In Nudge, the 2009 book on how to use behavioral research to help people, behavioral economists Richard H. Thaler and Cass R. Sunstein introduced the concept of choice architecture. The idea was that those responsible for designing things that influence important decisions should do so in a way that encourages the best outcomes for people with a stake in those decisions.
If ever there was an industry in need of heeding this advice it is healthcare marketing. Decisions in most health contexts are regrettably more complicated than ever (there is more choice, more information, more red tape, etc.). This not only makes it difficult for brands to get their message out in a way that drives results, but it is also a barrier to people making decisions in their best interests, or in the best interests of those they are deciding for.
To address this, teams that plan healthcare communications should consider whether they are using the best insights to inform programs that will facilitate optimal decision-making among their intended audience. Unfortunately, marketing programs too often rely on an overly simplistic understanding of human nature. In many instances the result is an inadequate campaign that fails to differentiate, and worse, will probably fail to realize its full potential in encouraging the ideal decisions and behaviors.
Getting Healthcare Communications to Work Harder
Healthcare communications must work harder to be effective as the marketplace becomes more competitive and demanding of brands. This will require an evolution in how campaign planners approach marketing program design.
For starters, it is critical that they incorporate more robust insights regarding the motivational, cognitive and contextual factors that influence a specific audience. This will provide the foundation for campaigns that are more relevant to the nature and peculiarities of that audience. It will also better predict how people will actually decide and behave, as opposed to what they theoretically should do based on superficial assumptions and guesswork.
Richer Insights into Human Behavior Can Make the Difference
Marketing is about understanding human behavior, which is not always easy to decipher. And while there is no substitute for audience-specific insights, there are numerous concepts from behavioral sciences research about human decision-making that can help.
There are three valuable benefits of using behavioral sciences concepts when planning a marketing program. First, they provide validated models for understanding human behavior. Second, they reveal how non-rational (and thus deceptive to the observer) impulses influence decision-making. Third, they provide a conceptual basis for insights that could make the difference between an average campaign and one that is high impact.
Four Insights From the Behavioral Sciences
What follows are four insights from the behavioral sciences that can be used to design more effective healthcare marketing programs.
1. The effect of framing on decision-making: People are subject to a host of cognitive biases when making decisions. Loss aversion is one of the most powerful of these biases. People will do just about anything to avoid loss, even if it means acting against their best interests. Consider the following example:
A doctor is responsible for dispensing vaccines during an epidemic in which 600 have become ill. He or she is faced with a choice between two programs:
- Program A: 200 lives will be saved.
- Program B: There is a one-third probability that 600 will be saved, and a two-thirdsprobability that no one will be saved.
Which should he or she choose?
Now imagine the doctor is presented with a choice between these two different programs:
- Program C: 400 will die.
- Program D: There is a one-third probability that no one will die and a two-thirdsprobability that 600 people will die.
Which should he or she choose?
You have probably discerned that both sets of options are identical. They are just framed differently (the first set emphasizes a sure gain; the second a sure loss).
These scenarios were presented to two groups of 150 doctors. One group chose between programs A and B, the other between programs C and D. The results were remarkable:
- Group 1: 72% chose A, and 28% chose B
- Group 2: 22% chose C, and 78% chose D
Both groups of doctors had the same goal (to save lives). Yet the loss aversion bias caused them to make different decisions.
Implication: Don’t assume that people perfectly compute the value of all options and make fully informed, logical choices. Decisions are rarely based on perfect information. Even when they are, people seldom understand the full implications of that information.
2. The “it cannot happen to me” syndrome: Motivation has a powerful influence over behaviors. Unfortunately, motivations are frequently affected by prejudices that are not based on an objective point of view.
One such prejudice in the context of health risks assessments is the self-positivity bias. People simply believe they are less prone to health risks than others in their reference group (e.g., the elderly or smokers). The culprit is the tendency for people to favor absolute measures when assessing risk (e.g., a chance of one in 250), as opposed to relating to actual people who are affected by a health condition.
Implication: Marketers can make health risks more concrete by avoiding comparative references to an “average person” and showing real people in the context of their life roles (mother, spouse, sibling, etc.) suffering from a particular disease.
3. The sway of social norms: Context plays an important role in shaping attitudes and behaviors. Social norms are one of the more potent contextual forces. Norms serve a basic social function by providing rules that govern acceptable behavior in groups and society.
The opportunity for marketers is to determine how norms influence target audience preferences and behaviors. For instance, understanding the social norms behind the treatment habits of a specialty physician group (say, oncologists) could yield powerful insights on how to best introduce a new standard of care to the group.
Implication: Answers to a few key questions can help understand group norm dynamics and inform more effective communications:
- What values and principles guide group behaviors?
- How does the group form attitudes?
- What role do group leaders play in setting/enforcing norms?
- How do norm changes and innovations occur in the group?
4. How physiological responses influence perceptions: Conventional wisdom is that actions are based on impulses generated by thought. Research shows, however, that this mind-to-body relationship is not as one-directional as once presumed.
A variety of physiological responses (e.g., changes in heart rate, sweating, etc.) influence perceptions and cause people to infer attitudes from those perceptions. For instance, motor actions accompanying performance on a task can influence thoughts and feelings about that task.
Implication: Health oriented smartphone apps and wearable trackers not only encourage healthy activities (e.g., Nike+ Fuelband), but can also influence perceptions and attitudes about their underlying health benefits. A virtuous cycle if ever there was one!
Choice Architect, a New Role for Healthcare Marketers
Human decision-making is complex, error-prone and imperfect. This is especially true in a complicated and emotional domain like healthcare. When planning campaigns, healthcare marketers should make it a priority to help people make the most informed decisions possible and have clear pathways to act in their best interest. And we should do it in a way that builds trust while driving profits. In short, we should be choice architects. It is, after all, what our key stakeholders and society expect of us.
The effect of framing on decision-making
“Choices, Values and Frames,” Kahneman and Tversky, American Psychologist, 1984 (a classic of cognitive psychology). This study, among others, won Kahneman and Tversky the Nobel in economics.
The “it cannot happen to me” syndrome
“Effects of Temporal Framing on Judgments of Health Risks,” Journal of Consumer Research, 2004.
The sway of social norms
“Under the Influence: How the Group Changes What We Think,” Shirley S. Wang, The Wall Street Journal, May 3, 2011.
How physiological responses influence perceptions
“Embodiment in Attitudes, Social Perception, and Emotion,” Niedenthal, et al,
Personality and Social Psychology Review, 2005, Vol. 9, No. 3, 184–211.
“From Firm Muscles to Firm Willpower: Understanding the Role of Embodied Cognition in Self-Regulation,” Hung and Labroo, Journal of Consumer Research, Vol. 37, No. 6 (April 2011), pp. 1046-1064.