1 00:00:10,500 --> 00:00:14,000 Hello, hello, and welcome to the behavioral design podcast hosted 2 00:00:14,000 --> 00:00:17,200 by Samuel Salter. Hi Sam, hello. 3 00:00:17,300 --> 00:00:20,900 Hello and myself Eileen holsworth, Sam. 4 00:00:21,200 --> 00:00:25,500 I have a question for you. Are you more of a treadmill or a 5 00:00:25,500 --> 00:00:30,700 rower person at the gym? Yeah, I'm not, you know, Article 6 00:00:30,700 --> 00:00:33,000 roller. I'm one of those people that 7 00:00:33,000 --> 00:00:35,900 really usually, there's like one rolling machine at the gym that 8 00:00:35,900 --> 00:00:38,600 no one uses and I guess I'm depressed. 9 00:00:39,000 --> 00:00:45,100 It's the exception. Yeah, yeah, I would say I align 10 00:00:45,100 --> 00:00:50,200 with the with the most popular sentiment of Terror when looking 11 00:00:50,200 --> 00:00:52,900 at the rowing machine. It's definitely not definitely 12 00:00:52,900 --> 00:00:56,700 not something I've ever even. I don't think I've even tried 13 00:00:56,700 --> 00:00:59,100 it. Like I do I like doing the the 14 00:00:59,100 --> 00:01:01,700 weights that sort of Simulate the version of rowing, but the 15 00:01:01,700 --> 00:01:05,700 actual machine is horrifying, well, fun fact in Sweden, that 16 00:01:05,700 --> 00:01:07,700 is actually very similar, kind of machine. 17 00:01:07,700 --> 00:01:12,300 Always look so different, but where it's a machine used for, 18 00:01:12,300 --> 00:01:15,700 like, long-distance skiing. So you have like this two ropes 19 00:01:15,700 --> 00:01:23,300 where you can like, skiing way and so that's, that's yeah. 20 00:01:23,300 --> 00:01:26,400 That's the funniest one. And even one thing I saw today, 21 00:01:26,400 --> 00:01:28,900 given that now we have clear the roads from snow. 22 00:01:29,900 --> 00:01:35,500 I saw someone skiing with artificial skis with wheels to 23 00:01:35,500 --> 00:01:37,600 work and so that's something you can see here in Stockholm. 24 00:01:37,700 --> 00:01:39,600 Yeah yeah. How about you? 25 00:01:39,600 --> 00:01:42,500 What do you what do you end up going from the gym? 26 00:01:42,500 --> 00:01:45,600 You you said treadmill or something else. 27 00:01:45,600 --> 00:01:47,600 What is your cardio equipment of choice? 28 00:01:47,900 --> 00:01:50,000 I'll be honest. It's been a while since I've 29 00:01:50,000 --> 00:01:53,800 been to an actual gym but back in the day. 30 00:01:53,800 --> 00:01:58,200 Yeah, yeah, I definitely I definitely would consider myself 31 00:01:58,200 --> 00:02:01,200 more of a treadmill person. I like to just Just tune out do 32 00:02:01,200 --> 00:02:04,800 a little Temptation bundling and hit the treadmill. 33 00:02:05,300 --> 00:02:07,700 But in terms of skiing I'm definitely more of a downhill 34 00:02:07,700 --> 00:02:10,500 skier than a cross-country. Yeah. 35 00:02:10,600 --> 00:02:13,200 I don't like I don't understand really where the fun is in 36 00:02:13,200 --> 00:02:14,700 cross-country. Well yes it's a good question. 37 00:02:14,700 --> 00:02:20,100 Usually one of the fun Parts with social norms in Sweden with 38 00:02:20,200 --> 00:02:23,900 cross-country skiing is that you know you have tracks obviously 39 00:02:23,900 --> 00:02:28,900 you go down and so You want to kind of keep those tracks clean 40 00:02:29,100 --> 00:02:32,200 as I usually clean track and then beside the track is kind of 41 00:02:32,200 --> 00:02:34,300 more of a messy path. You can also go. 42 00:02:34,700 --> 00:02:38,000 And so the clean track is the best place to be obviously. 43 00:02:38,500 --> 00:02:43,600 And in Sweden is the person behind that has the right to 44 00:02:43,600 --> 00:02:47,800 stay in the track. And so if you're skiing and then 45 00:02:47,800 --> 00:02:51,300 you have some quicker coming behind you, they can scream at 46 00:02:51,300 --> 00:02:56,900 you pretty much get the F out of the way and you You don't have 47 00:02:56,900 --> 00:02:58,400 to be like. Okay okay, yeah. 48 00:02:59,800 --> 00:03:03,400 And so in Swedish, the word is used for sport. 49 00:03:03,700 --> 00:03:06,900 This means like out of the track and so you can often times hear 50 00:03:07,200 --> 00:03:11,200 hear, even if you're in the woods, that happen to have a ski 51 00:03:11,500 --> 00:03:15,800 track, you can just hear someone screaming in the woods and, you 52 00:03:15,800 --> 00:03:17,400 know, that's okay. People are staying. 53 00:03:19,600 --> 00:03:23,500 All right, let's get to it. Let's talk about about this 54 00:03:23,500 --> 00:03:25,500 episode. We have an oh yeah, there's some 55 00:03:25,500 --> 00:03:29,400 have to Yeah, we also, we're here for a podcast, not just 56 00:03:29,400 --> 00:03:33,500 catching up, just so we talk to me test. 57 00:03:33,500 --> 00:03:37,600 Patel he studies nudges and gamification as a means of 58 00:03:37,600 --> 00:03:40,700 improving health and me, touch founded and led the pain 59 00:03:40,700 --> 00:03:43,800 medicine nudge unit. You've probably heard of it and 60 00:03:43,800 --> 00:03:46,900 is currently the vice president for clinical transformation and 61 00:03:46,900 --> 00:03:51,200 the national lead for Behavioral insights at Ascension so fancy. 62 00:03:51,700 --> 00:03:56,000 Yeah, very and we discussed quite a few things including 63 00:03:56,200 --> 00:03:59,200 Being as always, you know how people design can be explored in 64 00:03:59,200 --> 00:04:03,500 the wild specifically when it comes to encouraging healthy 65 00:04:03,500 --> 00:04:07,600 behaviors. And so we explored topics of 66 00:04:07,600 --> 00:04:13,000 gamification and also when it came to be on kind of just 67 00:04:13,000 --> 00:04:15,800 encouraging exercise. A little bit seeing how we can 68 00:04:15,800 --> 00:04:18,500 use people science when it comes to Health Care overall 69 00:04:18,800 --> 00:04:23,200 specifically as the product Deep dive we dive into. 70 00:04:23,200 --> 00:04:27,900 Jim's hands are Random discussion previously. 71 00:04:28,400 --> 00:04:30,900 And so it's not as random as you thought. 72 00:04:30,900 --> 00:04:33,400 Exactly. So, you'll get a chance to hear 73 00:04:33,400 --> 00:04:37,400 what Natasha to say about how we can optimize the gym experience, 74 00:04:37,400 --> 00:04:39,200 using behavioral design principles. 75 00:04:39,800 --> 00:04:44,000 Okay, and lift up those dumbbells, and let's get episode 76 00:04:44,000 --> 00:04:58,500 started at Troy So I'm very excited to say, 77 00:04:58,500 --> 00:05:01,900 welcome attached to the behavioral design podcast, thank 78 00:05:01,900 --> 00:05:04,400 you for having me. We're so excited to chat with 79 00:05:04,400 --> 00:05:06,400 you today. We have a lot of really fun 80 00:05:06,400 --> 00:05:10,800 topics on the agenda. I want to jump right in and talk 81 00:05:10,800 --> 00:05:13,700 a little bit about behavioral design in the wild. 82 00:05:14,000 --> 00:05:17,300 So For Better or Worse, a lot of people have been applying 83 00:05:17,300 --> 00:05:21,000 Behavioral Science in the real world and I know you have a lot 84 00:05:21,000 --> 00:05:23,700 of experience with this you know, both in the academic. 85 00:05:24,100 --> 00:05:27,800 Each side but also in you know doing behavioral design and you 86 00:05:27,800 --> 00:05:29,900 know whatever you want to call it Behavioral Science, very real 87 00:05:29,900 --> 00:05:35,700 economics and so on affecting real people and I'm curious if 88 00:05:35,700 --> 00:05:42,200 you have a favorite example of either good behavioral design or 89 00:05:42,400 --> 00:05:45,500 you know where things have really really gone wrong bad 90 00:05:45,500 --> 00:05:47,900 behavioral design. Yeah that's a good question. 91 00:05:47,900 --> 00:05:51,600 I you know my favorite example is the kind of project or 92 00:05:52,400 --> 00:05:56,000 highlight that really Started my whole career and using 93 00:05:56,000 --> 00:05:59,000 Behavioral Science to change health and Healthcare delivery. 94 00:05:59,300 --> 00:06:02,600 It's around. Prescribing generic medications 95 00:06:02,600 --> 00:06:05,900 versus brand name medications. Generic medications are exactly 96 00:06:05,900 --> 00:06:08,000 the same as brand name medications but they're much 97 00:06:08,000 --> 00:06:10,400 more affordable. They're cheaper her patients 98 00:06:10,400 --> 00:06:12,300 cheaper for the insurance company's Health Systems. 99 00:06:12,300 --> 00:06:14,800 All around is a win-win and their data to show that people 100 00:06:14,800 --> 00:06:18,600 take their generic medications for a longer and more reliably 101 00:06:18,600 --> 00:06:20,600 than their brand-name prescription because they're 102 00:06:20,600 --> 00:06:23,900 probably more portable. And we were wrestling with this. 103 00:06:24,100 --> 00:06:27,400 When I was at Penn Medicine, probably almost a decade ago now 104 00:06:27,600 --> 00:06:30,500 and the health system was struggling to get clinicians to 105 00:06:30,500 --> 00:06:33,100 prescribe the generic medication and every when you talk to a 106 00:06:33,100 --> 00:06:36,100 clinician I said oh we want to do this then when you know it's 107 00:06:36,100 --> 00:06:37,900 the right thing for our patients we're going to try as hard as we 108 00:06:37,900 --> 00:06:41,300 can to help Grand rounds and get clinician feedback on their 109 00:06:41,300 --> 00:06:42,800 performance. But when you look at the 110 00:06:42,800 --> 00:06:45,300 electronic health record, we found that it was like you had 111 00:06:45,300 --> 00:06:48,800 it made a jump through hoops to prescribe the generic medication 112 00:06:48,800 --> 00:06:51,800 and clinicians only have 10 to 15 minutes with patients in 113 00:06:51,800 --> 00:06:53,300 which they have to do a lot of stuff from time. 114 00:06:53,300 --> 00:06:55,000 There's many medications. Instead of ordering. 115 00:06:55,400 --> 00:06:58,500 And so it was really hard. And so we tried a couple of 116 00:06:58,500 --> 00:07:02,000 things in a pilot test with the internal medicine practices. 117 00:07:02,000 --> 00:07:05,800 One was to hide the brand name prescriptions on the first page, 118 00:07:05,800 --> 00:07:08,100 you could still get to them by clicking an extra box. 119 00:07:08,800 --> 00:07:10,900 We found that work a little bit at boosted. 120 00:07:10,900 --> 00:07:14,600 Generic prescribing from 75 to 80 85 percent. 121 00:07:15,000 --> 00:07:17,300 We tested a couple other versions but then ultimately the 122 00:07:17,300 --> 00:07:19,800 version that launched across the health system and had a huge 123 00:07:19,800 --> 00:07:23,100 impact, was basically making generic prescriptions the 124 00:07:23,100 --> 00:07:27,000 default and then Adding a check box on the screen at the bottom 125 00:07:27,000 --> 00:07:30,400 left and if you check that box it would go to the pharmacist as 126 00:07:30,400 --> 00:07:33,100 they brand name prescription. But if you didn't, it would go 127 00:07:33,100 --> 00:07:36,000 as a generic prescription. And what was interesting was 128 00:07:36,300 --> 00:07:38,900 before, all of the prescribing went to the electronic health 129 00:07:38,900 --> 00:07:41,100 record. That's what a paper Prescription 130 00:07:41,100 --> 00:07:55,700 Pad look like. Type and added that checkbox 131 00:07:55,700 --> 00:07:58,500 feature and the generic prescribing right with him, 75 132 00:07:58,500 --> 00:08:02,500 percent to 99 percent overnight and still sustain that way. 133 00:08:02,800 --> 00:08:06,000 Now, you know, a decade later and over the first two years 134 00:08:06,000 --> 00:08:09,700 they had about 32 million dollars in unnecessary cost. 135 00:08:09,700 --> 00:08:12,700 Just for the top 100 medications and we prescribe thousands of 136 00:08:12,700 --> 00:08:14,800 medications. So the potential benefits are 137 00:08:14,800 --> 00:08:18,600 huge. Default started again, yeah. 138 00:08:18,800 --> 00:08:22,800 But I have to say this is one of my all-time favorite examples of 139 00:08:22,800 --> 00:08:24,800 favorable design. Of course, This is something 140 00:08:24,800 --> 00:08:27,100 that's, you know, very close to home for you. 141 00:08:27,600 --> 00:08:30,700 Um, why can't we just use default for everything? 142 00:08:31,200 --> 00:08:35,400 Wouldn't that be the dream that, you know, if you can use a 143 00:08:35,408 --> 00:08:37,600 default that's typically where we go through, we think of it, 144 00:08:37,700 --> 00:08:39,000 you know, the nudge intervention ladder. 145 00:08:39,000 --> 00:08:42,100 That's often how we come up with interventions and default, you 146 00:08:42,100 --> 00:08:44,900 know, are at the top of nudges right below and you know, 147 00:08:44,900 --> 00:08:46,500 incentives on the broader a ladder. 148 00:08:46,900 --> 00:08:49,100 There's a couple challenges in healthcare are situations. 149 00:08:49,100 --> 00:08:52,300 When we can't use default. So if you can use default great, 150 00:08:52,300 --> 00:08:54,200 you should do that because it's going to work and we have You 151 00:08:54,200 --> 00:08:57,600 have other examples around that the areas where we can't use, it 152 00:08:57,600 --> 00:09:00,600 are a couple of things, you know, one is if the guidelines 153 00:09:00,600 --> 00:09:03,200 aren't clear as to what we should be defaulting patients, 154 00:09:03,200 --> 00:09:05,900 into or doctors into are not for some things. 155 00:09:05,900 --> 00:09:08,900 We have very clear guidelines but for other things like you 156 00:09:08,908 --> 00:09:12,100 know, what's the right intravenous fluid to use, in the 157 00:09:12,100 --> 00:09:15,200 ICU, there's debate around that and that continues or when 158 00:09:15,200 --> 00:09:18,500 should a patient get a mammogram, should it be when an 159 00:09:18,500 --> 00:09:20,700 adult in their 40s? Or should it be when their 50s 160 00:09:20,700 --> 00:09:22,500 or somewhere in between their different guidelines? 161 00:09:22,500 --> 00:09:23,600 That have changed multiple times. 162 00:09:23,600 --> 00:09:26,400 So that's One Challenge, when you probably should, it should 163 00:09:26,400 --> 00:09:27,600 be a conversation. It shouldn't be. 164 00:09:27,600 --> 00:09:30,900 So automatic another is when we can't identify that, the 165 00:09:30,900 --> 00:09:33,800 guidelines are clear but we can't identify the patient 166 00:09:33,800 --> 00:09:36,100 clearly with the electronic health record or whatever data 167 00:09:36,100 --> 00:09:38,200 we have. And a good example here is 168 00:09:38,200 --> 00:09:40,800 smoking and lung cancer screening. 169 00:09:40,800 --> 00:09:42,300 There's new methods of screening. 170 00:09:42,300 --> 00:09:44,900 One for lung cancer using CT scan. 171 00:09:45,400 --> 00:09:47,000 There's National guidelines on that. 172 00:09:47,400 --> 00:09:50,300 We don't do a good job, documenting smoking status. 173 00:09:50,300 --> 00:09:52,800 They are you a smoker or not? How many if so, how many years 174 00:09:52,800 --> 00:09:55,000 when did you quit India? Chronic health record, many 175 00:09:55,000 --> 00:09:58,000 Health Systems only document that for ten to twenty percent 176 00:09:58,000 --> 00:10:01,500 of patients and so and we can't default patients into the right, 177 00:10:01,500 --> 00:10:04,300 screening mechanism because we don't have the data to do that. 178 00:10:04,400 --> 00:10:08,000 Another example, the through pops up for me is when there's 179 00:10:08,000 --> 00:10:11,300 the behavior change is really the responsibility of the 180 00:10:11,300 --> 00:10:15,500 patient that we don't have the ability to to default, there's 181 00:10:15,500 --> 00:10:17,900 nothing to default, right? It requires the patient to do 182 00:10:17,900 --> 00:10:21,800 something. We need to look towards other 183 00:10:21,800 --> 00:10:24,900 other forms of motivation. That's totally right. 184 00:10:24,900 --> 00:10:27,300 And I think that applies it certainly transactional 185 00:10:27,300 --> 00:10:28,900 Behavior. Like you can't default someone 186 00:10:28,900 --> 00:10:31,200 to get a flu shot, you could certainly default them to an 187 00:10:31,200 --> 00:10:34,000 appointment for the flu shot and that that has been shown to help 188 00:10:34,300 --> 00:10:37,400 but the continuous behaviors like exercise, eat. 189 00:10:37,400 --> 00:10:40,800 Well, you can't default people to not eat dessert or to go to 190 00:10:40,800 --> 00:10:43,400 the gym every day and so that's going to require a different 191 00:10:43,400 --> 00:10:47,000 type of intervention. Yeah, I'm curious a quick 192 00:10:47,600 --> 00:10:50,300 question, but when it comes Default versus kind of like, 193 00:10:50,300 --> 00:10:53,400 prompted choice or like an active choice. 194 00:10:53,400 --> 00:10:56,200 Where you have someone maybe in the case of what you mentioned 195 00:10:57,100 --> 00:11:01,000 it when prescribing certain way? And you want to kind of maintain 196 00:11:01,000 --> 00:11:03,300 for whatever reason, maybe that doesn't apply to the first 197 00:11:03,300 --> 00:11:05,500 example, but for whatever reason, you kind of want to 198 00:11:05,508 --> 00:11:11,400 maintain a little more ability to make a decision, but you 199 00:11:11,408 --> 00:11:15,400 still want to kind of maybe get them away from this traditional 200 00:11:15,400 --> 00:11:17,400 approach. For the most part in providing 201 00:11:17,400 --> 00:11:20,600 more of an Active choice to provide from are very conscious 202 00:11:20,600 --> 00:11:23,000 decision. Perhaps that is sometimes being 203 00:11:23,300 --> 00:11:25,800 kind of recommended as an alternative to defaults when 204 00:11:25,800 --> 00:11:29,000 defaults could be little more risk of being unethical. 205 00:11:29,000 --> 00:11:32,000 For example, have you had a personal experience without or 206 00:11:32,000 --> 00:11:34,700 seeing like, how effective that is in comparison to defaults, 207 00:11:34,700 --> 00:11:36,600 for example? Yeah, acting trick is a great 208 00:11:36,600 --> 00:11:40,100 tool to use when you can't do defaults their various different 209 00:11:40,100 --> 00:11:41,600 reasons. I think there's pros and cons, 210 00:11:41,600 --> 00:11:44,300 active Choice. The biggest con is just alert 211 00:11:44,300 --> 00:11:46,000 fatigue. You know, for clinicians in the 212 00:11:46,008 --> 00:11:49,100 electronic health record for patients, whether Text message 213 00:11:49,100 --> 00:11:51,100 our notification. I mean, I can't tell you how 214 00:11:51,108 --> 00:11:53,800 many notifications I get on my phone, even if I try to turn 215 00:11:53,800 --> 00:11:56,400 them off and and I want to pay attention to all of them, but, 216 00:11:56,600 --> 00:11:58,200 you know, I'm going to miss a couple of just, it's just so 217 00:11:58,200 --> 00:12:00,100 many that come out and clinicians. 218 00:12:00,100 --> 00:12:03,200 The risk is they'll just start dismissing all of the alerts in 219 00:12:03,200 --> 00:12:05,300 the electronic health record. The good with the bad. 220 00:12:05,300 --> 00:12:08,000 So if you can design a notification, well, so it 221 00:12:08,000 --> 00:12:10,800 provides additional information. But we all, we often say, the 222 00:12:10,800 --> 00:12:13,000 best types of active Choice, prompt of the ones that don't 223 00:12:13,000 --> 00:12:15,800 just remind you, but they also facilitate. 224 00:12:16,000 --> 00:12:19,600 So, for example, we did a trial. Where we were trying to nudge 225 00:12:19,600 --> 00:12:22,600 doctors to order statins for patients, that have high 226 00:12:22,600 --> 00:12:25,200 cholesterol or high risk of heart disease, then save lives 227 00:12:25,200 --> 00:12:27,500 30 percent reduction in mortality, and so on and so 228 00:12:27,500 --> 00:12:29,600 forth. Evidence-based, we didn't just 229 00:12:29,600 --> 00:12:31,800 say, hey, the patient's do first at inconsiderate. 230 00:12:31,800 --> 00:12:35,000 We said, if patients do for a Statin and we provided options 231 00:12:35,000 --> 00:12:38,800 with the tour or receive a Statin, the generic versions. 232 00:12:38,800 --> 00:12:42,400 Of course, as we talked about and we pre-selected one, we made 233 00:12:42,400 --> 00:12:44,600 it a 90-day prescription instead of a 30-day. 234 00:12:44,600 --> 00:12:46,700 So the patient won't have to refill every month and they 235 00:12:46,700 --> 00:12:48,200 could. All of that work takes a couple 236 00:12:48,200 --> 00:12:50,700 of That's for the doctor and we made it one click. 237 00:12:50,700 --> 00:12:56,400 So you can say except or cancel and that study is in presses and 238 00:12:56,400 --> 00:12:58,300 out yet. But you know, we've had other 239 00:12:58,300 --> 00:13:01,000 studies where we've done that for colon cancer, screening flu 240 00:13:01,000 --> 00:13:04,500 shots and breast cancer screening and had about a 20 241 00:13:04,500 --> 00:13:08,400 percentage Point increase for cancer, screening 50, 60 percent 242 00:13:08,400 --> 00:13:11,800 to 70, 80 percent for vaccination, it's worked as 243 00:13:11,800 --> 00:13:13,300 well. And we test that in a couple of 244 00:13:13,300 --> 00:13:15,900 practices and was rolled out. But the one thing we learned 245 00:13:15,900 --> 00:13:19,200 when we implemented that as we started by Alerting clip, 246 00:13:19,200 --> 00:13:22,400 doctors when they were in the room with the patient and we 247 00:13:22,400 --> 00:13:26,300 shifted to alerting the medical assistant, the medical assistant 248 00:13:26,400 --> 00:13:27,700 gets the patient from the waiting room. 249 00:13:27,700 --> 00:13:30,400 They take their blood pressure, their weight, and then they also 250 00:13:30,700 --> 00:13:32,900 ask the patient a couple questions and we train the 251 00:13:32,900 --> 00:13:35,700 practices, basically train them to accept all of the alerts and 252 00:13:35,700 --> 00:13:38,000 notify the patient. Hey, you're due for breast 253 00:13:38,000 --> 00:13:40,400 cancer, screening, I've gone ahead and place an order in 254 00:13:40,400 --> 00:13:41,500 there. You can talk to your doctor. 255 00:13:41,500 --> 00:13:43,400 If you have any questions or if you don't want it, they can 256 00:13:43,400 --> 00:13:46,200 remove it. But basically it facilitates for 257 00:13:46,200 --> 00:13:50,000 the physician. Do most, but it Prime's the 258 00:13:50,000 --> 00:13:52,300 patient is as the patient. When you walk into the room with 259 00:13:52,308 --> 00:13:54,900 your doctor, you've got a list of what you want to talk about. 260 00:13:55,000 --> 00:13:57,200 I've got back pain and I need a refill of this medication. 261 00:13:57,200 --> 00:13:59,200 Whatever else might be, you know, thinking about preventive, 262 00:13:59,200 --> 00:14:01,500 screening. But if we can use this active 263 00:14:01,500 --> 00:14:04,300 choices and mechanism to Prime the patient right before they 264 00:14:04,300 --> 00:14:06,500 see their doctor, they're not going to be much more amenable 265 00:14:06,700 --> 00:14:08,100 to getting that treatment or test. 266 00:14:08,300 --> 00:14:10,700 I love about that's really wonderful. 267 00:14:11,000 --> 00:14:14,300 And let's see what we can do. In terms of also, what we talked 268 00:14:14,300 --> 00:14:18,000 about when may be active choice of defaults are not enough, 269 00:14:18,400 --> 00:14:22,000 Because one of the themes for this season, the podcast is, 270 00:14:22,000 --> 00:14:24,400 were trying to get even more practical. 271 00:14:24,400 --> 00:14:28,200 We're trying to get really just thinking about how we can, you 272 00:14:28,200 --> 00:14:31,000 know, change the world for better using Behavioral Science. 273 00:14:31,400 --> 00:14:37,000 And so we're going to try to dive into one product or service 274 00:14:37,000 --> 00:14:40,700 or kind of scenario for guests here. 275 00:14:40,700 --> 00:14:44,300 And so for you the the case study, we're trying to look into 276 00:14:44,300 --> 00:14:48,400 here is Jim's. And the idea is obviously, that 277 00:14:49,400 --> 00:14:52,600 you'll be great, if people were more likely to exercise and take 278 00:14:52,600 --> 00:14:54,500 care of their cardiovascular health, and so on. 279 00:14:55,200 --> 00:15:01,400 But, you know, how, how do, how would you change a gym to 280 00:15:01,400 --> 00:15:04,600 encourage people to spend more time there or encourage them to 281 00:15:04,600 --> 00:15:08,100 go more regularly, for example? Yeah, that's a great question. 282 00:15:08,100 --> 00:15:11,600 I mean, the concept of Jim has changed a lot, you know, close 283 00:15:11,600 --> 00:15:13,300 to covid. You know, used to be used to 284 00:15:13,300 --> 00:15:16,200 think a lot about like, going to gyms and then, Now, people's 285 00:15:16,200 --> 00:15:20,900 homes have become gyms and we were, you know, in terms of Y, 286 00:15:20,900 --> 00:15:22,900 then you do see a Resurgence of people going back. 287 00:15:23,000 --> 00:15:24,400 I guess a couple of things come to mind. 288 00:15:25,000 --> 00:15:29,600 One is you know improving access and reducing friction to going 289 00:15:29,600 --> 00:15:32,000 to the gym some through the location of the gym. 290 00:15:32,000 --> 00:15:34,200 Like if it's in your home that the least amount of friction but 291 00:15:34,200 --> 00:15:36,600 certainly that's close by something impossible. 292 00:15:37,000 --> 00:15:39,800 We've seen some organizations or large tech companies put gyms on 293 00:15:39,800 --> 00:15:42,000 their workplace. They also seem like financial 294 00:15:42,000 --> 00:15:44,300 institutions that, you know, I live in Philadelphia and I walk 295 00:15:44,300 --> 00:15:47,000 back up all these big plans. So, you'll see Jim's on the 296 00:15:47,000 --> 00:15:49,600 first floor with people running. So you can go for a workout 297 00:15:49,600 --> 00:15:53,800 right before or right after actually where I worked at hand, 298 00:15:54,200 --> 00:15:58,300 you know, you're to go there was one of the professor's headache 299 00:15:58,300 --> 00:16:03,900 and a shower built into the into the hallway where offices were 300 00:16:04,100 --> 00:16:06,100 and so you could take a shower when you came in. 301 00:16:06,100 --> 00:16:08,400 So it's kind of like promoted the idea that you could go for a 302 00:16:08,400 --> 00:16:11,300 run, maybe run to work even and then get a gym. 303 00:16:11,300 --> 00:16:14,700 So access to that or making it really easy. 304 00:16:14,900 --> 00:16:18,600 Is obviously a key. Factor a colleague of mine, 305 00:16:18,600 --> 00:16:20,900 Katie milk went in, a lot of work with temptation bundling 306 00:16:21,300 --> 00:16:24,100 and so like, you know, making it making there, something else 307 00:16:24,100 --> 00:16:25,700 we're awarding. Now, you can do that on your own 308 00:16:25,700 --> 00:16:28,700 by bringing your phone and helping you, but a podcast, 309 00:16:28,700 --> 00:16:31,500 maybe it's this podcast or something or show or something 310 00:16:31,500 --> 00:16:33,300 else. But Jim's can also do that with 311 00:16:33,300 --> 00:16:36,000 TVs or other things. And now you see these treadmills 312 00:16:36,000 --> 00:16:37,500 that have their own personalized TVs. 313 00:16:37,500 --> 00:16:41,100 It used to be a big two TVs up on top with like 20 treadmills 314 00:16:41,100 --> 00:16:44,300 and now he's treadmill has their own TV and some of you only let 315 00:16:44,300 --> 00:16:47,100 yourself watch your certain show or Or with different podcast 316 00:16:47,100 --> 00:16:50,200 when you're when you're running and the gym potentially know 317 00:16:50,200 --> 00:16:54,800 what your shirt you're so just turn off as soon as you start as 318 00:16:54,800 --> 00:16:57,600 soon as you stop like yeah they could be have to run. 319 00:17:01,200 --> 00:17:03,700 It's also good because these days there's so many different, 320 00:17:03,700 --> 00:17:06,700 you know, streaming services. So the gyms can like you know, 321 00:17:07,000 --> 00:17:09,599 be that place you like you don't you don't have to subscribe to 322 00:17:09,599 --> 00:17:12,200 53 meters as you just go to our gym. 323 00:17:12,200 --> 00:17:17,300 Yeah, yeah exactly. And say of the, you know, like 324 00:17:17,300 --> 00:17:20,700 when you're generating electricity Bike by writing the 325 00:17:20,700 --> 00:17:24,500 bicycle, it's like you can only watch the television show if 326 00:17:24,500 --> 00:17:28,200 you're actively, you're turning. Yeah, if they have that could 327 00:17:28,200 --> 00:17:31,700 work but I got the see how that could backfire frustrated by the 328 00:17:31,700 --> 00:17:34,500 technology but you know a couple other things come to mind. 329 00:17:34,500 --> 00:17:37,500 You seen some gyms add other kind of things that they would 330 00:17:37,500 --> 00:17:39,000 think about pre and post-workout. 331 00:17:39,000 --> 00:17:42,600 So, like a Smoothie Bar power, you know, protein shakes and 332 00:17:42,600 --> 00:17:45,300 things like that to help supplement people in some gyms 333 00:17:45,300 --> 00:17:48,100 with like, These like Aqua massage chairs, and things like 334 00:17:48,100 --> 00:17:50,900 that, that you're thinking about what would people want before or 335 00:17:50,900 --> 00:17:54,500 after and then I think one of the bigger things is like these 336 00:17:54,500 --> 00:17:56,600 social elements. Whether it's a class that you 337 00:17:56,608 --> 00:17:57,800 might do with people, you don't know. 338 00:17:57,800 --> 00:18:00,100 But you have an instructor or it's something that you might go 339 00:18:00,100 --> 00:18:03,800 with someone you do anything that could facilitate you doing 340 00:18:03,800 --> 00:18:07,200 that with a friend or a buddy with more likely to hold you 341 00:18:07,200 --> 00:18:09,000 accountable. You know, you feel like you feel 342 00:18:09,000 --> 00:18:11,400 like you're tired one day but you're signed up to go to a 343 00:18:11,408 --> 00:18:14,500 class with a friend. You might still go because you 344 00:18:14,500 --> 00:18:17,200 don't let that person down. I'm kind of there for that 345 00:18:17,200 --> 00:18:18,300 person. I think that's probably the 346 00:18:18,300 --> 00:18:21,000 strongest, facilitator, and so being a way to integrate that 347 00:18:21,000 --> 00:18:24,500 with Jim's. How might yeah, like getting 348 00:18:24,500 --> 00:18:27,100 really practical? How might a gym actually 349 00:18:27,100 --> 00:18:30,600 facilitate those kinds of social connections, I think right now, 350 00:18:31,000 --> 00:18:34,400 these things are really left to gym members, right to do on 351 00:18:34,400 --> 00:18:36,400 their own. Other than saying, okay we're 352 00:18:36,400 --> 00:18:39,500 going to have this class and there will be people here if you 353 00:18:39,500 --> 00:18:42,900 were the gym Mogul, what might you do? 354 00:18:43,700 --> 00:18:46,800 Yeah, one thing that I would do is Let's say I'm going to give 355 00:18:46,800 --> 00:18:48,700 you an example here, just for discussions sake. 356 00:18:48,700 --> 00:18:51,300 Let's say you've got a class that can fit 30 people, you 357 00:18:51,300 --> 00:18:54,600 know, and you might what you might do is for the first you 358 00:18:54,608 --> 00:18:57,900 know 10 people or whatever that sign up, you might give them a 359 00:18:57,900 --> 00:19:00,800 pass that they can send to one person that has to sign up in 360 00:19:00,800 --> 00:19:04,200 the next let's say three days and if they don't use it in 361 00:19:04,208 --> 00:19:07,100 three days that pass goes away. So they're basically holding 362 00:19:07,100 --> 00:19:09,400 spots for those people that are your friends and family members 363 00:19:09,400 --> 00:19:12,200 or they're willing to overbook the class by a couple of people. 364 00:19:12,400 --> 00:19:14,700 You know, not many are they after some time they could 365 00:19:14,700 --> 00:19:17,600 probably figure out the math. Give away 10, you know, friend 366 00:19:17,600 --> 00:19:19,400 passes. How many actually come in so 367 00:19:19,400 --> 00:19:22,000 that they know how many spots the hold and so on and so forth. 368 00:19:22,100 --> 00:19:24,000 Boy, it does a couple of things for the person. 369 00:19:24,000 --> 00:19:26,100 It makes them feel like they have something that they can 370 00:19:26,100 --> 00:19:29,300 lose and it's a free pass. Many might not even have to be 371 00:19:29,300 --> 00:19:30,700 free. They could maybe only the first 372 00:19:30,700 --> 00:19:34,500 ones free but it's like a spot basically. 373 00:19:34,500 --> 00:19:37,400 They could lose its kind of deadlines associated with it so 374 00:19:37,400 --> 00:19:39,700 you could act on it pretty soon otherwise you know the questions 375 00:19:39,700 --> 00:19:41,400 going to fill up. And then for the gym, it might 376 00:19:41,400 --> 00:19:43,700 be introducing more people to that gym that otherwise wouldn't 377 00:19:43,700 --> 00:19:46,800 have gone there and make Then continue to go there if they 378 00:19:46,800 --> 00:19:49,400 start doing this class together. So anything that makes it easy 379 00:19:49,400 --> 00:19:53,600 for you to book a class with someone else that you know, I 380 00:19:53,600 --> 00:19:56,400 think would be really helpful in facilitating that. 381 00:19:56,400 --> 00:19:58,500 Now if you look at like something that you're using at 382 00:19:58,500 --> 00:20:00,600 home, they allow you to do that. Virtually sign up for a thing 383 00:20:00,600 --> 00:20:02,200 and then defend it to your friend. 384 00:20:02,200 --> 00:20:04,300 Who's following you. It's really seamless the 385 00:20:04,300 --> 00:20:06,400 challenge with Jim's is like it's the physical world. 386 00:20:06,400 --> 00:20:09,400 You've got to get someone to go somewhere setup setup time and 387 00:20:09,400 --> 00:20:13,800 we need to plan for that but I don't see a lot of that being 388 00:20:13,800 --> 00:20:14,900 done. It's like you said, just 389 00:20:14,900 --> 00:20:17,100 basically like Got to do that work on your own. 390 00:20:17,100 --> 00:20:19,600 Find a friend, get them to sign up, send them the link, tell 391 00:20:19,600 --> 00:20:22,100 them which Jim all that people Gables. 392 00:20:22,100 --> 00:20:24,500 I wish learning path. Yeah, one tap, you should be 393 00:20:24,500 --> 00:20:27,400 able to share a link to someone and say, hey this expires in 394 00:20:27,400 --> 00:20:30,200 three days, click here to sign up for. 395 00:20:30,200 --> 00:20:32,200 I already signed you up for this class. 396 00:20:32,300 --> 00:20:35,200 You have to now have something better. 397 00:20:35,300 --> 00:20:37,000 Yeah. Right. 398 00:20:37,500 --> 00:20:39,500 And I'm not getting my money back. 399 00:20:41,900 --> 00:20:44,000 Another thing that Winston to hear your thoughts on is study 400 00:20:44,000 --> 00:20:46,900 of personalizing. The gym experience. 401 00:20:46,900 --> 00:20:49,500 So kind of how do we take advantage of individual 402 00:20:49,500 --> 00:20:51,700 differences across people? You know, contextual 403 00:20:51,700 --> 00:20:56,000 information, time-based differences and so on, is there 404 00:20:56,000 --> 00:20:57,300 something you would change there? 405 00:20:58,300 --> 00:21:01,500 In the gym scenario still? Yeah, in addition, I think 406 00:21:01,500 --> 00:21:03,300 there's a couple of things that you could play with. 407 00:21:03,300 --> 00:21:06,100 I mean one is like the, you know, the communications around 408 00:21:06,100 --> 00:21:08,700 going to the gym and maybe, you know, assuming you've got 409 00:21:08,700 --> 00:21:10,600 something to try to motivate. People haven't been to the gym 410 00:21:10,600 --> 00:21:12,200 in a while. You could personalize that 411 00:21:12,200 --> 00:21:16,000 messaging, you know, based on their either past history. 412 00:21:16,000 --> 00:21:18,800 Like we see it's been 12 days since you've been to the gym, 413 00:21:18,800 --> 00:21:21,700 come back and you know, Beauvoir whatever the motivational 414 00:21:21,700 --> 00:21:24,400 messages. Once you're in the gym, you 415 00:21:24,400 --> 00:21:26,900 could design all kinds of things around how to personalize their 416 00:21:26,900 --> 00:21:29,200 routine. You know, again, the Peter has 417 00:21:29,200 --> 00:21:31,200 to give you information, but let's say you're doing. 418 00:21:32,000 --> 00:21:34,800 You're going to lift weights for your like back and chest and 419 00:21:34,800 --> 00:21:36,000 then you're going to go for a run. 420 00:21:36,000 --> 00:21:38,400 You might offer. Here's a routine that many of 421 00:21:38,400 --> 00:21:41,400 our members use and then show a map around the gym, you know, 422 00:21:41,400 --> 00:21:44,400 where the different, you know, things are that might help them 423 00:21:44,400 --> 00:21:47,700 to discover new opportunities or there might be a class that 424 00:21:47,700 --> 00:21:49,500 relates to something that they're working on. 425 00:21:49,900 --> 00:21:52,300 And then, of course, there's like host Jim messaging. 426 00:21:52,300 --> 00:21:54,600 If you're able to track metrics, maybe it's the person's 427 00:21:54,600 --> 00:21:56,500 blogging. What they did, giving them 428 00:21:56,500 --> 00:21:58,000 feedback on how long they were at the gym. 429 00:21:58,100 --> 00:22:01,100 Jim, what they accomplished. So and so forth that requires 430 00:22:01,100 --> 00:22:04,500 kind of almost like a reporting tracking and communication 431 00:22:04,500 --> 00:22:07,200 system, but another jet lot of gyms have that in place. 432 00:22:07,200 --> 00:22:10,100 But that's how are you. Yeah. 433 00:22:19,000 --> 00:22:22,300 All right, one last gym, really good question. 434 00:22:23,300 --> 00:22:26,100 So you have run a lot of experiments. 435 00:22:26,100 --> 00:22:29,500 I think most gyms to not. With a few exceptions, most gyms 436 00:22:29,500 --> 00:22:32,700 are not experts at running experiments. 437 00:22:32,700 --> 00:22:37,800 But say, you could run one experiment to better understand 438 00:22:38,000 --> 00:22:42,700 your gym members get them to get the most benefit out of your 439 00:22:42,700 --> 00:22:45,500 gym. What what would you do and you 440 00:22:45,500 --> 00:22:49,400 could do anything. That's a good question. 441 00:22:51,700 --> 00:22:57,300 No limitations in terms of resources or yeah, I guess what 442 00:22:57,300 --> 00:23:00,900 I would say, what I would do is try to, you know, thinking of 443 00:23:00,900 --> 00:23:03,400 the model that I described you've got, you know, good 444 00:23:03,400 --> 00:23:06,700 Communications to get people to go to the gym, you've got things 445 00:23:06,700 --> 00:23:09,700 at the gym and then you have things after you leave the gym 446 00:23:09,700 --> 00:23:11,800 to hope that they appreciated what they did. 447 00:23:11,800 --> 00:23:15,400 And then they come back, I would test Communications or 448 00:23:15,700 --> 00:23:18,600 interventions across those different time points and 449 00:23:18,600 --> 00:23:21,400 combinations or have been to see what's the best. 450 00:23:21,500 --> 00:23:23,900 Best timing. I think a lot of people focus on 451 00:23:23,900 --> 00:23:26,400 getting you to the gym. You know, let's send you an 452 00:23:26,400 --> 00:23:28,700 email or a text message or whatever it is to get you to go 453 00:23:28,700 --> 00:23:30,300 to the gym and then we assume, okay, they went to the gym. 454 00:23:30,300 --> 00:23:31,800 That's great. They did their work but 455 00:23:31,800 --> 00:23:35,500 obviously like the workouts can vary but I think it's it's a 456 00:23:35,500 --> 00:23:37,800 broader than that. Once you go to the gym you need 457 00:23:37,800 --> 00:23:40,300 that, you might need that reinforcement after you leave. 458 00:23:40,500 --> 00:23:44,900 And so I would run, you know, many different interventions of 459 00:23:44,900 --> 00:23:50,400 communications before during. And after gym visits to try to 460 00:23:50,400 --> 00:23:53,500 see what Timing and interventions where the most 461 00:23:53,500 --> 00:23:56,400 effective to get people to build a habit of going to the gym at 462 00:23:56,400 --> 00:24:00,500 their number of times a week. And is there a particular kind 463 00:24:00,500 --> 00:24:02,900 of intervention that you would want to test their in terms of 464 00:24:02,900 --> 00:24:07,700 the flavor of that messaging? Yeah, I think a good question. 465 00:24:07,700 --> 00:24:09,800 I would probably use something that were mostly focused on 466 00:24:09,800 --> 00:24:11,500 nudges. They're not incentives. 467 00:24:11,900 --> 00:24:16,100 It's more scalable because, you know, paternity test incentives, 468 00:24:16,100 --> 00:24:18,500 a long nap but then them, you know, figuring out how you would 469 00:24:18,500 --> 00:24:19,800 scale. That might be more challenging, 470 00:24:19,800 --> 00:24:24,400 but I don't know if II have a, you know, approach in mind, it 471 00:24:24,408 --> 00:24:26,500 might be, you know, we might crowdsource different things and 472 00:24:26,500 --> 00:24:29,900 run when I like the mega studies that colleagues have run around 473 00:24:29,900 --> 00:24:33,000 testing different, approaches head to head, but I think either 474 00:24:33,000 --> 00:24:36,000 texting, or if there's an app for the gym than using a 475 00:24:37,000 --> 00:24:40,200 notifications, would be that to us did I? 476 00:24:40,208 --> 00:24:42,500 Can I pitch an idea and see what you think of it? 477 00:24:42,900 --> 00:24:46,900 Yeah. So okay. 478 00:24:46,900 --> 00:24:49,300 I'm on the Bears. One of the writers I think is, 479 00:24:49,300 --> 00:24:51,800 you know, people feeling like they look stupid and the Right 480 00:24:51,800 --> 00:24:55,000 because they don't know what to wear and we talked a little bit 481 00:24:55,000 --> 00:24:58,900 about this idea of you know, social support and so on. 482 00:24:59,300 --> 00:25:02,900 And what if you know you have a gym chain that provides people 483 00:25:02,900 --> 00:25:07,000 with kind of good-looking clothes but also like kind of a 484 00:25:07,000 --> 00:25:11,300 unique like they kind of little bit stand stand out in a way and 485 00:25:11,300 --> 00:25:13,600 so you can have everyone is given the same kind of 486 00:25:13,600 --> 00:25:17,700 comfortable the like pretty good nice looking but also little bit 487 00:25:17,700 --> 00:25:20,200 like weird maybe like some strange color or something like 488 00:25:20,200 --> 00:25:23,800 this, just makes it stand out. Out to everyone who joins the 489 00:25:23,808 --> 00:25:25,200 gym. What you think about this? 490 00:25:25,200 --> 00:25:28,400 This clothing line I like the idea. 491 00:25:28,400 --> 00:25:31,600 I wonder if it would dive more with people that had certain 492 00:25:31,600 --> 00:25:34,400 phenotypes like if you were more extroverted and introverted and 493 00:25:34,400 --> 00:25:37,000 things like that. But I like, you know, you both a 494 00:25:37,008 --> 00:25:40,300 couple aspects into that, so it sounds like it's fun, you know, 495 00:25:40,300 --> 00:25:42,600 it's something different, it's engaging, you know, there's a 496 00:25:42,608 --> 00:25:44,700 lot of work on that and gamification and things around 497 00:25:44,700 --> 00:25:46,300 there. But this is a very subtle way of 498 00:25:46,300 --> 00:25:49,500 like making it a bit more fun. It sounds like it's building a 499 00:25:49,500 --> 00:25:52,000 community because you're finding someone, that's Maybe has the 500 00:25:52,000 --> 00:25:55,100 same you know color shirt you think of like Orange Theory 501 00:25:55,100 --> 00:25:57,400 Fitness or something like that. There's like a color that goes 502 00:25:57,400 --> 00:26:00,400 with or you know both like oh whatever it is. 503 00:26:00,400 --> 00:26:03,700 You feel like you recognize someone as a part of your gym or 504 00:26:03,700 --> 00:26:06,500 Community because of that and that can be important. 505 00:26:06,500 --> 00:26:09,700 And it's also an element of almost like surprise, like you 506 00:26:09,700 --> 00:26:12,100 go there and you're going to see what maybe someones got 507 00:26:12,100 --> 00:26:15,200 something different or your, it's part of the Delight of 508 00:26:15,200 --> 00:26:17,800 going to the gym because you can see what what silly or not the 509 00:26:17,800 --> 00:26:19,200 silly out that people are wearing. 510 00:26:20,300 --> 00:26:22,700 That's really nice. I have a different version of 511 00:26:22,700 --> 00:26:25,100 this. You tweak the mirrors so that 512 00:26:25,100 --> 00:26:27,700 when people are running, they they don't actually see 513 00:26:27,700 --> 00:26:31,100 themselves in the reflection, they see like their own, their 514 00:26:31,100 --> 00:26:34,100 favorite celebrity. So what I'm reading, it's not 515 00:26:34,200 --> 00:26:37,300 awkward Ali and it's like trying to stay on the treadmill. 516 00:26:37,500 --> 00:26:45,700 It's you know it's JLo or whoever is cool now, I think 517 00:26:45,700 --> 00:26:53,300 she's Yeah. Well this is great and I think 518 00:26:53,300 --> 00:26:57,800 we can probably build on some of this as, you know, first of all, 519 00:26:57,900 --> 00:27:03,400 I think this is open for any gym owner to take some inspiration 520 00:27:03,400 --> 00:27:07,800 here but also, you know, moving us along. 521 00:27:07,800 --> 00:27:11,400 I think one topic will be interesting to explore with, you 522 00:27:11,400 --> 00:27:17,500 is gamification and I think it's interesting because I've also 523 00:27:17,500 --> 00:27:20,800 been working with immigration for a while, and I think I think 524 00:27:20,800 --> 00:27:23,800 there's two views of what can the occasion is. 525 00:27:23,800 --> 00:27:29,500 Where one is a very much, this simplified strawman view of 526 00:27:29,500 --> 00:27:32,600 gamification, can a thinking that okay, gamification? 527 00:27:32,600 --> 00:27:36,800 Is you having a problem and then you throw leaderboard, streaks, 528 00:27:37,200 --> 00:27:39,000 progress, bars, whatever at the problem. 529 00:27:40,400 --> 00:27:44,700 And then there is maybe perhaps a steel man version about like a 530 00:27:44,708 --> 00:27:49,000 little more thoughtful. A addition of other 531 00:27:49,000 --> 00:27:54,600 gamification, but I'm curious to hear what is your Explanation of 532 00:27:54,600 --> 00:27:59,100 what good gamification is like what is that Steel Man of 533 00:27:59,400 --> 00:28:02,200 gamification? Look like is it just throwing on 534 00:28:02,200 --> 00:28:04,200 some some of these tricks and bells and whistles? 535 00:28:04,200 --> 00:28:07,400 Or how do you think about good unification? 536 00:28:08,700 --> 00:28:09,700 Yeah, I think you see a question. 537 00:28:09,700 --> 00:28:12,500 I think there's many different elements of gamification has 538 00:28:12,500 --> 00:28:16,200 basic. You know foundations it's using 539 00:28:16,200 --> 00:28:18,800 game-based elements to try to make things more fun and 540 00:28:18,800 --> 00:28:22,400 engaging. I think there have been things 541 00:28:22,500 --> 00:28:27,400 like Pokemon go or you know dance dance, whatever. 542 00:28:27,400 --> 00:28:30,400 It's called being a revolutionary Revolution, your 543 00:28:30,400 --> 00:28:33,300 exercise games that get that get you to exercise. 544 00:28:33,400 --> 00:28:36,000 And for people that those work for, they can be very fun and 545 00:28:36,000 --> 00:28:39,700 engaging, I think the challenge when we We approach this filled 546 00:28:39,700 --> 00:28:43,900 with to say that not many people that could benefit the most from 547 00:28:43,900 --> 00:28:46,000 changing Behavior or participating in, those types of 548 00:28:46,000 --> 00:28:48,500 games are willing to like open an app or have the resources to 549 00:28:48,500 --> 00:28:50,900 buy a gaming system. And so, we wanted to create 550 00:28:50,900 --> 00:28:53,900 something that didn't actually make require you to play the 551 00:28:53,900 --> 00:28:58,300 game to like actively play, like the game runs itself. 552 00:28:58,300 --> 00:29:00,200 You're basically pushed messaging, and you're told 553 00:29:00,200 --> 00:29:02,400 you're entered into a game you're pushing to messaging 554 00:29:03,000 --> 00:29:05,400 because that would get the people who are least likely to 555 00:29:05,400 --> 00:29:07,700 participate to participate. If there's actually no work to 556 00:29:07,700 --> 00:29:10,000 participate, you just To strive for whatever you were doing. 557 00:29:10,000 --> 00:29:13,600 In our case, tested it for weight loss, physical activity 558 00:29:13,600 --> 00:29:15,800 and other behaviors. If you're trying to get your 559 00:29:15,800 --> 00:29:18,500 step count, it's one thing to try to get yourself counts with 560 00:29:18,500 --> 00:29:19,900 nothing. You have to play a game and then 561 00:29:19,900 --> 00:29:22,500 figure out which, you know, Monster you're battling against 562 00:29:22,500 --> 00:29:24,500 or which, you know, special power you're doing. 563 00:29:24,900 --> 00:29:28,200 And so we focused a lot on basic elements and I think this is 564 00:29:28,200 --> 00:29:32,100 really important because we see gamification used in two major 565 00:29:32,100 --> 00:29:35,500 areas that reach populations. One is in digital help app. 566 00:29:35,600 --> 00:29:38,900 We did a study looking at the top 50 app and the Apple health 567 00:29:38,900 --> 00:29:41,600 stores is like 5 years ago and two thirds of them, use 568 00:29:41,600 --> 00:29:45,500 gamification. And then we also see many most 569 00:29:45,500 --> 00:29:49,200 employers or workplace wellness program use gamification in some 570 00:29:49,200 --> 00:29:54,200 way but those both of those get little engagement compared to 571 00:29:54,200 --> 00:29:57,300 what they could have because it requires people to download app 572 00:29:57,300 --> 00:30:01,200 connect to platform. Open the apps every day, log 573 00:30:01,200 --> 00:30:03,100 your steps manually, things of that. 574 00:30:03,100 --> 00:30:06,300 So we want to remove all of the friction and just harness the 575 00:30:06,300 --> 00:30:09,500 core elements of gamification. The addition of behavioural, 576 00:30:09,500 --> 00:30:11,700 insights and social incentives. Those are the two things we were 577 00:30:11,700 --> 00:30:13,300 looking to add to gamification that. 578 00:30:13,300 --> 00:30:16,000 We thought missing, in addition, to, in addition, to Too Much 579 00:30:16,000 --> 00:30:17,500 friction. Most of them are traditional 580 00:30:17,500 --> 00:30:21,000 economic based and and some of them use social invented, some 581 00:30:21,000 --> 00:30:24,100 of them, don't I always struggle with when when people talk about 582 00:30:24,100 --> 00:30:28,900 gamification because it's this whole bucket of strategies and I 583 00:30:29,000 --> 00:30:32,300 you know it's hard to know which ones are they actually using? 584 00:30:32,300 --> 00:30:35,700 And you know what's the relative efficacy of different 585 00:30:35,700 --> 00:30:37,700 strategies? You know you see a lot of people 586 00:30:37,700 --> 00:30:38,900 are using gamification Education. 587 00:30:38,900 --> 00:30:42,200 Are they using it? Well, how how, how are we doing? 588 00:30:43,500 --> 00:30:44,700 Yes. And when we looked, when we do 589 00:30:44,700 --> 00:30:46,600 that for any of the apps, we look to see what were the 590 00:30:46,600 --> 00:30:49,000 elements of gamification that were used in the apps. 591 00:30:49,000 --> 00:30:53,200 Most people think about points and levels and badges, and we 592 00:30:53,200 --> 00:30:57,400 found is, like, actually most of them used the most common 593 00:30:57,400 --> 00:31:00,200 elements of gamification used for things around social 594 00:31:00,200 --> 00:31:02,700 support. So, competition, collaboration, 595 00:31:03,700 --> 00:31:08,000 and support some use Badges and in game elements, and so on, and 596 00:31:08,000 --> 00:31:09,600 so forth. Well, that was one of the things 597 00:31:09,600 --> 00:31:11,400 that made us think about. Okay, how do we make this? 598 00:31:11,400 --> 00:31:14,400 How do we harness our inner? You know, competition 599 00:31:14,400 --> 00:31:16,800 collaboration supporter, inner social incentives to those are 600 00:31:16,800 --> 00:31:19,000 relationships that we might have with our family members, our 601 00:31:19,000 --> 00:31:21,400 friends, our co-workers that are long-lasting. 602 00:31:21,600 --> 00:31:25,500 And so when we turn the game off messaging off your still you 603 00:31:25,500 --> 00:31:28,300 still interacting with other people and so if we can harness 604 00:31:28,300 --> 00:31:30,100 those social incentives, we might create something that's 605 00:31:30,100 --> 00:31:33,100 more sustainable than let's say, a financial incentive. 606 00:31:33,100 --> 00:31:36,300 So we focus on a couple of basic things points and levels but 607 00:31:36,300 --> 00:31:39,200 then we really try to focus on how do we Embed, the behavioral 608 00:31:39,200 --> 00:31:42,100 insights and add in the social incentives, mice. 609 00:31:42,200 --> 00:31:46,000 And what do you have you seen in an examples of things 610 00:31:46,000 --> 00:31:47,900 backfiring? When some of these things been 611 00:31:47,900 --> 00:31:51,200 added and any context things. But in particular, if that's the 612 00:31:51,200 --> 00:31:55,100 case, where you see like a high risk of some of these elements 613 00:31:55,100 --> 00:31:56,700 leading to may be unintended consequences. 614 00:31:56,800 --> 00:31:59,800 I think in some of the early studies that we did, there are a 615 00:31:59,800 --> 00:32:02,900 couple of things that stood out. We had initially four levels to 616 00:32:02,900 --> 00:32:07,100 the game. It was what was it platinum, 617 00:32:07,100 --> 00:32:08,900 gold silver. Bronze. 618 00:32:09,500 --> 00:32:12,000 And what we found is, that people either went all the way 619 00:32:12,000 --> 00:32:14,500 up to platinum, right away. You know, you can move up a 620 00:32:14,500 --> 00:32:17,300 level once a week where they just stayed in bronze. 621 00:32:18,500 --> 00:32:21,200 And so we realize two things, one we need to make more levels. 622 00:32:21,200 --> 00:32:23,400 So if you're like really on debated and you could get so 623 00:32:23,400 --> 00:32:25,500 there's more progression because once you get to the top you get 624 00:32:25,500 --> 00:32:27,900 a little bit bored. So in future studies, we added a 625 00:32:27,908 --> 00:32:30,900 couple more levels. The other with we and the bigger 626 00:32:30,900 --> 00:32:33,800 problem was how do we get people to engage in the first place? 627 00:32:33,800 --> 00:32:35,900 Because if you don't move, if you don't engage in that first 628 00:32:35,900 --> 00:32:39,500 week or two, we probably lost you for the Hole 6 months or 1, 629 00:32:39,500 --> 00:32:42,000 year, study, or whatever? And so we started doing that 630 00:32:42,000 --> 00:32:45,400 work really well, was we made five levels and we put people in 631 00:32:45,408 --> 00:32:47,900 the middle. We have blue bronze, silver, 632 00:32:47,900 --> 00:32:50,200 gold, and platinum. Instead of starting everybody at 633 00:32:50,200 --> 00:32:53,700 the bottom at Blue, we started everybody at Silver and this did 634 00:32:53,700 --> 00:32:56,700 two things for people that were, you know, we were trying to kick 635 00:32:56,700 --> 00:32:58,600 into gear that may not have otherwise been engaged. 636 00:32:58,600 --> 00:33:02,500 It made them feel like they had some endowed status already that 637 00:33:02,500 --> 00:33:04,400 they could lose. So if you didn't engage in the 638 00:33:04,408 --> 00:33:08,700 first week you would move from Silver to Brawn but you That 639 00:33:08,700 --> 00:33:11,400 loss and social status and we make it really Salient to you. 640 00:33:11,400 --> 00:33:14,000 We text you a picture of that you see it on your dashboard, 641 00:33:14,000 --> 00:33:17,100 all of that stuff. The second is that it made the 642 00:33:17,400 --> 00:33:20,800 hit, made the journey not being so hard to start with. 643 00:33:21,000 --> 00:33:24,000 So, if you think about, you know, you're running a race. 644 00:33:24,200 --> 00:33:26,000 You're looking at the person in front of you, you're not looking 645 00:33:26,000 --> 00:33:28,600 at the person that's in, you know, miles ahead of you. 646 00:33:28,600 --> 00:33:30,500 And if you do, you're probably gonna stop running shoe to drop 647 00:33:30,500 --> 00:33:33,600 out of the race. And so we wanted to try to embed 648 00:33:33,600 --> 00:33:35,700 that with in here, a little bit by thing, or you're still very 649 00:33:35,700 --> 00:33:37,400 only two steps away from Platinum. 650 00:33:38,400 --> 00:33:40,400 It makes it seem more achievable to people. 651 00:33:42,400 --> 00:33:46,300 Do you ever see a backfire like are there people who are just so 652 00:33:46,300 --> 00:33:49,800 averse to the points in the levels, that just, you know, 653 00:33:49,800 --> 00:33:54,200 like, see all of these metrics and law, like they can't, they 654 00:33:54,200 --> 00:33:57,300 can't do it. And then they, you know, they're 655 00:33:57,300 --> 00:33:59,900 not going to participate just, just because of that. 656 00:33:59,900 --> 00:34:04,300 Or, or what do you, what's your, are there differences in how 657 00:34:04,300 --> 00:34:07,700 people are accepting of gamification? 658 00:34:08,300 --> 00:34:11,100 Yes, I think, you know, not, not are, there's no one intervention 659 00:34:11,100 --> 00:34:12,000 that's going to work for everyone. 660 00:34:12,000 --> 00:34:14,500 So, The some people will this will not be for you. 661 00:34:15,199 --> 00:34:19,199 I think in our trials and we were in a 10 or 15 of these 662 00:34:19,199 --> 00:34:22,199 large trials at very high risk. Patients patients that had heart 663 00:34:22,199 --> 00:34:25,300 attacks had diabetes or uncontrolled had Strokes. 664 00:34:25,800 --> 00:34:28,900 Just delivered, a baby. All kinds of different stages of 665 00:34:28,900 --> 00:34:32,800 Life, the average dropout rate was less than 3% and I'm across 666 00:34:32,800 --> 00:34:35,500 all of the studies and we had no study that had more than five 667 00:34:35,500 --> 00:34:37,100 percent. So very few people dropped out. 668 00:34:37,100 --> 00:34:39,100 Now what does it mean to drop out to drop out? 669 00:34:39,100 --> 00:34:42,100 It means you've got to contact the study either by email. 670 00:34:42,199 --> 00:34:44,199 Mail or text message or phone call and say hey I'm not 671 00:34:44,199 --> 00:34:46,300 interested in participating, talk to messaging. 672 00:34:46,300 --> 00:34:49,800 Yeah but if you think about it it's really easy to continue 673 00:34:49,800 --> 00:34:51,900 participating because you don't have to do anything. 674 00:34:51,900 --> 00:34:53,600 We send you a text message every day. 675 00:34:53,600 --> 00:34:56,699 One one text message today and it tells you congrats, you reach 676 00:34:56,699 --> 00:34:59,700 your goal yesterday. You still have so many points, 677 00:35:00,200 --> 00:35:02,700 keep it up, and we randomize the messaging, so it's not the 678 00:35:02,700 --> 00:35:04,800 robotic. So it's really easy for people 679 00:35:04,800 --> 00:35:06,900 to stay in the game. I think where we, where we 680 00:35:06,900 --> 00:35:08,300 initially in the in the early stages. 681 00:35:08,300 --> 00:35:12,000 Got law, got lost with some people are more people, was if 682 00:35:12,000 --> 00:35:15,200 they Understand the game, you know, we gave people 70 points 683 00:35:15,200 --> 00:35:17,400 and preach a the week we gave it to them on Monday. 684 00:35:17,400 --> 00:35:19,400 We used to start people on any day and we were like we should 685 00:35:19,400 --> 00:35:22,000 talk people on Monday because it thinks with their weeks and so 686 00:35:22,000 --> 00:35:26,200 we're slowly making changes. But then we started explaining 687 00:35:26,200 --> 00:35:29,900 that we, where we used to do is we send them a long email, which 688 00:35:29,900 --> 00:35:32,600 would have liked for paragraph explaining each part of the 689 00:35:32,600 --> 00:35:34,400 game. We used to have like these, you 690 00:35:34,408 --> 00:35:36,500 could call on, you could forgiveness things. 691 00:35:36,500 --> 00:35:39,400 You could call a friend from your circle or whatever and they 692 00:35:39,600 --> 00:35:42,400 substitute was too confusing. So we decided what we Would send 693 00:35:42,400 --> 00:35:44,700 you a shorter version and then we would walk you through the 694 00:35:44,707 --> 00:35:46,900 game. So every day, we'd explain, hey, 695 00:35:46,900 --> 00:35:49,800 it's day 1, your goal, you're starting off with 70 points, 696 00:35:49,800 --> 00:35:51,900 your goal is to achieve your step count. 697 00:35:52,300 --> 00:35:53,600 Now it's day two. Great job. 698 00:35:53,600 --> 00:35:55,400 You met your goal or sorry, you didn't meet your goal. 699 00:35:55,400 --> 00:35:58,000 We would kind of walk people through and we found that that 700 00:35:58,500 --> 00:36:03,000 explanation as you go, work much better because they're willing 701 00:36:03,000 --> 00:36:04,700 to read like a two-sentence, text message. 702 00:36:04,700 --> 00:36:07,000 They're not going to read that page long email, no matter what 703 00:36:07,000 --> 00:36:10,600 you do and so that was a better. No one's going to read the page 704 00:36:10,600 --> 00:36:13,200 long. Awesome, Talk really briefly 705 00:36:13,200 --> 00:36:15,800 about what you're doing because you're up to some really 706 00:36:15,800 --> 00:36:20,200 exciting things now and, you know, we talked about behavioral 707 00:36:20,200 --> 00:36:24,000 design in the wild earlier. I'm curious, you know, what can 708 00:36:24,000 --> 00:36:26,600 you tell us about your experience doing applied 709 00:36:26,600 --> 00:36:28,900 Behavioral, Science and health care itself? 710 00:36:28,900 --> 00:36:31,200 You know, like really out in the real world. 711 00:36:31,200 --> 00:36:34,600 What is it like? Yeah, I can say, there's lots 712 00:36:34,600 --> 00:36:36,900 and lots of opportunities that being said, it is really 713 00:36:36,900 --> 00:36:40,000 challenging to get people to apply this in the real world. 714 00:36:40,000 --> 00:36:42,100 I think there are a couple of big things. 715 00:36:42,200 --> 00:36:45,000 Themes that come up. We're often looking to test 716 00:36:45,000 --> 00:36:49,400 approaches compared to other things and you know, where we 717 00:36:49,400 --> 00:36:52,700 live in a culture within Health Systems and ensures and other 718 00:36:52,700 --> 00:36:55,000 organizations where a lot of times, we're implementing new 719 00:36:55,000 --> 00:36:56,900 things and rolling them out and then they're moving on to the 720 00:36:56,900 --> 00:36:58,700 next thing on the list because there's so many things we want 721 00:36:58,700 --> 00:37:00,900 to do. And there's not a cycle of 722 00:37:01,100 --> 00:37:03,200 testing and learning that we can apply there. 723 00:37:03,200 --> 00:37:05,400 And so, getting that structure in place is often a culture 724 00:37:05,400 --> 00:37:08,500 change for organizations, but something that many of the 725 00:37:08,500 --> 00:37:10,400 organization's, I've worked on, have really embraced, and it's 726 00:37:10,400 --> 00:37:13,000 allowed me to be able to do Up there but we're looking to 727 00:37:13,008 --> 00:37:16,900 translate more broadly. The second is the clinicians 728 00:37:16,900 --> 00:37:18,700 that spent over a decade training. 729 00:37:18,700 --> 00:37:21,100 A lot of our, interventions are targeted to clinicians and they 730 00:37:21,600 --> 00:37:24,000 gone through residency and fellowship and they're experts 731 00:37:24,000 --> 00:37:26,500 in their field. And so they often are averse to 732 00:37:26,500 --> 00:37:29,800 someone else coming in and helping design, things that 733 00:37:29,800 --> 00:37:33,000 influence them or their patients when they're not from the same 734 00:37:33,000 --> 00:37:35,300 field. And so, the way we get it, the 735 00:37:35,308 --> 00:37:38,300 way, we have a dress, that is two one reveal to them. 736 00:37:38,300 --> 00:37:40,200 You're already being a judge, is not like, we're introducing 737 00:37:40,200 --> 00:37:42,000 something new, whatever the system you're in. 738 00:37:42,200 --> 00:37:44,800 In for the design of your EHR your patient Communications. 739 00:37:44,800 --> 00:37:47,700 There's a notch there, you just often don't recognize it that is 740 00:37:47,700 --> 00:37:49,600 eye-opening them. Those extra steps you need to 741 00:37:49,600 --> 00:37:52,200 prescribe your generic or whatever it might be probably 742 00:37:52,200 --> 00:37:53,700 getting in the way we can help you. 743 00:37:53,900 --> 00:37:56,800 And then two is to is to flip the script as opposed to us 744 00:37:56,800 --> 00:37:58,400 saying, hey we want to help you do this. 745 00:37:58,700 --> 00:38:01,300 We would do crowdsourcing campaigns so that the clinicians 746 00:38:01,300 --> 00:38:03,200 are the patients and the Frontline members would come to 747 00:38:03,200 --> 00:38:06,600 us and say we need help to increase cancer screening. 748 00:38:07,000 --> 00:38:09,100 And now we've got the clinician saying, hey, this is something 749 00:38:09,100 --> 00:38:12,000 we're working on, we could use your help, that's something. 750 00:38:12,200 --> 00:38:14,500 Probably would have warned worked on as well, but it works 751 00:38:14,500 --> 00:38:17,900 better if it comes from them. And then scaling, the 752 00:38:17,900 --> 00:38:20,300 interventions is probably the third kind of thing. 753 00:38:20,800 --> 00:38:24,200 Uh, our interventions are much easier to scale than others. 754 00:38:24,200 --> 00:38:27,100 If you have a, if these are witches are places because once 755 00:38:27,100 --> 00:38:29,800 you turn it on and then there and it can be expanded how many 756 00:38:29,800 --> 00:38:34,100 text based intervention can be that way things that we require 757 00:38:34,300 --> 00:38:37,000 or manual effort or resources that obviously less scalable. 758 00:38:37,800 --> 00:38:40,800 And then there's such variation in some Health Systems compared 759 00:38:40,800 --> 00:38:42,000 to others that you have to make changes. 760 00:38:42,100 --> 00:38:44,400 Changes to fit within the culture of the context of the 761 00:38:44,400 --> 00:38:47,400 work flow. So, I say scaling interventions 762 00:38:47,400 --> 00:38:49,200 is another area, whether it's opportunity. 763 00:38:49,800 --> 00:38:54,100 Awesome, we have a very fun segment coming up. 764 00:38:54,500 --> 00:38:57,600 So we call this game. Matt will it replicates? 765 00:38:57,700 --> 00:39:01,200 And is really just kind of a thought, experiment to make some 766 00:39:01,400 --> 00:39:07,500 Concepts concrete. Okay, So, first hypothetical 767 00:39:08,300 --> 00:39:11,600 people who invite a friend to their annual checkup, or more 768 00:39:11,600 --> 00:39:15,600 likely to attempt, I think it would not, replicate and leftist 769 00:39:15,600 --> 00:39:17,500 and left. The friend was a family member. 770 00:39:18,000 --> 00:39:20,800 All right, place prescriptions get patients, to floss more 771 00:39:20,800 --> 00:39:24,400 regularly compared to dentist recommendations I think that 772 00:39:24,400 --> 00:39:26,700 could work well people really trust the doctor and I think of 773 00:39:26,700 --> 00:39:29,900 a prescription is more concrete than just what's often a verbal 774 00:39:29,900 --> 00:39:33,900 recommendation times leaderboards. 775 00:39:34,000 --> 00:39:36,600 Facilitate me? Kitchen adherence among people 776 00:39:36,700 --> 00:39:41,200 who are high in neuroticism but backfire in people who are high 777 00:39:41,200 --> 00:39:44,400 in extraversion, I think leaderboard I think would not 778 00:39:44,400 --> 00:39:46,700 replicate. I think later book leaderboards, 779 00:39:46,700 --> 00:39:52,600 in many settings are hard to make work well because the 780 00:39:52,600 --> 00:39:55,300 person in first place is often running away from everyone else 781 00:39:55,300 --> 00:39:58,000 and like a more social norming intervention, might work better. 782 00:39:58,000 --> 00:40:01,900 Regardless of someone's personality type companies that 783 00:40:01,900 --> 00:40:06,000 claim to nudge consumers toward better be Xavier are perceived 784 00:40:06,000 --> 00:40:09,900 as more paternalistic than those claiming to quote unquote 785 00:40:09,900 --> 00:40:13,200 designed for Behavior change. I think that I would agree with 786 00:40:13,200 --> 00:40:15,200 that phone. I could see that replicating. 787 00:40:15,500 --> 00:40:20,500 Okay, final one piano staircases and Office Buildings lead to an 788 00:40:20,500 --> 00:40:23,600 increase in the use of stairs in favor of taking the elevator. 789 00:40:24,100 --> 00:40:26,000 If you are comparing a regular their cases, I think. 790 00:40:26,000 --> 00:40:30,400 Yeah, I like unit are cases would be more effective at long 791 00:40:30,400 --> 00:40:34,800 term as well. Sorry, that was my bias, Frank. 792 00:40:34,800 --> 00:40:39,900 I'm curious to long-term know if they may be for small, maybe not 793 00:40:39,900 --> 00:40:42,000 an average. But for small percentage of the 794 00:40:42,008 --> 00:40:45,200 population, you want to make prediction for, like, what is 795 00:40:45,200 --> 00:40:48,300 their phenotype of like, what is their personality traits? 796 00:40:48,300 --> 00:40:51,400 That makes them more likely to enjoy that. 797 00:40:52,300 --> 00:40:57,300 Maybe they are. They're more likely to I see you 798 00:40:57,300 --> 00:41:00,800 the benefit of the design of the staircase or the probably more 799 00:41:00,800 --> 00:41:03,800 motivated at Baseline and they're looking to change their 800 00:41:03,800 --> 00:41:07,100 behavior. Well done, that was those will 801 00:41:07,100 --> 00:41:10,700 very well done. All right. 802 00:41:11,000 --> 00:41:13,200 We test. We have one final question for 803 00:41:13,200 --> 00:41:15,400 you. And this one is a, this is a 804 00:41:15,408 --> 00:41:17,800 tough one. So, take your time with it. 805 00:41:18,100 --> 00:41:22,400 What is your most controversial opinion, in Behavioral Science, 806 00:41:22,900 --> 00:41:26,000 my most controversial opinion, in Behavioral Science? 807 00:41:26,500 --> 00:41:29,200 I guess the one that I've been trying to put out there more 808 00:41:29,200 --> 00:41:32,700 recently given that shifted. My focus has been, I think a lot 809 00:41:32,700 --> 00:41:36,600 of effort in Behavioral Science are on testing different 810 00:41:36,600 --> 00:41:38,300 approaches. And I'm, you know, I was a 811 00:41:38,300 --> 00:41:40,500 behavior. I was an Analysts and the 812 00:41:40,500 --> 00:41:43,100 clinical trial list and so testing record of my heart. 813 00:41:43,800 --> 00:41:47,300 But I think we're a decade in now and I think what needs more 814 00:41:47,300 --> 00:41:51,400 effort or attention is the implementation at the applied 815 00:41:51,400 --> 00:41:53,700 Behavioral Science? I would say we should continue 816 00:41:53,700 --> 00:41:56,700 testing even the applied settings, but I think there's 817 00:41:56,700 --> 00:42:00,400 two almost too much focus on testing and not enough focus on 818 00:42:00,400 --> 00:42:02,300 applications into the real world. 819 00:42:03,400 --> 00:42:07,000 And I think a lot of Behavioral scientists are Yeah, of course, 820 00:42:07,300 --> 00:42:09,200 Hollister Lake to randomize and things like that. 821 00:42:09,200 --> 00:42:13,900 And as do I or did I, I think there needs to be a change and 822 00:42:13,900 --> 00:42:16,400 we they mindset that we need to shift the focus and we need to 823 00:42:16,408 --> 00:42:18,600 shift the efforts towards application. 824 00:42:18,600 --> 00:42:21,800 Still testing but much more on applications. 825 00:42:22,300 --> 00:42:25,200 Yeah, I wonder if there's just a fear that the testing will go 826 00:42:25,200 --> 00:42:28,400 away if you don't keep, you know, emphasizing it. 827 00:42:29,600 --> 00:42:32,000 Yeah. I like a chicken-egg problem. 828 00:42:32,000 --> 00:42:34,200 Like if you can get it to be applied and show that it's go 829 00:42:34,200 --> 00:42:36,100 quietly, maybe it shows you that we need to. 830 00:42:36,600 --> 00:42:40,300 There's always room to improve but but if we don't get it to a, 831 00:42:40,800 --> 00:42:43,100 we don't apply it in the real world and look the point of the 832 00:42:43,100 --> 00:42:47,400 testing in the first place. And I think that well, it's 833 00:42:47,400 --> 00:42:49,300 interesting, especially in the applied world. 834 00:42:49,300 --> 00:42:53,200 I think people especially those who don't have a lot of 835 00:42:53,200 --> 00:42:56,500 experience testing. They they really struggle with 836 00:42:56,900 --> 00:43:01,100 how to prioritize, what to test versus, you know what, to just 837 00:43:01,100 --> 00:43:05,200 go ahead and apply. So maybe maybe the world just 838 00:43:05,200 --> 00:43:07,800 needs more meat. I should sue know what to just, 839 00:43:07,800 --> 00:43:11,000 go ahead and apply right, but you almost need to do the 840 00:43:11,000 --> 00:43:14,000 testing in order to understand that. 841 00:43:14,000 --> 00:43:17,900 So yeah, but I do think we have a decade of testing now. 842 00:43:17,900 --> 00:43:20,900 So we, you know, you know, there's been like 30 different 843 00:43:20,900 --> 00:43:23,400 trials and how do you judge people to get the flu shot now, 844 00:43:23,400 --> 00:43:25,300 or cancer, screening or anything. 845 00:43:25,300 --> 00:43:27,100 Now there's going to be other things where you don't have as 846 00:43:27,100 --> 00:43:28,900 much evidence. Not just from my work move but 847 00:43:28,900 --> 00:43:30,800 from other people's work. And so I think I think 10 years 848 00:43:30,800 --> 00:43:34,000 ago we didn't have that in healthcare or health as much but 849 00:43:34,000 --> 00:43:37,000 now there's much more evidence at least That can serve as a 850 00:43:37,000 --> 00:43:39,600 starting point, so people shouldn't be starting from 851 00:43:39,600 --> 00:43:41,800 scratch. This should start by using that 852 00:43:41,800 --> 00:43:46,100 base Foundation - yo, that's really wonderful advice. 853 00:43:46,100 --> 00:43:49,400 And, you know, in general, this was a really wonderful 854 00:43:49,700 --> 00:43:50,900 conversation. I'm really happy to say that 855 00:43:50,900 --> 00:43:53,100 you've Advanced to Diamond League now. 856 00:43:54,900 --> 00:43:58,500 So it's going to thank you for joining the people talking 857 00:43:58,500 --> 00:44:01,900 points. Yeah, golden badge. 858 00:44:03,900 --> 00:44:05,600 Thank you for having me on. This is great discussion. 859 00:44:06,300 --> 00:44:07,600 It? Yeah, it's really fun. 860 00:44:07,600 --> 00:44:12,500 Thank you. Probably time to wrap up another 861 00:44:12,500 --> 00:44:15,400 episode of the behavioral design podcast. 862 00:44:15,400 --> 00:44:20,000 We hope you enjoyed the show. Oh, and I am an AI. 863 00:44:20,200 --> 00:44:22,900 Yeah, welcome to uncanny valley Sam. 864 00:44:22,900 --> 00:44:26,300 And allene told me this is going to be an awesome season, so make 865 00:44:26,300 --> 00:44:29,200 sure to subscribe and help spread the word, maybe share the 866 00:44:29,200 --> 00:44:31,400 podcast with a colleague, or friend. 867 00:44:31,700 --> 00:44:35,700 And if you want to show us some extra love head over to Habit 868 00:44:35,700 --> 00:44:38,000 weekly. We Come & join, our community 869 00:44:38,200 --> 00:44:41,000 Pro members, get access to a wealth of resources in the 870 00:44:41,000 --> 00:44:43,400 chance to interact with leading practitioners. 871 00:44:43,600 --> 00:44:46,400 It's a great way to support the podcast and deepen. 872 00:44:46,400 --> 00:44:49,900 Your understanding of Behavioral design are fantastic. 873 00:44:49,900 --> 00:44:53,400 Show music is Murgatroyd by the wonderful Dave Pizarro and 874 00:44:53,400 --> 00:44:55,400 thanks to the team at Orange wall media. 875 00:44:55,400 --> 00:44:58,700 For the production of this episode for questions or ideas 876 00:44:58,700 --> 00:45:03,100 for future episodes, email podcast at habit weekly.com, 877 00:45:03,400 --> 00:45:06,800 we'd love to hear from you. Thanks again for I'm listening. 878 00:45:06,900 --> 00:45:07,900 See you next time.