I've visited eight adult social care departments this year, and talked with front line staff in all of them.
This week I attended City University’s behaviour change seminar ‘Beyond Nudge: Risk, psychology and choice architecture in policy’.
On the way home afterwards the ‘beyond nudge’ part of the event title was at the forefront of my mind. ‘Nudging’ can be effective but if we want people to make the right choices, then we shouldn’t stop at a nudge. For a decision to be optimal and sustainable, we must understand the true underlying choice preferences of the citizens/customers/patients we are trying to influence.
Eric Johnson (Columbia University) emphasised this point when he spoke about choice architecture (the tools deployed to help/nudge people to make a choice) design. Defaults are particularly popular; the ‘opt-out’ rather than ‘opt-in’ is a common behaviour change technique. Defaults work insofar that they can work for the majority, but it is ultimately a one-size-fits all approach that may mis-categorize people because they haven’t really thought about it properly, or the right information is not available (or we’re too lazy to find it!). Choice architecture designed in a way that gives us relevant information and more time (by asking the right questions), would enable us make choices that are more aligned with actual preferences.
Magda Osman (Queen Mary University) reinforced Eric’s message. She discussed the example of how in 1988, the Croatian government opted everyone ‘in’ to organ donation. But actually, organ donations only saw a significant increase after better protocols for organ donation and better communication with families were put in place. Nudges can help, but if true change is to happen then nudges need to be reflective of true underlying preferences. This can be done by considering the wider context, environment and values. Nudging alone will otherwise be limited to superficial, short term change. At iMPOWER, we spend a lot of time understanding behaviours and values before co-designing services or nudges; this event reinforced why that part of the process is so important.
In public services, as the sector starts to use more behavioural science, shifting thinking from ‘nudging’ to ‘doing all we can to help people make the right choice’ is, I think, quite powerful. Using data to design a more customised choice architecture will mean that services better meet need and are even more personal. A nudge might be the first step, but we should strive to move ‘beyond nudging’. As Eric summed up, we should want to nudge people less, and help people more.