Behavioral Economics in Action: Techniques for Creating Behavioral Change

In his 2012 behavioral economics and neuromarketing book Unconscious Branding, Douglas Van Praet outlines a seven step plan for creating behavior change.  QRCs can implement this plan to help their clients create the desired behavioral shift.


 

Behavioral change remains the Holy Grail of social science. Whether it’s devising ways to help people eat less, exercise more, or quit smoking, effective techniques that produce long-term results remain elusive.  However, when it comes to behavioral change related to customers’ purchase decisions, empirical studies in the field of behavioral economics can inform qualitative research techniques to help break old habits, bring automatic, unconscious behaviors into the domain of conscious choice, and otherwise “nudge” behavior in the direction that benefits our clients’ brands.
 

The Interaction of System 1 and System 2 Creates Behavior

As described by Daniel Kahneman, the originator of behavioral economics (see Kahneman, Daniel, and Amos Tversky "Prospect Theory: An Analysis of Decision under Risk", Econometrica, XLVII (1979), 263-291), System 1 is effortless and automatic and hates to think statistically.  It is also emotional and irrational.   System 2 is mental effort that requires a lot of physiologic resources to work its rational calculations. Kahneman’s fundamental proposition is that we identify with System 2, “the conscious, reasoning self that has beliefs, makes choices and decides what to think about and what to do”. But the one that is really in charge is System 1 as it “effortlessly originates impressions and feelings that are the main sources of the explicit beliefs and deliberate choices of System 2”.  System 1 is also subject to predictable errors in reasoning that can be exploited for the purposes of inducing behavioral change.  Modulating the interaction of Systems 1 and 2 can be a powerful tool in the qualitative researcher’s arsenal for guiding and creating new behaviors.
 

Creating a Framework for Behavioral Change

In his 2012 behavioral economics and neuromarketing book Unconscious Branding, Douglas Van Praet outlines a seven step plan for creating behavior change.  QRCs can implement this plan to help their clients create the desired behavioral shift:
 
Step 1: Interrupt the Pattern
 
Step 2: Create Comfort
 
Step 3: Lead the Imagination
 
Step 4: Shift the Feeling
 
Step 5: Satisfy the Critical Mind
 
Step 6: Change the Associations
 
Step 7: Take Action
 

Step 1: Interrupt the Pattern

System 1 works through a process of pattern recognition.  If we want to get its attention and shift behavior patterns, we need to interrupt predictable perceptual patterns and do something unexpected.
In almost all qualitative research, the client’s ultimate agenda is to use the findings of the research to help drive end-customer behavior toward their product and away from the competition.  While the principles of behavioral economics can be applied to all industries, in this article I will be drawing on an example from the medical field.  
 
In medical research, we are often tasked with trying to change physician behaviors with regard to how they go about treating various types of disease states.  In discussing the standard of care, physicians expect the best outcomes to be associated with patients whose course of treatment most closely followed the standard of care.  One way to interrupt this pattern is to begin the conversation by presenting cases where following the standard of care led to bad outcomes.  This serves as a jolt to System 1 and can put physicians slightly on the defensive, which is an ideal starting point for creating behavioral change.
 

Step 2: Create Comfort

Step 2 continues the appeal to System 1’s automatic processing. System 1 gravitates to the known, the safe and the trusted.  While something different will get its attention, it prefers the familiar (e.g., mere exposure effects, repetition compulsion, and automaticity).
Once you’ve done something shocking to get System 1’s attention, it’s important to satisfy its craving for familiarity or you risk losing rapport with the customer. One way to introduce familiarity is through the use of analogy and metaphor.  One reality of medicine is that what is considered the standard of care today will likely be considered hopelessly outdated in ten years.  It is easy enough to provide physicians with examples of other treatment categories that have undergone significant changes to treatment goals over the years driven by data and the availability of new, more effective medications.  Taking a moment to “normalize” the shocking and unexpected data from Step 1 will go a long way toward bringing the respondent back to the research with an open mind and less defensiveness.
 

Step 3: Lead the Imagination

Step 3 begins the engagement of System 2 in the behavioral change process.  System 2 gives us the unique ability to plan behavior and create new possibilities.  It gives us the capacity to imagine the benefits of doing something differently and to anticipate the consequences of our actions.
At this point as researchers, you can begin to introduce data showing the benefits of changing the target behavior.  With physicians in our study, we were able to show better overall patient outcomes by following a set of guidelines that differed appreciably from the current standard of care. This step successfully created a palpable cognitive dissonance for most physicians. Their current behavior was now inconsistent with the accumulating data convincing their rational System 2 of a better course of action.
 

Step 4: Shift the Feeling

Because of the architecture of the mind, emotions (System 1) influence our thinking (System 2) more than our thinking influences our emotions.  In order to change behaviors, feelings must shift. Step 4 returns to System 1 and appeals to feelings associated with engaging in the new behavior.
After presenting the new treatment data in our study, we talked about what these kinds of changes might mean to the physician’s practice (in terms of happier, healthier patients, satisfying the targets put forth by Accountable Care Organizations and/or the Patient Centered Medical Home, etc.) until we could see obvious signs of emotional engagement.  We talked about these benefits until the physicians smiled or laughed, signifying the emotional shift from being threatened to being relieved and optimistic.

Step 5: Satisfy the Critical Mind

Step 5 shifts the attention back to System 2. System 2 gives us the ability to rationally reject an idea if it does not make sense based on our experience.  In order to act consciously, we must give ourselves logical permission to submit to the emotions and impulses of System 1.
At this point, we presented specific detailed data collected from a medical group similar to the groups from which our physicians had been recruited.  This gave the message that these results are generalizable to “practices like mine and patients like mine”.  Making sure the data are relevant to the respondents’ unique set of circumstances is critical to prevent System 2 from rejecting the data as “not applicable to me”.
 

Step 6: Change the Associations

Memory works by association.  Repetition and emotion strengthen neural associations so that they become automatic and effortless (System 1).  If we want to change perceptions of anything, we have to change the associations. Behavioral economics refers to this as shifting the frame.
 
In our standard of care research, the disease state had largely been regarded by most physicians as a disease in which you treat the symptoms.  There is virtually nothing to be done to modify the underlying disease state, but symptoms can sometimes be mitigated and progression slowed down by use of various medications only when the disease becomes symptomatic.  This study attempted to change these associations and create a new frame by drawing parallels between this disease state and other progressive “silent” diseases. These diseases may be asymptomatic, especially in their early stages, but failing to treat them early on only leads to worsening of the disease, increased cost to the healthcare system and premature death for the patient.  This step works extensively with analogies and metaphors and a working knowledge of semiotics can be quite helpful in constructing narratives that can effectively change pre-existing associations.
 

Step 7: Take Action

Physical actions demand more of our brain than just imagining a behavior.  The more we repeat an action, the more ingrained the experience becomes in our unconscious mind (shifting from System 2 to System 1).
Physicians had been repeating the actions associated with the standard of care in this disease category for years so overcoming that inertia and System 1’s tendency to “do today what I did yesterday” would be challenging.  In our study, 90% of physicians reported they intended to change their treatment approach as a result of what they learned in the research.  Future prescribing data will be able to support or refute this prediction.
 

Moving Forward

Behavioral economics and neuromarketing offer great promise for making the market research function more consultative and actionable, while providing the real possibility of being able to measure the impact of our interventions.  The techniques of behavioral economics can be applied in a systematic fashion as part of an overall brand strategy to drive customer behavior and bottom line results.
 
Deanna A. Manfredi, Ph.D., MBA is a member of the Qualitative Research Consultants Association (QRCA) and a licensed psychologist and director of Manfredi Consulting, specializing in the pharmaceutical, biotechnology and medical devices industries. She is a qualitative research consultant who manages research projects throughout the world with a particular focus on Western Europe, Southeast Asia, and Latin America.
 
QRCA is celebrating 30 years of leadership in Qualitative Research, 1983-2013.
 
 
This content was provided by QRCA. Visit their website at www.qrca.org.

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