I'm fascinated by how we can leverage evidence to inform behavior change. A thread based on literature & our #design of spaces & processes in high-stakes environments @AdvPerformHD @HumanFact0rz @ASPphysician @jyangstar 1/ 
2/ After the wkd, its clear some in Ontario are experiencing quarantine fatigue (bit.ly/2TFbbRw). Below are thoughts combining work from change management (amzn.to/3c2qWbx), behavior psych (bit.ly/3d0yIUp), risk perception (Kahneman) & #harmreduction
3/ Current state = #publichealth experts tell us that we cannot return to our previous way of life despite many who wish to do so. RESULT = need for substantial behaviour change. CHALLENGE = people don't like to change. #default & familiar behaviour is preferred
4/ Kahneman & others have shown that 1) our ability to calculate risk is hindered by numerous cognitive biases 2) risk perception drives behavior and 3) Emotions are linked to risk perception (anger reduces risk perception, fear increases it (to a degree)
5/ Authorities can help improve understanding of risk & positively support preferred behavior.
“Risk is not binary” (bit.ly/2X21eQ5). The false dichotomy of “#stayhome” vs “spreading covid19” is NOT helpful.
“Risk is not binary” (bit.ly/2X21eQ5). The false dichotomy of “#stayhome” vs “spreading covid19” is NOT helpful.
6/ Citizens need clarity about spectrum of low & high risk activities or honesty by authorities when evidence is lacking. E.g. walking alone on street with a mask doesn't align w/ our understanding of #covid19 transmission risk. So there's work to be done.
7/ Harm reduction principles are helpful here too. Its worked for other PH initiatives (HIV, opiate use etc). Acknowledge no one is perfect. Evidence supports that authorities would be well positioned to take such an approach rather than #pandemicshaming.
8/ Communication is key. Evidence based principles include: 1) empathy – acknowledge this is tough 2) form a group identity using “we” & “us” rather than “you” (e.g. pandemic shaming) 3) highlight how many people continue to follow recommendations! Similar to @CDCgov
9/ the media isn't exempt. Imagine if they reported “10,000 people gathered at #TrinityBellwoods BUT the rest of the city parks were sparsely populated and nearly all of the 14 Million Ontarians still stayed home”! That msg still provides social proof that we're doing well.
10/ A key element to messaging is empathy. For example, “we’d love if you #stayhome, as it will keep us all safe. But we get it, the past 2 months haven’t been easy. If you’re going to the park…” And then lay out how people should behave
11/ This might include 1) only go with your "isolation team of 4 people" (few ppl you've selected to see during #pandemic 2) head to the park to walk, run but sitting won't be permitted as it will increase risk to all of us by promoting congregation 3) or create circles!
12/ interesting a reply by @JohnTory re: circles..."how do you enforce" the use of these park circles? bit.ly/3c2sK4j Perfection is the enemy of good. Not everyone will comply, but many will and that's better than nothing. Good #design will nudge people to best direction
13/ And change management folks have provided ample perspective here amzn.to/3bVGZI0
1. ppl are both rational & emotional...and emotions often win!
2. to support change, we need specific & tangible goals
3. "script critical moves" - provide a #default path for behavior
1. ppl are both rational & emotional...and emotions often win!
2. to support change, we need specific & tangible goals
3. "script critical moves" - provide a #default path for behavior
14/ I'd love to see the govt provide a risk spectrum of different activities with suggestions on how to make them safer. These should be anchored on best evidence...
e.g. prolonged, indoor activities with +++ people is more risky then contamination from Amazon package!
e.g. prolonged, indoor activities with +++ people is more risky then contamination from Amazon package!
15/ Familiarity with the best course of action is well studied to make the decision more attractive. Maybe a checklist or set of questions (if you're going to the park then do X, Y, Z...)
16/ Reflecting on #TrinityBellwoods issues...tbh, its far better that people congregated outside than inside. An empathetic response by authorities that we need to do better (script critical moves) esp in areas where ppl unlikely to have other outdoor alternatives would help.
17/ So, in summary, honest, empathetic messaging while providing people with clear ways to behave safely while highlighting differences in behavior risk is well supported by evidence. Plenty of evidence to back this. We are in this together and we got this...just a bit of work.
