself is of interest, since it altered successfully some of the chaotic aspects of the typical public meeting.