Reducing Antibiotic Prescribing Through Personalized Feedback: An Innovative Approach

In this episode of The Brainy Business podcast, host Melina Palmer welcomes Dr. Michael Hallsworth, a co-author of Behavioral Insights and a key figure in applying behavioral science to public policy. Dr. Hallsworth shares fascinating anecdotes from his extensive work, highlighting projects such as reducing antibiotic prescriptions in the UK and influencing food consumption habits to combat obesity. 

The discussion delves into the evolution of his team’s approach, tackling bigger policy issues like economic mobility and social justice with support from major foundations. Lessons from both successful and unsuccessful trials are explored, underscoring the importance of sharing outcomes to refine interventions. 

Dr. Hallsworth also touches on the nuances of replicating behavioral strategies across different countries and contexts, emphasizing the need for a deep understanding of specific problems before proposing solutions. This episode is a treasure trove for anyone interested in how small nudges can lead to significant societal shifts and is packed with real-world applications of behavioral economics.

In this episode:

• Maximize Business Impact: Harness the Power of Behavioral Insights in Decision-Making.
• Policy Design Precision: Unleashing the Impact of Behavioral Economics in Policy Formation.
• Optimize Antibiotic Prescribing: Strategies for Effective and Efficient Antibiotic Use.
• Elevate Economic Mobility: Leveraging Behavioral Insights for Greater Social Mobility.
• Health Impact Strategies: Designing Effective Sugar Drinks Tax for Public Health.

00:00:00 - Introduction The episode introduces Dr. Michael Hallsworth, managing director of the Behavioral Insights team, and his journey into behavioral science. He discusses the institute for government and the development of mindspace as a framework for applying behavioral science in practice. 00:06:48 - Flagship Project - Antibiotic Prescribing Michael shares a flagship project on antibiotic prescribing in the UK. By identifying prescribers who were outliers and sending them letters based on social norms, there was a substantial decline in antibiotic prescribing, equivalent to around 1% of England's total. This approach had a comparable effect to a massive financial incentive program, showing the effectiveness of alternative methods. 00:10:33 - Generalizability of Behavioral Insights The conversation delves into the generalizability of behavioral insights across different contexts. Michael emphasizes the complexity of generalizability, highlighting examples where similar interventions have had comparable results in different countries, while also acknowledging instances where interventions haven't worked as expected. 00:13:12 - Importance of Testing The discussion underscores the importance of rigorous testing and questioning the transferability of behavioral insights. Michael emphasizes the need for ongoing testing and the productive tension between retaining active ingredients that work and adapting interventions to different contexts. 00:14:02 - Applying Behavioral Insights Michael outlines a ten-step process for applying behavioral insights, emphasizing the importance of identifying the behavior in question, understanding the context, and diagnosing the underlying problem. 00:15:38 - The Behavioral Change Process Michael explains the common stages in behavioral change frameworks, from identifying factors to developing interventions and scaling the results. He emphasizes the importance of understanding the overall context and distinguishing between strategic and tactical use of behavioral science. 00:17:26 - Policy Impact of Behavioral Science Michael discusses the strategic and tactical use of behavioral science in influencing policy and structural changes. He shares an example of the behavioral effects of the sugar drinks tax in the UK and how it influenced reformulation rather than consumer behavior. 00:24:25 - Rapid Trials in Response to COVID-19 Michael talks about rapid trials conducted in the US with cities in response to COVID-19, focusing on messaging effectiveness for behaviors like staying home, social distancing, and mask use. He highlights the counterintuitive results and the importance of testing and implementing effective communication strategies. 00:27:34 - Urban Environment Design Michael discusses the potential for applying behavioral science to arrange urban environments to facilitate behaviors such as maintaining distance in crowded areas. He draws parallels to studies on choice architecture and redesigning traffic intersections, emphasizing the importance of making it easier for people to adhere to desired behaviors. 00:28:51 - Learning from Failed Interventions Michael emphasizes the importance of being transparent about interventions that did not work and the value of learning from those experiences to guide future initiatives. He explains how failures can lead to insights about the need for more intensive or structural changes in interventions. 00:30:45 - Exploring Bigger Policy Issues Michael discusses the idea that behavioral insights should be applied to more upstream and bigger policy issues instead of just downstream issues. This includes projects on economic mobility and social justice. 00:31:49 - Balancing Evidence and Pragmatism Michael highlights the tension between evidence and pragmatic needs when applying behavioral insights to upstream issues. He emphasizes the importance of finding a balance between knowing the evidence and being flexible in decision-making. 00:33:21 - Productive Balance in Applying Behavioral Insights Michael addresses the need for practitioners to find a balance between being knowledgeable about evidence and being flexible in strategic conversations. This balance is crucial for behavioral insights to fulfill its promise of transforming the way things are done. 00:34:49 - Conclusion, What stuck with you while listening to the episode? What are you going to try? Come share it with Melina on social media -- you'll find her as @thebrainybiz everywhere and as Melina Palmer on LinkedIn.

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Connect with Michael:

• Dr. Michael Hallworth on the BI Team Website
• Michael on Twitter
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Learn and Support The Brainy Business:

Check out and get your copies of Melina’s Books. 

Get the Books Mentioned on (or related to) this Episode:

• Behavioral Insights, by Michael Hallsworth
• Engaged, by Amy Bucher
• Behavioral Science in the WIld, by Dilip Soman and Nina Mazar
• Designing for Behavior Change, by Stephen Wendel
• Nudge, by Richard Thaler & Cass Sunstein

Top Recommended Next Episode: Michael Hallsworth Interview 2  (ep 218)

Already Heard That One? Try These: 

• Questions or Answers? (ep 4)
• Steve Wendell Interview (ep 116)
• The Most Important Step In Applying Behavioral Economics: Understanding the Problem (ep 126)
• Elina Halonen Interview (ep 188)
• Framing (ep 296)

Other Important Links: 

• Brainy Bites - Melina’s LinkedIn Newsletter
• https://www.nature.com/articles/s41562-023-01555-3
• Nudge vs. Superbugs: A Behavioural Economics Trial to Reduce the Overprescribing of Antibiotics
• Reductions in Portion Size and Energy Density of Foods are Additive and Lead to Sustained Decreases in Energy Intake