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Small Changes in Your Environment
Can Have Big Effects on Your Behavior
Environmental changes are the low
hanging fruit of behavior change
• It’s far easier to change people’s environment than it is to
change their mind
• What looks like a “people” problem is often just an “environment”
or “situation” problem
2
Broken windows theory
3
Keez Keiser confirmed this theory through a
series of real world experiments
• When graffiti was present, the proportion of
litterers more than doubled from 33% to 69%
Keizer, K.; Lindenderg, S.; Steg, L. The spreading of disorder. Science 2008, 322, 1681-1685.
4
Second experiment
• When the first sign was disregarded, 82% (more
than three times as many people), disregarded
the second sign
Keizer, K.; Lindenderg, S.; Steg, L. The spreading of disorder. Science 2008, 322, 1681-1685.
5
Third experiment
• When the the mailbox was covered with graffiti the
proportion of thieves more than doubled to 27%
Keizer, K.; Lindenderg, S.; Steg, L. The spreading of disorder. Science 2008, 322, 1681-1685.
6
Take away
• Small changes in our environment can have a big impact on our
behavior
7
So how can leverage this finding?
1. Tweaking the environment
• Make the desired task easier to complete
9
Amazon does this through its One-click
ordering feature
10
Morning exercise people do this by laying out
there workout clothes before they go to bed
11
Charities do this by placing donation drops in
high traffic areas
12
Nurses do this by wearing red vests to discourage
interruptions during medication deliveries
13
Dieters do this by shifting from family size
bags to single serve packaging
14
Governments do this by making organ
donation the default option
15
High school cafeterias are doing this by
displaying healthy foods more prominently
16
So how big can these small
environmental changes be?
Tweaking a College Food Donation Campaign
All Students
Profiling Survey
Givers
Switch by Chip and Dan Heath, 2010
Non-Givers
They Prepared 2 Different Donation Letters
Basic Letter
• Announced the launch of food
drive the following week
• Asked them bring canned food to
a booth in a well known place on
campus
•
•
•
•
Switch by Chip and Dan Heath, 2010
More Detailed Letter
Announced the launch of food
drive the following week
Included a map to the precise
spot on campus where booth
would be
Requested cans of beans
specifically
Suggested that they plan a time
when they will be near booth so
drop off will be easy
Tweaking a College Food Donation Campaign
All Students
Profiling Survey
Givers
Detail
Donation
Rate
42%
Non-Givers
Basic
Detail
Basic
8%
25%
0%
3X
What looks like a people problem is often an environment or situation problem
Switch by Chip and Dan Heath, 2010
2. Setting action triggers
• Create a mental plan of action that gets triggered when a cue
is present
Switch by Chip and Dan Heath, 2010
21
Research shows that action triggers are most
useful in difficult situations
• In one study of patients recovering from hip- or knee surgery, one
group was asked to set action triggers
• Individuals were asked to write down when they would take their walks
and where they planned to go on those walks
• On average, the action trigger patients were bathing themselves
without assistance in 3 weeks versus 7 weeks
• Action trigger patients were standing up in 3.5 weeks versus 7.7
weeks
• In just 1 month, the action trigger patients were getting into and out of
cars on their own versus 2.5 months for patients in the other group 22
Switch by Chip and Dan Heath, 2010
And while action triggers aren’t foolproof, it’s
hard to find an easier way to drive change
• A recent meta-study that analyzed 8,155 participants across 85
studies found that the typical person who set an action trigger
did better than 74% of people on the same task who didn’t set
one
Switch by Chip and Dan Heath, 2010
23
Checklists are slightly more detailed
forms of action triggers
• The Story of Dr. Peter Pronovost
– ICU physician at Johns Hopkins
– Mission: Reduce IV line infections in ICUs
– Challenge: No direct authority over his colleagues
Switch by Chip and Dan Heath, 2010
24
So he began by studying the literature on IV
line infections
• The medical literature confirmed 5 major sources of line infections
• Studies in other hospitals confirmed that reductions in any of
these 5 indicators resulted in reductions in IV line infections
• Peter drafted a 5 step checklist
• Published his checklist in a leading medical journal
Switch by Chip and Dan Heath, 2010
Peter’s Checklist
1. Wash your hands before inserting a line
2. Clean patient’s skin with antiseptic at the point of insertion
3. Put sterile drapes over the entire patient
4. Wear a sterile mask, hat, gown, and gloves
5. Put sterile dressing over the catheter site once the line is in
Source: New Yorker Magazine; December 10, 2007
Peter’s initial test at JHU was a major
success
• Peter decides to test the checklist in more challenging
environment
• He works with state of Michigan to implement the checklist at all
state managed hospitals
• State managed hospitals were among the lowest performing
hospitals with the worst reputation for quality and outcomes
Source: New Yorker Magazine; December 10, 2007
The Results speak for themselves
• Peter’s checklist implemented in Michigan ICUs over 18 months
• ICU line infections declined to almost zero
• The checklist saved approximately 1,500 lives
• The reduction in line infections reduced costs by $175 million
Source: New Yorker Magazine; December 10, 2007
Summary
• Environmental changes are the low hanging fruit of behavior
change because it’s far easier to change people’s environment
than it is to change their mind
• In fact, what looks like a “people” problem is often just an
“environment” or “situation” problem
• By making small changes in our environment we can have a big
impact on behavior
– Tweaking the environment you’re trying to change
– Setting action triggers to preload important decisions
29
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