Behavior change is often the lynchpin of successful public health services and programming. Overcoming structural and political barriers is often not enough to achieve beneficial public health outcomes. Many consider individual behavior change the “last mile” in public health programming. For example, ensuring widespread contraceptive access will not have much impact if people don’t take up services; offering free vaccinations will have no effect in disease prevention if caregivers don’t take action to immunize children. Behavioral economics (BE) and social and behavior change communication (SBCC) are two behavior change approaches used in public health programming. Neither of these approaches are new – they have both been utilized by behavior change experts and program designers for years across different sectors. BE has historically had limited application in the public health space, but has recently generated some buzz as a “new” behavior change paradigm. So what does this mean? If BE isn’t a new discipline, what is different about this approach? How does BE fit into the behavior change toolkit alongside other approaches like SBCC?
BE, one discipline within the field of behavioral science, takes a new angle on the complexity of human behavior. As humans, we often behave in unexpected ways – we sometimes make quirky decisions that seem to defy common sense or we may change our minds from one day to the next. What we see, time and time again, is that our preferences do not always define our actions. Think about your intention to save money, perhaps to pay your children’s school fees, make improvements on your house, or put something away for a rainy day. In general, most of us around the world are pretty bad at saving. Why is this? We know it’s a good thing to do and we probably all intend to do it. Context plays a huge role in shaping our perceptions and behavior. Sometimes this context can channel us towards our goals, but other times it can create barriers that prevent us from following through on our intentions. We may not save enough money because we don’t immediately set funds aside when a paycheck comes in, or because we’re immediately confronted with readily available temptations, like that new dress we see in the shop window every day. BE offers tools to help remove these behavioral barriers or design channels to allow individuals to follow through on their intentions.
Together BE and SBCC are complementary approaches to behavior change. Both recognize that human behavior occurs in a complex socio-ecological context and there are many different factors within this context that influence behavior. SBCC primarily seeks to change behaviors by positively influencing knowledge, attitudes and social norms through multi-faceted communication approaches. The SBCC toolkit includes communications approaches ranging from mass media programming to advocacy and interpersonal communication, among others. BE complements these tools by designing solutions for other factors influencing behavior, such as, but not limited to, changing the sequence, timing or format of information, eliminating process hassles, or strengthening pathways to action.
Take smoking cessation as an example of a health behavior that BE and SBCC can address. From one angle, SBCC can develop targeted mass media campaigns to inform people about the health risks of smoking. From another angle, BE can help smokers to decouple physical cravings to smoke from the actual smoking behavior through commitment devices, like throwing away all cigarettes and removing lighters from the house, or reframing risks and rewards, like self-imposing a financial or social penalty for smoking.
Ultimately, we shouldn’t be thinking about the various behavior change approaches with an either/or mindset. We share a common goal – to unlock positive behaviors that allow individuals to live happy, healthy and productive lives. If we can reach that goal using all the tools in the toolkit, why not leverage everything we’ve got? In an upcoming post, we’ll dive deeper into a BE-informed approach for solving behavioral challenges. We’ll highlight some of the behavioral challenges that ideas42 has been exploring in the field of international family planning and reproductive health and share some of the behavioral insights from this work. Stay tuned!