? All interventions
| LL Shua, Nina Mazarb, Francesca Gino, Dan Ariely, Bazermanc MH|
PNAS, September 18, 2012, vol. 109, no. 38
Many written forms required by businesses and governments rely on honest reporting. Proof of honest intent is typically provided through signature at the end of, e.g., tax returns or insurance policy forms. Still, people sometimes cheat to advance their financial self-interests—at great costs to society. We test an easy-to-implement method to discourage dishonesty: signing at the beginning rather than at the end of a self-report, thereby reversing the order of the current practice. Using laboratory and field experiments, we find that signing before–rather than after–the opportunity to cheat makes ethics salient when they are needed most and significantly reduces dishonesty
| M Hallsworth, JA List, RD Metcalfe, I Vlaev|
Journal of Public Economics, Volume 148, Issue null, Pages 14-31 (2017)
This paper presents results from two large-scale natural field experiments that tested the effect of social norm messages on tax compliance. Using administrative data from > 200,000 individuals in the United Kingdom, we show that including social norm messages in standard reminder letters increases payment rates for overdue tax. This result offers a rare example of social norm messages affecting tax compliance behavior in a real world setting. We find no evidence that loss framing is more effective than gain framing. Descriptive norms appear to be more effective than injunctive norms. Messages referring to public services or financial information also significantly increased payment rates. The field experiments accelerated the collection of tax revenue at little cost.
| Johnson, EJ Goldstein, G Daniel|
Science, Vol. 302, pp. 1338-1339, 2003.
The article discusses how should policy-makers choose defaults regarding organ donors. First, consider that every policy must have a no-action default, and defaults impose physical, cognitive, and, in the case of donation, emotional costs on those who must change their status. Second, note that defaults can lead to two kinds of misclassification, willing donors who are not identified or people who become donors against their wishes. Changes in defaults could increase donations in the United States of additional thousands of donors a year. Because each donor can be used for about three transplants, the consequences are substantial in lives saved.
| Richard Thaler, Shlomo Benartzi|
Journal of Political Economy 112(2004): S164-S187.
As firms switch from defined‐benefit plans to defined‐contribution plans, employees bear more responsibility for making decisions about how much to save. The employees who fail to join the plan or who participate at a very low level appear to be saving at less than the predicted life cycle savings rates. Behavioral explanations for this behavior stress bounded rationality and self‐control and suggest that at least some of the low‐saving households are making a mistake and would welcome aid in making decisions about their saving. In this paper, we propose such a prescriptive savings program, called Save More Tomorrow™ (hereafter, the SMarT program). The essence of the program is straightforward: people commit in advance to allocating a portion of their future salary increases toward retirement savings. We report evidence on the first three implementations of the SMarT program. Our key findings, from the first implementation, which has been in place for four annual raises, are as follows: (1) a high proportion (78 percent) of those offered the plan joined, (2) the vast majority of those enrolled in the SMarT plan (80 percent) remained in it through the fourth pay raise, and (3) the average saving rates for SMarT program participants increased from 3.5 percent to 13.6 percent over the course of 40 months. The results suggest that behavioral economics can be used to design effective prescriptive programs for important economic decisions.
| J Blumenstock, M Callen, T Ghani|
Through a field experiment in Afghanistan, we show that default enrollment in payroll deductions increases rates of savings by 40 percentage points, and that this increase is driven by present-biased preferences. Working with Afghanistan’s primary mobile phone operator, we designed and deployed a new mobile phone-based automatic payroll deduction system. Each of 967 employees at the country’s largest firm was randomly assigned a default contribution rate (either 0% or 5%) as well as a matching incentive rate (0%, 25%, or 50%). We find that employees initially assigned a default contribution rate of 5% are 40 percentage points more likely to contribute to the account 6months later than individuals assigned to a default contribution rate of zero; to achieve this effect through financial incentives alone would require a 50% match from the employer. We also find evidence of habit formation: default enrollment increases the likelihood that employees continue to save after the trial ended, and increases employees’ self-reported interest in saving and sense of financial security. To understand why default enrollment increases participation, we conducted several interventions designed to induce employees to make a non-default election, and separately measured employee time preferences. Ruling out several competing explanations, we find evidence that the default effect is driven largely by present-biased preferences that cause the employee to procrastinate in making a non-default election.
We developed a prototype tool and tested it with young people from Cape Town’s Cape Flats neighborhoods. We wanted to assess whether it was more effective than the traditional approach of improving safety awareness in two respects:
• Improving how “safe” the young people reported feeling.
• Reducing the number of violent events they experienced in the past week.
The tool had powerful effects. A randomized controlled trial found that young people in the treatment group were half as likely as the control group to participate in unsafe activities by the end of the study. The treatment population was also almost half as likely as the control group to report feeling unsafe, and half as likely to report experiencing violence in the past week.These results have significant implications for how we think about improving safety and reducing crime. In many parts of the world violent crime is a serious problem, with policy makers and practitioners alike looking to increased investment in enforcement as a way of mitigating the problem. This pilot project illustrates that supporting targeted decision-making and planning for both potential victims and perpetrators has the potential to significantly reduce violent crime.
Researchers sought to examine the impact of factors including price, persuasion, promotion and the chlorination products themselves with a two-phase study. Prior to the study baseline surveys were administered to a random selection of households.In the first phase, households were given seven WaterGuard bottles, an individual water treatment product, each sufficient for one month’s supply of clean water. They were also provided with improved drinking water storage pots with a tap to prevent contamination and detailed instructions on use. One third of this group received twelve coupons for a 50 percent discount on WaterGuard bottles, each valid for one month during the next year, and calendars with reminders. Another third received additional verbal persuasion messages beyond the basic WaterGuard instructions, and another third received no additional coupons or messages. To estimate social networking effects, the free WaterGuard bottles were distributed in different percentages in each community, allowing researchers to see if higher community levels of use increased individual adoption. A follow-up survey was administered between 2 and 7 months after the free WaterGuard was distributed.In the second phase researchers compared six different treatments designed to increase WaterGuard adoption. For the first three treatments, scripted promotional messages were delivered at either the(1) household level, (2) community level, or (3) both. The second two treatments included repeated promotion of chlorination through a home visit by a community elected promoter. Despite volunteering to work for free, the promoter was paid either a (4) flat rate, or was (5) paid based on how many households had chlorinated water at follow-up visits. The last treatment (6) combined the incentivized promoter model with an unlimited supply of free WaterGuard delivered through a point-of-collection chlorine dispenser at the local water source. Follow-up surveys were conducted 3 weeks and 3-6 months after the start of the study.
| KG. Volpp, DA Asch, George Loewenstein, JD Park, J Zhu, Y Tao, MF Hu, SL Bellamy, B Stearman, EB Riley, TB Sewell, AP Sen|
J Gen Intern Med. 2014 May;29(5):770-7.
Home wireless device monitoring could play an important role in improving the health of patients with poorly controlled chronic diseases, but daily engagement rates among these patients may be low. OBJECTIVE:
To test the effectiveness of two different magnitudes of financial incentives for improving adherence to remote-monitoring regimens among patients with poorly controlled diabetes. DESIGN:
Randomized, controlled trial. (Clinicaltrials.gov Identifier: NCT01282957). PARTICIPANTS:
Seventy-five patients with a hemoglobin A1c greater than or equal to 7.5% recruited from a Primary Care Medical Home practice at the University of Pennsylvania Health System. INTERVENTIONS:
Twelve weeks of daily home-monitoring of blood glucose, blood pressure, and weight (control group; n = 28); a lottery incentive with expected daily value of $2.80 (n = 26) for daily monitoring; and a lottery incentive with expected daily value of $1.40 (n = 21) for daily monitoring. MAIN MEASURES:
Daily use of three home-monitoring devices during the three-month intervention (primary outcome) and during the three-month follow-up period and change in A1c over the intervention period (secondary outcomes). KEY RESULTS:
Incentive arm participants used devices on a higher proportion of days relative to control (81% low incentive vs. 58%, P = 0.007; 77% high incentive vs. 58%, P = 0.02) during the three-month intervention period. There was no difference in adherence between the two incentive arms (P = 0.58). When incentives were removed, adherence in the high incentive arm declined while remaining relatively high in the low incentive arm. In month 6, the low incentive arm had an adherence rate of 62% compared to 35% in the high incentive arm (P = 0.015) and 27% in the control group (P = 0.002). CONCLUSIONS:
A daily lottery incentive worth $1.40 per day improved monitoring rates relative to control and had significantly better efficacy once incentives were removed than a higher incentive.
This paper documents a widely overlooked dimension of relationship lending: the personal interaction between the borrower and the lender reduces the willingness of the borrower to engage in moral hazard and default on the loan officer. We conduct a randomized experiment with small business borrowers of the largest commercial bank in India to test the impact of three different levels of interactions between the borrower and the bank. Borrowers who are regularly called either by a single assigned relationship manager or by one manager randomly selected from a small team of managers show much better repayment behavior and greater satisfaction with the bank services than borrowers who either receive no follow up or only receive follow up calls from the bank when they are delinquent. The results are economically and statistically significant: borrowers who receive the more intensive treatment see a large reduction in the number of late payment spells and delinquencies.
| T Rogers, J Ternovski, E Yoeli|
People contribute more to public goods when their contributions are made more observable to others. We report an intervention that subtly increases the observability of public goods contributions when people are solicited privately and impersonally (e.g., mail, email, social media). This intervention is tested in a large-scale field experiment (n=770,946) in which people are encouraged to vote through get-out-the-vote letters. We vary whether the let-ters include the message, “We may call you after the election to ask about your voting experience.” Increasing the perceived ob-servability of whether people vote by including that message increased the impact of the get-out-the-vote letters by more than the entire effect of a typical get-out-the-vote letter. This tech-nique for increasing perceived observability can be replicated whenever public goods solicitations are made in private.
Low rates of adherence to artemisinin-based combination therapy (ACT) regimens increase the risk of treatment failure and may lead to drug resistance, threatening the sustainability of current anti-malarial efforts. We assessed the impact of text message reminders on adherence to ACT regimens. Methods
Health workers at hospitals, clinics, pharmacies, and other stationary ACT distributors in Tamale, Ghana provided flyers advertising free mobile health information to individuals receiving malaria treatment. The messaging system automatically randomized self-enrolled individuals to the control group or the treatment group with equal probability; those in the treatment group were further randomly assigned to receive a simple text message reminder or the simple reminder plus an additional statement about adherence in 12-hour intervals. The main outcome was self-reported adherence based on follow-up interviews occurring three days after treatment initiation. We estimated the impact of the messages on treatment completion using logistic regression. Results
1140 individuals enrolled in both the study and the text reminder system. Among individuals in the control group, 61.5% took the full course of treatment. The simple text message reminders increased the odds of adherence (adjusted OR 1.45, 95% CI [1.03 to 2.04], p-value 0.028). Receiving an additional message did not result in a significant change in adherence (adjusted OR 0.77, 95% CI [0.50 to 1.20], p-value 0.252). Conclusion
The results of this study suggest that a simple text message reminder can increase adherence to antimalarial treatment and that additional information included in messages does not have a significant impact on completion of ACT treatment. Further research is needed to develop the most effective text message content and frequency.
There is limited evidence on whether growing mobile phone availability in sub-Saharan Africa can be used to promote high adherence to antiretroviral therapy (ART). This study tested the efficacy of short message service (SMS) reminders on adherence to ART among patients attending a rural clinic in Kenya. Design
A randomized controlled trial of four SMS reminder interventions with 48 weeks of follow-up. Methods
Four hundred and thirty-one adult patients who had initiated ART within 3 months were enrolled and randomly assigned to a control group or one of the four intervention groups. Participants in the intervention groups received SMS reminders that were either short or long and sent at a daily or weekly frequency. Adherence was measured using the medication event monitoring system. The primary outcome was whether adherence exceeded 90% during each 12-week period of analysis and the 48-week study period. The secondary outcome was whether there were treatment interruptions lasting at least 48 h. Results
In intention-to-treat analysis, 53% of participants receiving weekly SMS reminders achieved adherence of at least 90% during the 48 weeks of the study, compared with 40% of participants in the control group (P=0.03). Participants in groups receiving weekly reminders were also significantly less likely to experience treatment interruptions exceeding 48 h during the 48-week follow-up period than participants in the control group (81 vs. 90%, P = 0.03). Conclusion
These results suggest that SMS reminders may be an important tool to achieve optimal treatment response in resource-limited settings.
| D Ortega, C Scartascini|
There is an ample literature on the determinants of tax compliance. Several field experiments have evaluated the effect and comparative relevance of sending deterrence and moral suasion messages to taxpayers. The effect of different delivery mechanisms, however, has not been evaluated so far. This study conducts a field experiment in Colombia that varies the way the National Tax Agency contacts taxpayers on payments due for income, value added, and wealth taxes. More than 20,000 taxpayers were randomly assigned to a control or one of three delivery mechanisms (letter, email, and personal visit by a tax inspector). Results indicate large and highly significant effects, as well as sizable differences across delivery methods. A personal visit by a tax inspector is more effective than a physical letter or an email, conditional on delivery, but email tends to reach its target more often. Improving the quality of taxpayer contact information can significantly improve the collection of delinquencies.
Phone calls encouraging citizens to vote are staples of modern campaigns. Insights from psychological science can make these calls dramatically more potent while also generating opportunities to expand psychological theory. We present a field experiment conducted during the 2008 presidential election (N = 287,228) showing that facilitating the formation of a voting plan (i.e., implementation intentions) can increase turnout by 4.1 percentage points among those contacted, but a standard encouragement call and self-prediction have no significant impact. Among single-eligible-voter households, the formation of a voting plan increased turnout among persons contacted by 9.1 percentage points, whereas those in multiple-eligible-voter households were unaffected by all scripts. Some situational factors may organically facilitate implementation-intentions formation more readily than others; we present data suggesting that this could explain the differential treatment effect that we found. We discuss implications for psychological and political science, and public interventions involving implementation-intentions formation.
| Katy Milkman, JA Minson, Kevin Volpp|
We introduce and evaluate the effectiveness of temptation bundling—a method for simultaneously tackling two types of self-control problems by harnessing consumption complementarities. We describe a field experiment measuring the impact of bundling instantly gratifying but guilt-inducing “want” experiences (enjoying page-turner audiobooks) with valuable “should” behaviors providing delayed rewards (exercising). We explore whether such bundles increase should behaviors and whether people would pay to create these restrictive bundles. Participants were randomly assigned to a full treatment condition with gym-only access to tempting audio novels, an intermediate treatment involving encouragement to restrict audiobook enjoyment to the gym, or a control condition. Initially, full and intermediate treatment participants visited the gym 51% and 29% more frequently, respectively, than control participants, but treatment effects declined over time (particularly following Thanksgiving). After the study, 61% of participants opted to pay to have gym-only access to iPods containing tempting audiobooks, suggesting demand for this commitment device.
A loan application should collect necessary information while providing a painless, easy, and engaging experience for members and potential new members. Our recommendations for improving the loan application process were driven by three behavioral principles essential to the design of any human process: (1) reducing perceived hassles and uncer-tainty wherever possible; (2) avoiding jargon; and (3) designing with potential user error in mind. Our recommen-dations for Alliant included a new process timeline to more accurately set applicant expectations and reflected progress through the application; reframing key decision points to ensure users do not accidentally cancel their applications; and revising language that may be unfamiliar to some applicants, such as “collateral,” “debt-to-income,” and “co-borrower.” These principles and recommendations may seem simple, but through our work we have seen how even small changes can have big impacts on client behaviors. Moreover, as service designers, intimately aware of the loan process, it can be difficult for financial experts to design financial products and services that feel intuitive and easy to understand to new users. Alliant has incorporated the majority of our design recommendations into the new loan application process.
Importance Interventions based on behavioral science might reduce inappropriate antibiotic prescribing. Objective To assess effects of behavioral interventions and rates of inappropriate (not guideline-concordant) antibiotic prescribing during ambulatory visits for acute respiratory tract infections. Design, Setting, and Participants Cluster randomized clinical trial conducted among 47 primary care practices in Boston and Los Angeles. Participants were 248 enrolled clinicians randomized to receive 0, 1, 2, or 3 interventions for 18 months. All clinicians received education on antibiotic prescribing guidelines on enrollment. Interventions began between November 1, 2011, and October 1, 2012. Follow-up for the latest-starting sites ended on April 1, 2014. Adult patients with comorbidities and concomitant infections were excluded. Interventions Three behavioral interventions, implemented alone or in combination: suggested alternatives presented electronic order sets suggesting nonantibiotic treatments; accountable justification prompted clinicians to enter free-text justifications for prescribing antibiotics into patients’ electronic health records; peer comparison sent emails to clinicians that compared their antibiotic prescribing rates with those of “top performers” (those with the lowest inappropriate prescribing rates). Main Outcomes and Measures Antibiotic prescribing rates for visits with antibiotic-inappropriate diagnoses (nonspecific upper respiratory tract infections, acute bronchitis, and influenza) from 18 months preintervention to 18 months afterward, adjusting each intervention’s effects for co-occurring interventions and preintervention trends, with random effects for practices and clinicians. Results There were 14 753 visits (mean patient age, 47 years; 69% women) for antibiotic-inappropriate acute respiratory tract infections during the baseline period and 16 959 visits (mean patient age, 48 years; 67% women) during the intervention period. Mean antibiotic prescribing rates decreased from 24.1% at intervention start to 13.1% at intervention month 18 (absolute difference, −11.0%) for control practices; from 22.1% to 6.1% (absolute difference, −16.0%) for suggested alternatives (difference in differences, −5.0% [95% CI, −7.8% to 0.1%]; P = .66 for differences in trajectories); from 23.2% to 5.2% (absolute difference, −18.1%) for accountable justification (difference in differences, −7.0% [95% CI, −9.1% to −2.9%]; P < .001); and from 19.9% to 3.7% (absolute difference, −16.3%) for peer comparison (difference in differences, −5.2% [95% CI, −6.9% to −1.6%]; P < .001). There were no statistically significant interactions (neither synergy nor interference) between interventions. Conclusions and Relevance Among primary care practices, the use of accountable justification and peer comparison as behavioral interventions resulted in lower rates of inappropriate antibiotic prescribing for acute respiratory tract infections.
Importance “Nudges” that influence decision making through subtle cognitive mechanisms have been shown to be highly effective in a wide range of applications, but there have been few experiments to improve clinical practice. Objective To investigate the use of a behavioral “nudge” based on the principle of public commitment in encouraging the judicious use of antibiotics for acute respiratory infections (ARIs). Design, Setting, and Participants Randomized clinical trial in 5 outpatient primary care clinics. A total of 954 adults had ARI visits during the study timeframe: 449 patients were treated by clinicians randomized to the posted commitment letter (335 in the baseline period, 114 in the intervention period); 505 patients were treated by clinicians randomized to standard practice control (384 baseline, 121 intervention). Interventions The intervention consisted of displaying poster-sized commitment letters in examination rooms for 12 weeks. These letters, featuring clinician photographs and signatures, stated their commitment to avoid inappropriate antibiotic prescribing for ARIs. Main Outcomes and Measures Antibiotic prescribing rates for antibiotic-inappropriate ARI diagnoses in baseline and intervention periods, adjusted for patient age, sex, and insurance status. Results Baseline rates were 43.5% and 42.8% for control and poster, respectively. During the intervention period, inappropriate prescribing rates increased to 52.7% for controls but decreased to 33.7% in the posted commitment letter condition. Controlling for baseline prescribing rates, we found that the posted commitment letter resulted in a 19.7 absolute percentage reduction in inappropriate antibiotic prescribing rate relative to control (P = .02). There was no evidence of diagnostic coding shift, and rates of appropriate antibiotic prescriptions did not diminish over time. Conclusions and Relevance Displaying poster-sized commitment letters in examination rooms decreased inappropriate antibiotic prescribing for ARIs. The effect of this simple, low-cost intervention is comparable in magnitude to costlier, more intensive quality-improvement efforts.
| N Malhotra, MR Michelson, T Rogers, A Valenzuela|
Dale and Strauss’s (DS) noticeable reminder theory (NRT) of voter mobilization posits that mobilization efforts that are highly noticeable and salient to potential voters, even if impersonal, can be successful. In an innovative experimental design, DS show that text messages substantially boost turnout, challenging previous claims that social connectedness is the key to increasing participation. We replicate DS’s research design and extend it in two key ways. First, whereas the treatment in DS’s experiment was a “warm” text message combined with contact, we test NRT more cleanly by examining the effect of “cold” text messages that are completely devoid of auxiliary interaction. Second, we test an implication of NRT that habitual voters should exhibit the largest treatment effects in lower salience elections whereas casual voters should exhibit the largest treatment effects in higher salience elections. Via these two extensions, we find support for NRT.
Compared to whites, African Americans have a greater incidence of diabetes, decreased control, and higher rates of micro-vascular complications. A peer mentorship model could be a scalable approach to improving control in this population and reducing disparities in diabetic outcomes. Objective
To determine whether peer mentors or financial incentives are superior to usual care in helping African American Veterans improve their glycosylated hemoglobin (HbA1c) levels. Design
A six month randomized controlled trial. (ClinicalTrials.gov registration number: NCT01125956) Setting
The Philadelphia VA Medical Center. Patients
African American veterans, age 50-70 years old, with persistently poor diabetes control. Measurements
Change in HbA1c at 6 months Intervention
118 participants were randomized to one of the three arms. Usual care participants were notified of their starting HbA1c and recommended goals for HbA1c. Those in the peer mentor arm were assigned a peer mentor who formerly had poor glycemic control but now had good control (HbA1c < 7.5%) who was asked to talk with the participant at least once a week. Peer mentors were matched on race, sex, and age. Those in the financial incentive arm could earn $100 by dropping their HbA1c by one point and $200 by dropping it by two points or to a HbA1c of 6.5%. Results
Mentors and mentees talked the most in the first month (mean calls 4: range 0-30) and dropped to a mean of 2 calls (range 0-10) by the sixth month. HbA1c dropped from 9.9% to 9.8% in the control arm, 9.8% to 8.7% in the peer mentor arm and from 9.5% to 9.1% in the financial incentive arm. Mean change in HbA1c from baseline to 6 months relative to control was −1.07 (95% CI −1.84 to −0.31) in the peer mentor arm and −0.45 (95% CI −1.23 to 0.32) in the financial incentive arm. Limitations
The study included only veterans and lasted only 6 months. Conclusions
Peer mentorship improved glucose control in a cohort of African American Veterans with diabetes.
| George Loewenstein, J Price, K Volpp|
We present findings from a field experiment conducted at 40 elementary schools involving 8000 children and 400,000 child-day observations, which tested whether providing short-run incentives can create habit formation in children. Over a 3- or 5-week period, students received an incentive for eating a serving of fruits or vegetables during lunch. Relative to an average baseline rate of 39%, providing small incentives doubled the fraction of children eating at least one serving of fruits or vegetables. Two months after the end of the intervention, the consumption rate at schools remained 21% above baseline for the 3-week treatment and 44% above baseline for the 5-week treatment. These findings indicate that short-run incentives can produce changes in behavior that persist after incentives are removed.
We tested whether providing adults with obstructive sleep apnea (OSA) with daily Web-based access to their positive airway pressure (PAP) usage over 3 mo with or without a financial incentive in the first week improves adherence and functional outcomes.Academic- and community-based sleep centers.One hundred thirty-eight adults with newly diagnosed OSA starting PAP treatment.Participants were randomized to: usual care, usual care with access to PAP usage, or usual care with access to PAP usage and a financial incentive. PAP data were transmitted daily by wireless modem from the participants' PAP unit to a website where hours of usage were displayed. Participants in the financial incentive group could earn up to $30/day in the first week for objective PAP use ≥ 4 h/day.Mean hours of daily PAP use in the two groups with access to PAP usage data did not differ from each other but was significantly greater than that in the usual care group in the first week and over 3 mo (P < 0.0001). Average daily use (mean ± standard deviation) during the first week of PAP intervention was 4.7 ± 3.3 h in the usual care group, and 5.9 ± 2.5 h and 6.3 ± 2.5 h in the Web access groups with and without financial incentive respectively. Adherence over the 3-mo intervention decreased at a relatively constant rate in all three groups. Functional Outcomes of Sleep Questionnaire change scores at 3 mo improved within each group (P < 0.0001) but change scores of the two groups with Web access to PAP data were not different than those in the control group (P > 0.124).Positive airway pressure adherence is significantly improved by giving patients Web access to information about their use of the treatment. Inclusion of a financial incentive in the first week had no additive effect in improving adherence.
Data on the effectiveness of employer-sponsored financial incentives for employee weight loss are limited. OBJECTIVE:
To test the effectiveness of 2 financial incentive designs for promoting weight loss among obese employees. DESIGN:
Randomized, controlled trial. (ClinicalTrials.gov: NCT01208350) SETTING:
Children's Hospital of Philadelphia. PARTICIPANTS:
105 employees with a body mass index between 30 and 40 kg/m2. INTERVENTION:
24 weeks of monthly weigh-ins (control group; n = 35); individual incentive, designed as $100 per person per month for meeting or exceeding weight-loss goals (n = 35); and group incentive, designed as $500 per month split among participants within groups of 5 who met or exceeded weight-loss goals (n = 35). MEASUREMENTS:
Weight loss after 24 weeks (primary outcome) and 36 weeks and changes in behavioral mediators of weight loss (secondary outcomes). RESULTS:
Group-incentive participants lost more weight than control participants (mean between-group difference, 4.4 kg [95% CI, 2.0 to 6.7 kg]; P < 0.001) and individual-incentive participants (mean between-group difference, 3.2 kg [CI, 0.9 to 5.5 kg]; P = 0.008). Twelve weeks after incentives ended and after adjustment for 3-group comparisons, group-incentive participants maintained greater weight loss than control group participants (mean between-group difference, 2.9 kg [CI, 0.5 to 5.3 kg]; P = 0.016) but not greater than individual-incentive participants (mean between-group difference, 2.7 kg [CI, 0.4 to 5.0 kg]; P = 0.024). LIMITATION:
Single employer and short follow-up. CONCLUSION:
A group-based financial incentive was more effective than an individual incentive and monthly weigh-ins at promoting weight loss among obese employees at 24 weeks.
| M Kosfeld, S Neckermann|
We study the impact of status and social recognition on worker performance in a field experiment. In collaboration with an international non-governmental organization, we hired students to work on a database project. Students in the award treatment were offered a congratulatory card honoring the best performance. The award was purely symbolic to ensure that any behavioral effect is driven by non-material benefits. Our results show that the award increases performance by about 12 percent on average. The results provide strong evidence for the motivating power of status and social recognition in labor relations. (JEL C93, J33, M12, M52)
Background Poor adherence to medications is a major cause of morbidity and inadequate drug effectiveness. Efforts to improve adherence have typically been either ineffective or too complex to implement in clinical practice. Lottery-based incentive interventions could be a scalable approach to improving adherence.MethodsThis was a randomized, controlled clinical trial of a daily lottery-based incentive in patients on warfarin stratified by baseline international normalized ratio (INR). The trial randomized 100 patients to either a lottery-based incentive or no lottery intervention. Main outcome was out-of-range INRs.ResultsOver 6 months, the overall percentage of out-of-range INRs did not differ between the 2 arms (mean 23.0% in lottery arm and 25.9% in control arm, adjusted odds ratio[OR]0.93,95%CI0.62-1.41). However, among the a priori subgroup with a baseline INR below therapeutic range, there was a significant reduction in out-of-range INR in the lottery arm versus the control arm (adjusted OR 0.39, 95% CI 0.25-0.62), whereas there was no such effect among those with therapeutic INRs at baseline(adjusted OR 1.26, 95% CI, 0.76-2.09, P value for interaction = .0016). Among those with low INR at baseline, there was a nonsignificant 49% reduction in the odds of nonadherence with the intervention (OR 0.51, 95% CI 0.23-1.14).ConclusionsAlthough a lottery-based intervention was not associated with a significant improvement in anticoagulation control among all study participants, it improved control among an a priori group of patients at higher risk for poor adherence.(Am Heart J 2012;164:268-74.)
We show that two simple and nonintrusive ‘nudges’–reducing plate size and providing social cues–reduce the amount of food waste in hotel restaurants by around 20%. The results are statistically significant. They are also environmentally substantial as food waste is a major contributor to climate change and other forms of environmental degradation. Given the magnitude of the contribution of food waste to global environmental change, it is surprising that this issue has not received greater attention. The measures reduce the amount of food the restaurants need to purchase, and there is no change in guest satisfaction, making it likely that profits will increase. The measures thus constitute potential win–win opportunities.
Vote-buying and vote-selling obstruct the democratic process, yet they remain pervasive in many developing democracies. Researchers asked voters in the Philippines to make a simple, unenforceable promise not to accept money from politicians or to promise to vote according to their conscience, even if they do accept money, to test the impact of promises on voters’ behavior. A majority of respondents made promises not to sell their votes. Researchers found that the promise significantly reduced vote-selling, cutting the number of people who sold their votes by 11 percentage points in the smallest-stakes election, but was not effective in the mayoral election with higher pay-outs. These results suggest that simply asking voters to promise not to sell votes can help reduce vote-selling in elections where vote-buying payments are typically small.
The collection of delinquent fines is a vast and ongoing public administration challenge. In the United Kingdom, unpaid fines amount to more than 500 million pounds. Managing noncompliant accounts and dispatching bailiffs to collect fines in person is costly. This paper reports the results of a large randomized controlled trial, led by the UK Cabinet Office's Behavioural Insights Team, which was designed to test the effectiveness of mobile phone text messaging as an alternative method of inducing people to pay their outstanding fines. An adaptive trial design was used, first to test the effectiveness of text messaging against no treatment and then to test the relative effectiveness of alternative messages. Text messages, which are relatively inexpensive, are found to significantly increase average payment of delinquent fines. We found text messages to be especially effective when they address the recipient by name.
| E Haisley, Kevin Volpp, T Pellathy, George Loewenstein|
The biggest challenge for corporate wellness initiatives is low rates of employee participation. We test whether a behavioral economic approach to incentive design (i.e., a lottery) is more effective than a direct economic payment of equivalent monetary value (i.e., a grocery gift certificate) in encouraging employees to complete health risk assessments (HRAs). Design.
Employees were assigned to one of three arms. Assignment to a treatment arm versus the nontreatment arm was determined by management. Assignment to an arm among those eligible for treatment was randomized by office. Setting.
A large health care management and information technology consulting company. Patients.
A total of 1299 employees across 14 offices participated. Intervention.
All employees were eligible to receive $25 for completing the HRA. Those in the lottery condition were assigned to teams of four to eight people and, conditional on HRA completion, were entered into a lottery with a prize of $100 (expected value, $25) and a bonus value of an additional $25 if 80% of team members participated. Those in the grocery gift certificate condition who completed an HRA received a $25 grocery gift certificate. Those in the comparison condition received no additional incentive. Measures.
HRA completion rates. Analysis.
Logistic regression analysis. Results.
HRA completion rates were significantly higher among participations in the lottery incentive condition (64%) than in both the grocery gift certificate condition (44%) and the comparison condition (40%). Effects were larger for lower-income employees, as indicated by a significant interaction between income and the lottery incentive. Conclusion.
Lottery incentives that incorporate regret aversion and social pressure can provide higher impact for the same amount of money as simple economic incentives.
We report the results of a randomized field experiment aimed at improving the safety of long-distance mini-busses or matatus in Kenya. Our intervention combines evocative messages aimed at motivating passengers to speak up against bad driving with a lottery that rewards matatu drivers for keeping the stickers in place. Independent insurance claims data were collected for more than 2000 long-distance matatus before and after the intervention. Our results indicate that insurance claims fell by a half to two-thirds, from a baseline annual rate of about 10%, and that claims involving injury or death fell by 60%. While we are unable to identify the mechanism(s) underlying this effect, the intervention is more cost effective in reducing mortality than other documented public health interventions.
For this controlled trial, we randomly divided our sample population of 2,324 diabetics into four groups and sent each a different type of letter from the Oklahoma Health Care Authority. To track and compare the responses of the different groups, we analyzed Medicaid claims data for each patient over the next year, noting payments for physician visits, blood tests and filled prescriptions. By the end of our one-year analysis period, the control group had caught up with the nudge recipients (not surprising in a population of diabetics, who are likely to have medical checkups over an extended period). There was no longer a significant difference in the number of prescriptions filled, whether as the result of physician visits or renewals of existing prescriptions. So it seems that the value of the nudge is actually in prompting recipients to act more quickly – which should have a positive effect on long-term health outcomes, particularly when extended across a population of millions.
| A Drexler, G Fischer, A Schoar|
Micro-entrepreneurs often lack the financial literacy required to make important financial decisions. We conducted a randomized evaluation with a bank in the Dominican Republic to compare the impact of two distinct programs: standard accounting training versus a simplified, rule-of-thumb training that taught basic financial heuristics. The rule-of-thumb training significantly improved firms' financial practices, objective reporting quality, and revenues. For micro-entrepreneurs with lower skills or poor initial financial practices, the impact of the rule-of-thumb training was significantly larger than that of the standard accounting training, suggesting that simplifying training programs might improve their effectiveness for less sophisticated individuals.
Most opioid prescription deaths occur among people with common conditions for which prescribing risks outweigh benefits. General psychological insights offer an explanation: People may judge risk to be low without available personal experiences, may be less careful than expected when not observed, and may falter without an injunction from authority. To test these hypotheses, we conducted a randomized trial of 861 clinicians prescribing to 170 persons who subsequently suffered fatal overdoses. Clinicians in the intervention group received notification of their patients’ deaths and a safe prescribing injunction from their county’s medical examiner, whereas physicians in the control group did not. Milligram morphine equivalents in prescriptions filled by patients of letter recipients versus controls decreased by 9.7% (95% confidence interval: 6.2 to 13.2%; P < 0.001) over 3 months after intervention. We also observed both fewer opioid initiates and fewer high-dose opioid prescriptions by letter recipients.
Research suggests that the much higher HIV prevalence among young women in sub-Saharan Africa than among males of their age cohort is linked to the high prevalence of age-disparate sexual partnerships, and that incorrect beliefs about the relationship between age and HIV-risk are partly responsible. We report the results of an experiment that tests whether a simple, computer-based “HIV risk game” leads to better understanding of the relationship between HIV-risk and age among low-income South African adolescents than a version of the traditional “brochure approach” to dispensing information does. Our results are striking. The randomly assigned treatment group, which receives repeated doses of information about the link between age and HIV-risk as feedback to their own responses to simple questions about relative HIV-risk, is significantly more likely to correctly identify which of a pair of hypothetical men or women of different ages is more likely to have HIV than the control group. Subjects in the treatment group answer, on average, 1.65 times as many questions about HIV risk and age correctly as those in the control group. We also find that subjects’ (particularly female subjects’) beliefs about HIV risk among women are less accurate than their beliefs about HIV risk among men. Finally, a follow-up survey with no significant difference in attrition rates between those in the treatment and control groups, shows substantially higher information retention among treatment subjects than among control subjects.
| N Benhassine, F Devoto, E Duflo, P Dupas, V Pouliquen|
Conditional Cash Transfers (CCTs) have been shown to increase human capital investments, but their standard features make them expensive. We use a large randomized experiment in Morocco to estimate an alternative government-run program, a "labeled cash transfer" (LCT): a small cash transfer made to fathers of school-aged children in poor rural communities, not conditional on school attendance but explicitly labeled as an education support program. We document large gains in school participation. Adding conditionality and targeting mothers made almost no difference in our context. The program increased parents' belief that education was a worthwhile investment, a likely pathway for the results. (JEL H23, I24, 128, I38, J24, O15, O18)
| GB Chapman, H Colby, K Convery, EJ Coups|
The effectiveness of a pedometer intervention was affectedby manipulating the goals given to participants and byproviding social comparison feedback about how partici-pants’ performance compared with others. In study 1(n= 148), university staff members received a low,medium, or high walking goal (10%, 50%, or 100%increase over baseline walking). Participants walked1358 more steps per day (95% confidence interval [CI],729, 1985), when receiving a high goal than when receiv-ing a medium goal, but a medium goal did not increasewalking relative to a low goal (554 more steps; 95% CI,–71,1179). In study 2 (n= 64), participants received individual feedback only or individual plus social com-parison feedback. Participants walked 1120 more stepsper day (95% CI, 538, 1703) when receiving social compar-ison feedback than when receiving only individual feed-back. Goals and the performance of others act asreference points and influence the effect that pedometerfeedback has on walking behavior, illustrating the applica-bility of the principles of behavioral economics and socialpsychology to the design of health behavior interventions.
OBJECTIVE: More than 200 million children globally do not attain their developmental potential. We hypothesized that a parent training program could be integrated into primary health center visits and benefit child development. METHODS: We conducted a cluster randomized trial in the Caribbean (Jamaica, Antigua, and St Lucia). Fifteen centers were randomly assigned to the control (n = 250 mother-child pairs) and 14 to the intervention (n = 251 mother-child pairs) groups. Participants were recruited at the 6- to 8-week child health visit. The intervention used group delivery at 5 routine visits from age 3 to 18 months and comprised short films of child development messages, which were shown in the waiting area; discussion and demonstration led by community health workers; and mothers’ practice of activities. Nurses distributed message cards and a few play materials. Primary outcomes were child cognition, language, and hand-eye coordination and secondary outcomes were caregiver knowledge, practices, maternal depression, and child growth, measured after the 18-month visit. RESULTS: Eight-five percent of enrolled children were tested (control = 210, intervention = 216). Loss did not differ by group. Multilevel analyses showed significant benefits for cognitive development (3.09 points; 95% confidence interval: 1.31 to 4.87 points; effect size: 0.3 SDs). There were no other child benefits. There was a significant benefit to parenting knowledge (treatment effect: 1.59; 95% confidence interval: 1.01 to 2.17; effect size: 0.4). CONCLUSIONS: An innovative parenting intervention, requiring no additional clinic staff or mothers’ time, was integrated into health services, with benefits to child cognitive development and parent knowledge. This is a promising strategy that merits further evaluation at scale.
| Busso, Cristia, Humpage|
Many families fail to vaccinate their children despite the supply of these services at no cost. This study tests whether personal reminders can increase demand for vaccination. A field experiment was conducted in rural Guatemala in which timely reminders were provided to families whose children were due for a vaccine. The six-month intervention increased the probability of vaccination completion by 2.2 percentage points among all children in treatment communities. Moreover, for children in treatment communities who were due to receive a vaccine, and whose parents were expected to be reminded about that due date, the probability of vaccination completion increased by 4.6 percentage points. The cost of an additional child with complete vaccination due to the intervention is estimated at about $7.50.
Preventive health behaviors like flu vaccination have important benefits, but compliance is poor, and the reasons are not fully understood. We conducted a large study across six colleges (N = 9358), with a methodology that offers an unusual opportunity to look at three potential factors: inattention to information, informed intentions to not comply, and problems following through on intentions. We also tested three interventions in an RCT. We find that inattention to information is not the primary driver of low take-up, while informed decisions to not get the vaccine, but also lack of follow-through, are important factors. A financial intervention increased take-up and had persistent, positive effects on intentions for vaccination in future years. Two low-cost “nudges” did not increase vaccination rates, although the peer endorsement nudge increased exposure to information, especially if aligned with social networks.
We conducted two Facebook experiments (the first one during July 21–25, 2016, and the second during April 22–25, 2018) to determine what type of message related to injunctive norms is more effective in getting Hispanic women interested in learning about financial planning for retirement. We also explore how social media tools could be used in future interventions to promote retirement saving among Hispanic women. In both experiments, we found that a message centered on peer influence may be more successful than a message centered on familism in getting Hispanic women interested in learning more about financial planning for retirement. When we disaggregate our data by age and state, we find that click-through rates were higher among Hispanic women between 45 and 55 years old, and the largest numbers of impressions were among Hispanic women in California and Texas. When we disaggregate our data by device, we find that most study participants were reached through an Android smartphone.
To increase uptake of flu vaccines and maintain a healthy workforce during the 2016-17 flu season, New York City’s Behavioral Design Team (NYC BDT) partnered with WorkWell NYC to design behaviorally informed emails to encourage New York City employees to visit a worksite flu clinic. One version of the redesigned email used the strategy of “enhanced active choice,” whereby employees were prompted to make a choice that had a clear right answer. IMPACT
Behavioral emails more than doubled click-through rates and statistically increased appointment sign-ups. Most importantly, the enhanced active choice version of the email increased vaccine uptake by 5 percent at worksite locations.
| AV Banerjee, Duflo, Glennerster, Kothari|
Objective To assess the efficacy of modest non-financial incentives on immunisation rates in children aged 1-3 and to compare it with the effect of only improving the reliability of the supply of services. Design Clustered randomised controlled study. Setting Rural Rajasthan, India. Participants 1640 children aged 1-3 at end point. Interventions 134 villages were randomised to one of three groups: a once monthly reliable immunisation camp (intervention A; 379 children from 30 villages); a once monthly reliable immunisation camp with small incentives (raw lentils and metal plates for completed immunisation; intervention B; 382 children from 30 villages), or control (no intervention, 860 children in 74 villages). Surveys were undertaken in randomly selected households at baseline and about 18 months after the interventions started (end point). Main outcome measures Proportion of children aged 1-3 at the end point who were partially or fully immunised. Results Among children aged 1-3 in the end point survey, rates of full immunisation were 39% (148/382, 95% confidence interval 30% to 47%) for intervention B villages (reliable immunisation with incentives), 18% (68/379, 11% to 23%) for intervention A villages (reliable immunisation without incentives), and 6% (50/860, 3% to 9%) for control villages. The relative risk of complete immunisation for intervention B versus control was 6.7 (4.5 to 8.8) and for intervention B versus intervention A was 2.2 (1.5 to 2.8). Children in areas neighbouring intervention B villages were also more likely to be fully immunised than those from areas neighbouring intervention A villages (1.9, 1.1 to 2.8). The average cost per immunisation was $28 (1102 rupees, about £16 or €19) in intervention A and $56 (2202 rupees) in intervention B. Conclusions Improving reliability of services improves immunisation rates, but the effect remains modest. Small incentives have large positive impacts on the uptake of immunisation services in resource poor areas and are more cost effective than purely improving supply.
Importance Financial incentives to physicians or patients are increasingly used, but their effectiveness is not well established. Objective To determine whether physician financial incentives, patient incentives, or shared physician and patient incentives are more effective than control in reducing levels of low-density lipoprotein cholesterol (LDL-C) among patients with high cardiovascular risk. Design, Setting, and Participants Four-group, multicenter, cluster randomized clinical trial with a 12-month intervention conducted from 2011 to 2014 in 3 primary care practices in the northeastern United States. Three hundred forty eligible primary care physicians (PCPs) were enrolled from a pool of 421. Of 25 627 potentially eligible patients of those PCPs, 1503 enrolled. Patients aged 18 to 80 years were eligible if they had a 10-year Framingham Risk Score (FRS) of 20% or greater, had coronary artery disease equivalents with LDL-C levels of 120 mg/dL or greater, or had an FRS of 10% to 20% with LDL-C levels of 140 mg/dL or greater. Investigators were blinded to study group, but participants were not. Interventions Primary care physicians were randomly assigned to control, physician incentives, patient incentives, or shared physician-patient incentives. Physicians in the physician incentives group were eligible to receive up to $1024 per enrolled patient meeting LDL-C goals. Patients in the patient incentives group were eligible for the same amount, distributed through daily lotteries tied to medication adherence. Physicians and patients in the shared incentives group shared these incentives. Physicians and patients in the control group received no incentives tied to outcomes, but all patient participants received up to $355 each for trial participation. Main Outcomes and Measures Change in LDL-C level at 12 months. Results Patients in the shared physician-patient incentives group achieved a mean reduction in LDL-C of 33.6 mg/dL (95% CI, 30.1-37.1; baseline, 160.1 mg/dL; 12 months, 126.4 mg/dL); those in physician incentives achieved a mean reduction of 27.9 mg/dL (95% CI, 24.9-31.0; baseline, 159.9 mg/dL; 12 months, 132.0 mg/dL); those in patient incentives achieved a mean reduction of 25.1 mg/dL (95% CI, 21.6-28.5; baseline, 160.6 mg/dL; 12 months, 135.5 mg/dL); and those in the control group achieved a mean reduction of 25.1 mg/dL (95% CI, 21.7-28.5; baseline, 161.5 mg/dL; 12 months, 136.4 mg/dL; P < .001 for comparison of all 4 groups). Only patients in the shared physician-patient incentives group achieved reductions in LDL-C levels statistically different from those in the control group (8.5 mg/dL; 95% CI, 3.8-13.3; P = .002). Conclusions and Relevance In primary care practices, shared financial incentives for physicians and patients, but not incentives to physicians or patients alone, resulted in a statistically significant difference in reduction of LDL-C levels at 12 months. This reduction was modest, however, and further information is needed to understand whether this approach represents good value.
Low response rates to government surveys hinder research and limit the robustness of the policy evaluations and recommendation. To compensate for low rates of response, research teams often need to increase sample sizes, making research more costly.
The City of Philadelphia in Pennsylvania offers a discount to low-income senior citizens living in the municipality on their water bills. Senior water and sewer customers can apply to receive 25 percent off their payments for water in an effort to reduce the financial burden on those elderly citizens with lesser means.
Recent severe weather events have increased concerns about growing flood risk and the resiliency of households in the floodplain, prompting efforts to improve preparedness and insurance coverage.
In 2014, only 48.6% of Nigeria's adult population had access to, and used, formal financial products.To make these products more accessible to people of all incomes, a major bank and a telecommunications company in Nigeria jointly launched a mobile bank account.
A randomized evaluation found that writing both a date and time increased the number of employees getting their flu shots.. Employees who received the more detailed "time plan" mailer were 4 percentage points more likely than those who received the standard mailer to get their shot (37.1% compared to 33.1%).
A randomized evaluation found that a one-time message increased attendance at peer tutoring sessions by 7 percentage points, from 29% to 36%. Attendance at multiple tutoring sessions increased by 6 percentage points, from 18% to 24%.
To help first-year students understand that the challenges they faced were neither unique to them nor evidence of personal failure, all incoming first-year students at SF State were asked to watch a three-minute video in which older students described the struggles they had faced and their routes to success.
there was a mismatch between the actual rent due date (the first of the month) and when renters perceived rent to be due (the 10 th of the month, when penalties kicked in).
A randomized evaluation found that presenting patients with a default, preselected influenced the type of end-of-life care patients chose. When the advance directed had no preselected option, 61% percent of patients chose comfort-oriented care.
The researchers used a randomized control trial to test the effects of different types of messaging on employee 401(k) contributions. They found that among the employees who contributed the least to their 401(k) plans, those who received the $16,500 cue contributed higher proportions of income on average than those who received the $3,000 cue.
| PA Keller, B Harlam, George Loewenstein, Kevin Volpp|
Not adhering to medication regimens has individual, public health, and economic consequences. While helpful automatic prescription refill programs are widely available, few individuals enroll.
Project Summary. Posters and brochures emphasizing career incentives—especially the opportunity to move up to higher and better-paid positions—helped recruit new, more effective community health workers.
| Fiorello, Potok, Wright|
ideas42 redesigned four aspects of the CARD Bank system to increase savings: a new account opening form, a printed savings plan, reminders to make savings deposits, and a new savings calendar.
A randomized evaluation found that among families where both students and parents received the redesigned emails, 50% filed their financial aid application by the priority deadline.
A randomized evaluation showed that envelopes printed with dollar costs over time reduced borrowing from the payday lender in later pay cycles by about 11%.The other information types did not significantly reduce the likelihood of borrowing in a post-intervention pay cycle.
| J Blumenstock, M Callen, T Ghani|
A randomized evaluation found that selling farmers a voucher for fertilizer soon after the harvest increased fertilizer usage. In the first season, usage increased by 14 percentage points (on a base of 23%); in the second season, offering the voucher increased usage by 18 percentage points (on a base of 30%).
Past research indicates there is a positive relationship between parental involvement and students' success in school, but communication between educators and parents is often infrequent or unsystematic.
A randomized evaluation found that households which received letters comparing water consumption to their local neighbors reduced water consumption by 1.5 m 3 (from 28 to 26.5 m 3).
Good adherence to HIV medication is crucial to extend the length and quality of life and to eliminate transmission of HIV to others. However, in sub-Saharan Africa, only 29% of people living with HIV (PLHIV) have viral suppression, the ultimate goal of treatment.
A randomized evaluation found that clients who were offered commitment savings accounts saved an extra 235 pesos over the first six months of the program, and an extra 411 pesos during the first year.
A randomized evaluation found that workers who received their earmarked savings in two envelopes saved an average of 414 rupees, or 72% more than the 241 rupees saved by workers who received their savings in one envelope.
Improved agricultural technologies and inputs can raise productivity and incomes for smallholder farmers, and simultaneously drive down extension and buying costs for agribusinesses that source from these farmers.
Project Summary. The Queensland Government tested the impact of three different behaviorally informed letter designs on response rates. Impact. 21.8-24.8% of people responded to one of the intervention letters, compared to 5.3% who responded to the traditional control letter.
While the average take-up rate for all loan offers was 8.5%, this randomized evaluation found that extending the deadline to apply by two weeks (from 2 weeks to 4 weeks, or from 4 weeks to 6 weeks) increased the probability of applying by 3 percentage points, roughly equivalent to the increase achieved by reducing the interest rate 10 percentage points.
Students were instructed to download a smartphone app that, over a period of weeks, delivered timely reminders and simple instructions about important deadlines and upcoming tasks related to applying for financial aid.
| Dean Karlan, M McConnell, S Mullainathan, J Zinman|
Management Science, Volume 62 No. 12 pp. 3393-3411
Randomized evaluations in each country found that clients who were sent reminders had saved more and were more likely to have reached their savings goals by the commitment end dates (around a year after opening accounts) than clients who did not receive the messages.
| P Adams, S Hunt, Vale, Zaliauskas|
The FCA used a randomized evaluation to test the effect of the reminders in motivating consumers to switch their savings account. The study found that reminders increased the percentage of customers taking some action following the rate decrease, whether switching their account internally, or closing the account and moving to another institution, by between 5.4 and 7.9 percentage points.
Traditionally, utility companies have tried to promote energy conservation by providing subsidies for energy-efficient appliances. But recently there has been an increased focus on influencing consumer behavior.
A randomized evaluation found that on average, borrowers who were sent redesigned monthly statements and strategically timed reminders received 23% fewer penalties for having insufficient funds in their loan repayment
This randomized evaluation found that the average aid award for students receiving both redesigned emails rose by 2%, or $150.28 per student for the Spring semester, compared to students who received neither email ($6,368 vs. $6,217).
| Karlan, Morten, Zinman|
Behavioral Science & Policy, Volume 2, Issue 2, 2016
A randomized evaluation found that most of the messages failed to achieve any significant result on loan repayment. The only message that increased repayment rates was a positive framing and the inclusion of the account officer's name.
Farmers in Bangladesh received incentives to refer peers for agricultural training, in some cases contingent on the referred farmer adopting the innovation.
A randomized evaluation found that some versions of the Super Savers program had a positive impact on savings and educational outcomes. Students saved more when they were offered the less restrictive cash payout which returned their savings in cash compared to the more restrictive voucher payout (see Figure 1).
| MJJ Handgraaf, Margriet van Lidth de Jeude, Kirstin Appelt|
Energy consumption is a major source of CO2 emissions, which contribute to global climate change. Although technological solutions can help reduce CO2 emissions, behavioral changes are necessary to achieve sufficient reductions.
| Johan Egebark, E Mathias|
We conducted a natural field experiment to evaluate two resource conservation programs. One intervention consisted of a moral appeal message asking university employees to cut back on printing in general, and to use double-sided printing whenever possible. The other intervention tested whether people׳s tendency to stick with pre-set alternatives is applicable to resource use: at random points in time we changed the default setting on the university printers, from single-sided to double-sided printing. Whereas the moral appeal had no impact, the default change cut paper use by 15 percent. Further analysis adds two important insights. First, we show that defaults influence behavior also in the longer run. Second, we present results indicating that resource efficient defaults have the advantage of avoiding unintended behavioral responses. Overall, our findings send a clear message to anyone concerned about resource conservation: there are potentially large gains to be made from small interventions.
| GC Bryan, Mobarak Shyamal|
Hunger during pre-harvest lean seasons is widespread in the agrarian areas of Asia and Sub-Saharan Africa. We randomly assign an $8.50 incentive to households in rural Bangladesh to temporarily out-migrate during the lean season. The incentive induces 22% of households to send a seasonal migrant, their consumption at the origin increases significantly, and treated households are 8–10 percentage points more likely to re-migrate 1 and 3 years after the incentive is removed. These facts can be explained qualitatively by a model in which migration is risky, mitigating risk requires individual-specific learning, and some migrants are sufficiently close to subsistence that failed migration is very costly. We document evidence consistent with this model using heterogeneity analysis and additional experimental variation, but calibrations with forward-looking households that can save up to migrate suggest that it is difficult for the model to quantitatively match the data. We conclude with extensions to the model that could provide a better quantitative accounting of the behavior.
A randomized evaluation found that the redesigned emails increased the number of students applying for SEED jobs by 3 percentage points, from 9% to 12%.Additionally, there was a 56% increase in the number of applications submitted, from 304 to 475 applications.