Encore - How science can help you change your behavior for the better, with Katy Milkman, PhD

What can you learn from the science of behavior change that can help you make the changes you want to see in your life? Katy Milkman, PhD, a professor at the Wharton School of the University of Pennsylvania and author of the book How to Change: The Science of Getting From Where You are to Where You Want to Be, discusses the importance of accurately identifying the behavioral roadblocks standing in your way, how specific strategies such as “temptation bundling” and creating fresh starts can help you achieve your goals, how to turn laziness to your advantage by setting the right defaults, and more. Please take our listener survey at http://at.apa.org/SoPSurvey Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

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• 0:28Speaker 01

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• 1:01Kim Mills?

  Speaking of psychology, it's taking a summer break, so we're rerunning some of our favorite episodes from the past. In 2021, I talked to Katie Milkman, a behavioral scientist at the Wharton School of the University of Pennsylvania, about how to identify and overcome roadblocks that are getting in the way of making the changes you want to see in your life. I hope you enjoy this episode from the archives. We'll be back with a new episode next week. Change is hard. When you want to make a change in your life, whether it's eating healthier food, starting an exercise program, or saving more money, there are many human foibles that can stand in your way. Impulsivity, laziness, procrastination, or just plain forgetfulness are among them.

• 1:43Kim Mills?

  Libraries are full of books offering multi-step plans and other tactics to inspire a new you. Often, though, these plans fall flat. Our best intentions aren't enough to overcome the roadblocks of human nature that stand in our way. But in recent years, psychologists have begun to look at behavior change from a different angle. Instead of fighting human nature, this research suggests that we should analyze it and then leverage it to work for us rather than against us. What does that mean? What can we learn from the science of behavior change that can help us make the alterations we want to see in our lives? And how can organizations, companies, and governments use these insights to nudge whole populations into making better choices? Welcome to Speaking of Psychology, the flagship podcast of the American Psychological

• 2:28Kim Mills?

  Association that examines the links between psychological science and everyday life. I'm Kim Mills. Our guest today is Dr. Katie Milkman, a professor at the Wharton School of the University of Pennsylvania and author of the book, How to Change: The Science of Getting From Where You Are to Where You Want to Be. Her research explores how insights from psychology and economics can be harnessed to change people's behavior for the better on both an individual and a global scale. She has explored how relatively simple interventions can help people increase their savings, exercise more, and even get vaccinated, among other things. She is co-director of the Behavior Change for Good Initiative at Wharton. She also hosts the Charles Schwab podcast, Choiceology, about the science of decision-making.

• 3:13Kim Mills?

  Dr. Milkman, thank you for joining us today.

• 3:15Speaker 03

  Thank you so much for having me.

• 3:17Kim Mills?

  So as I said, your book is entitled How to Change, but in the first chapter, you start with a slightly different premise, which is when to change. You make the point that there are some moments in our lives that are particularly conducive to making change. What has your research found? And if you want to make a change in your life, when should you try to do it?

• 3:36Speaker 03

  I love that you opened with this question because it's one of my favorite topics that I've studied. And actually, it was a question just like the one you asked that started me on this course. I was visiting Google, presenting some of my work on nudges and choice architecture and strategies that could be used by HR managers to help their employees make better decisions and invest in new skills training, wellness programming, et cetera. And I was asked, is there some ideal time to encourage employees to change? And I realized, actually, there was very little I knew from the academic literature that would help me answer that great question. So I went back to my research team at the University of Pennsylvania, my former student,

• 4:19Speaker 03

  Heng Chen Dai, who's now a professor at UCLA's Anderson School, and also Jason Reese, who's the head of Behavioral Science at Wharton, Senior Fellow. We were all really interested in behavior change. We started talking about this question. And had really strong intuitions right away about when it might make sense to change. The first thing that came to mind for all of us was that we know people make more resolutions and set more goals around New Year's, right? So that was, that was well established. We weren't coming up with something wildly new there. But what we got interested in is whether there was something about that moment that might give us a hint as to other moments in our lives when we might be more open to change. And we started reading the literature on autobiographical memory, the way people think about time.

• 5:04Speaker 03

  What we learned is that there are moments in our lives that feel like new beginnings. And that's because the way we organize time in our memory is as if our life is a series of chapters and they have sort of beginnings, middles and ends. That's how we think about ourselves, like characters in a book, instead of thinking about time really truly linearly. And as a result of that, any moment that feels like a breakpoint can feel like a new beginning to us anytime we're opening a new chapter for any reason. And what happens at New Year's and what we found happens at some other moments as well is we feel like, you know, because we're closing a chapter, we can say, that was the old me who didn't manage to quit smoking last year, didn't manage to go to that skills training workshop.

• 5:46Speaker 03

  And the new me in the new year, you know, I'm, I'm different and I can do it. So we feel more optimistic. And we've found in our research that other moments that systematically feel like new beginnings to us and lead to a similar optimism and tendency to pursue goals include dates like just the start of a new week, the start of a new month, the celebration of a birthday, the celebration of certain holidays that we associate with new beginnings. So think more Labor Day and less Valentine's Day. And we've, we've shown in our research that people are more likely to do things like visit the gym at these moments, that they're more likely to set goals on a popular goal setting website around these, these dates that feel like new beginnings.

• 6:26Speaker 03

  And also if we reach out and say, when would you like to receive reminders to begin pursuing a goal or when would you like to start saving, for instance, and we simply label dates differently? If we label a date, As an ordinary day, right, no special label. It's not nearly as attractive as if we give it a label that makes it feel like a new beginning. So for example, in one study, we labeled March 20th as the first day of spring in one condition, but not in the others. It's the third Thursday in March. And we see really huge differences when it's labeled as the first day of spring and how attractive it is as a date to start pursuing a goal, for example. So we both see correlationally, sort of naturally, people take advantage of these moments when they're looking at when to change.

• 7:09Speaker 03

  And we can run experiments and show that if we change the labels associated with certain dates and add fresh start labels, dates that feel like a new beginning, we see this uptick. So taking that all together, it points to moments that feel like transitions, feel like a new beginning of a chapter in our lives, and particularly temporal landmarks that have those features that we've studied include the starts of these calendar cycles.

• 7:37Kim Mills?

  Okay, but that's an external nudge, in a sense. Now, what if I want to make a change, but there isn't some obvious fresh start right now? Is there something that I can do for myself that would just create a fresh start?

• 7:48Speaker 03

  Yeah, it's a wonderful question. First of all, I would say there are so many dates that even though they are external, you can sort of look for the next one and jump on it, right? You know, Monday occurs every seven days, it turns out. So even though you have to wait around for seven days to start, they're fairly frequent. So I do think even with that constraint, they can be useful as moments to sort of lock on to. In terms of whether you can create one for yourself, Heng Chen, who I mentioned, my former student, who's, she did some work in her dissertation related to a slightly different kind of fresh start. She calls it a reset. And it's a different way that, it's not a temporal landmark that wipes the slate clean,

• 8:31Speaker 03

  but rather some, a change in the way we're tracking our performance that can wipe the slate clean. So for instance, I wear a Fitbit. And every morning, I sort of feel like I have a bit of a fresh start because yesterday I had accumulated, you know, maybe a pathetically low number of steps, maybe a really high number of steps. Either way, I wake up and it says zero. And that's a reset and a fresh start in a sense. There's all these different ways in which we track our performance, whether it's sales performance, if you're in an organization, whether you're a professional athlete and you're sort of tracking your stats for the season. And things get reset at different frequencies, grades for students, whether it's semester, quarter. So one thing that we may have some more control over, especially if we're tracking ourselves, is when these resets occur.

• 9:15Speaker 03

  And if we're having a rough time, it turns out resets can be really valuable as a motivator to improve and set goals and do better. Interestingly, her research also finds that resets are harmful, and I think this is very intuitive, actually, in cases where we're doing really well. So you want to wipe the slate clean and have a fresh start when things aren't going your way, when you need the motivation to do something you haven't managed to do. But when you're on a roll, it's actually disruptive and harmful to have a fresh start. So we do have to use this particular tool with some caution.

• 9:49Kim Mills?

  You started out as an engineering student and you write in the book that in some ways you approach behavior change as an engineering problem. What do you mean by that?

• 9:57Speaker 03

  Yeah, it's funny to be on this podcast and I'm often labeled a psychologist. You will laugh. I have literally never taken a psychology class in my entire life. My undergraduate degree and PhD are both in engineering. And so that's the, it's a different way of looking at the world. It's sort of looking for problems that you can solve by pulling the right pieces together in order to plug a hole or fix a gap or improve a structure. That is the way that I was trained to think. And it turns out, I think it's quite a useful way of looking at a lot of psychology problems, especially in my field of behavioral science, where we have spent a lot of time documenting

• 10:41Speaker 03

  errors and judgment, the ways that people make systematic mistakes. But if you want to actually start correcting some of those mistakes, having this engineering mindset, like, you know, what, how can I build a structure that plugs that hole? How can I fill that gap? Is a really useful perspective, I think. And I've tried to bring that to my work. I've always been solutions oriented and looking for ways that what we know about the human mind not only presents conundrums and puzzles and problems and exposes limits, but also

• 11:11Speaker 03

  What we can do to actually overcome and build and grow and and bridge those gaps.

• 11:18Kim Mills?

  So some of your first research on behavior change was what you call temptation bundling, the idea for which came from something, a problem that you were trying to solve in your own life. Can you tell us that story and explain what temptation bundling is and how it can help people change their behavior?

• 11:36Speaker 03

  Yeah, I would love to. This is absolutely me-search, which is a term I'm borrowing. I think another psychologist named Carrie Morwich is the person who taught me that term. I love, I love that term. It's what drew me into the field, honestly, was that I was doing some me-search. So I was a graduate student at the time in engineering and and struggling with tough classes and tired at the end of a long day. And all I wanted to do when I came home and should have been working on problem sets was curl up on my couch with, you know, entertainment, a juicy page turner, or binge-watch Netflix, one of the above. I was struggling to find the motivation to get my work done. Similarly,

• 12:19Speaker 03

  I knew that I really needed to exercise regularly. It was important for my physical and mental health. I was a lifelong athlete, but I just could not drag myself to the gym. And especially at the end of those long days when I was feeling worn out, I sort of had this epiphany, a little me-search. And by the way, many other people have had this epiphany independently, which was, what if I only let myself enjoy these indulgent entertainment sources while I'm exercising? Maybe that would actually drag me to the gym. And so, and maybe also I'd stop wasting time at home binge-watching TV when I should have been doing my problem sets. So I tried this out. I made a new rule that I was only allowed to indulge in entertainment while I was exercising, and it was life-altering.

• 13:02Speaker 03

  All of a sudden, I'd come home from a long day, and all I wanted to do was rush to the gym to find out what happened and the latest. I was actually, I got into audiobooks, lowbrow audiobooks, like, well, this isn't very lowbrow, Harry Potter, James Patterson, you know, The Hunger Games, page turners, thrillers. I would, I would Want to know what happened next to these characters. So I dash off to the gym. I get in these great workouts where I didn't even notice that I was exercising. This time was flying so fast. Normally, exercise was a drag, but I was so into these characters and the stories. I kept going and then I'd come home and I was totally refreshed and rejuvenated, ready to get my work done and there's no distractions. And I thought, wow, this is really working for me and I should see if this could help other people.

• 13:45Speaker 03

  So I ended up doing some experiments to test whether or not what I now call temptation bundling or linking something that you find a pleasure and a temptation with an activity that would otherwise feel like a chore in order to make it more, you know, endurable, more, more pleasant could help people. So we've run a couple of experiments now showing that temptation bundling can be a helpful tool to other people, not just me, not an N of one. So one experiment, the first one we did, we randomly assigned people to a group where they would be given tempting audio novels that they could load onto iPods and then listen to the first 30 minutes while they were doing a workout at the gym. And we told them if they wanted to hear what happened next and whichever tempting novel

• 14:30Speaker 03

  they'd picked from a menu of 80 we gave them that had been pre-tested. Well, they would have to come back to the gym because we'd be holding their iPod hostage in a locked monitored locker they could only access when they came in for a workout. And we compared that group's exercise habits to a control group that also did a 30 minute workout at the start, also owned iPods, was also given an equally valued gift, a gift certificate to Barnes and Noble, which they could, of course, use to buy audiobooks if they wanted. But we gave them no suggestion to temptation bundle. And what we found is that temptation bundling did increase exercise pretty substantially in the short term. So the study went for 10 weeks. The effects were robust for seven weeks. Then along came Thanksgiving break. We did the City University Gym. The gym closed.

• 15:15Speaker 03

  Everybody went home. And this was actually, I think, another interesting part of the research. The effect was totally wiped out by that period of forced separation from the tempting stimulus. So, you know, we've done subsequent studies where we show it can have a more durable effect when you don't have that kind of disruption, but it also links back to what we were talking about with fresh starts and how resets and disruption can be good in some cases, but when you're on a roll can be harmful.

• 15:38Kim Mills?

  You get kind of dependent then on your iPod in order to go to the gym. If you don't have it when you go back home, forget it, I'm done.

• 15:44Speaker 03

  Exactly, exactly. And there's, anyway, all these things, I think, part of what makes them so interesting is there's, there are few things that are just sort of totally unambiguous, always work, there's no moderators. And that's one of the things that's so interesting about studying humans is that there's always interesting complexity to unpack. Anyway, so that's, that's the work on temptation bundling. And I've talked about it only in the context of exercise, but just want to point out for listeners who have other kinds of behaviors that they find to be chores or burdens, and they're trying to engage in more. It's a tool that theoretically should be applicable to lots of settings in life, not just getting yourself to the gym. So you can think about, you know, only letting yourself listen to your favorite podcasts, say this one, while you're doing household chores or cooking fresh meals, if those are goals that you want to fulfill, or only letting

• 16:29Speaker 03

  yourself pick up a favorite treat or snack on the way to hit the books at the library, if that feels like a chore, but you want something to make it more of a pleasure. So there's lots of ways we can create temptation bundles beyond exercise. But that is where I first did it and studied it.

• 17:15Speaker 04

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• 17:45Kim Mills?

  So your book is organized into chapters, each covering a different aspect of human nature, couple of which I mentioned in the introduction, impulsivity, laziness, procrastination. Can you talk about your favorite examples from the book about how we can work with rather than against these traits when we're trying to make change?

• 18:03Speaker 03

  Yeah, probably my favorite example is one that is, it's really well-known and yet it's so important, so I'm just gonna harp on it anyway. I think it's the power of defaults. And I think this is one of the biggest wins from behavioral science and it has to do with laziness. So in general, we humans prefer to take the path of least resistance. Whatever the easiest route is to, you know, collecting my paycheck or getting my lunch or, you know, whatever it is, whatever goal you have, we're always looking for the shortcuts and the easiest way instead of the hardest work path. And that actually, of course, is a challenge, right?

• 18:45Speaker 03

  When it comes to trying to get yourself in great physical shape or, you know, earning your PhD, the fact that we're looking for shortcuts does not really help, right? It's often a barrier to change. And so I talk a lot about that in the book. But one of the things that's so interesting is that defaults flip this on its head and turn laziness into an asset. So a default is the sort of option you will end up with in a situation if you literally don't lift a finger, if you do nothing. So your computer comes with default settings, right? You turn it on, it has some... Background screen, it has default fonts, it probably has a default browser. There's all these things that are just there.

• 19:27Speaker 03

  And if you take the path of least resistance, well, that's what you end up with. And so I think one of the really interesting things is, um, once you start to recognize their power, and they've been studied in so many different contexts, it's actually not something I've studied, but lots of wonderful scholars in this association have. I'll just mention, for instance, Eric Johnson and Dan Goldstein have some wonderful work on how much default organ donation policies change our decisions. So countries where you're defaulted into being an organ donor, but you can just opt out trivially easily by sort of checking a box and signing your name on a basic form, have vastly higher rates of organ donorship than countries where you have to, um, I said it the wrong way. No, I said it the right way, where you have to opt in. Right.

• 20:12Speaker 03

  Which is what we have in the United States. So in the United States, you go to the DMV, you check a box, you opt in, it's trivially easy, but we have lower donation rates because I had to take some action and we always look for the path of least resistance. So anyway, this is, organ donation is a particularly tricky one because it's more than just whether you sign your name and check a box and are opted in or opted out that determines what actually happens with organs. But it shows the power because of these huge differences of a default policy and how important it is to put deep thought into that if you want to change behavior in a positive direction. So when we have defaults that are structured to help people achieve their goals, right? We default them into getting apple slices with their meal instead of french fries on the side.

• 20:55Speaker 03

  Or we default people into, say, being organ donors, although again, that one, that one has some complexity. All of those choices, they use laziness to help us achieve a goal. So for instance, my browser's homepage is not Facebook or Twitter, it's the New York Times. So every day I encounter some news when I open it up and I don't get sucked into a vortex of something that maybe I, I'm going to be tempted to waste time with. Instead, I'm getting something that I consider enriching. There's defaults you can have in your pantry in terms of what foods you keep on hand so that it's, it's hard to get the burger and fries or the pizza that you crave that aren't as good for you. If you want to stay healthy, you don't have the cookies in the pantry, you have healthy snacks.

• 21:37Speaker 03

  And now your defaults and the path of least resistance is aligned with your goals. So I think that's a really powerful tool we can use to set ourselves up for success. Once we understand. The power of laziness and that we can use it and harness it to our benefit.

• 21:55Kim Mills?

  And that's a great one to get people to save as well. I mean, it always amazes me that every employer doesn't like automatically enroll you in the 401k plan. You know, you won't notice it, right? And I think you've done some work in that area as well.

• 22:11Speaker 03

  Absolutely. Probably, probably the, one of the most famous examples and most useful examples besides the organ donation is that employers, and this is work by Bridgette Majarian and Dennis Shia that first showed this in about, I think, 2003, when one employer switched from having new employees enroll by checking a box and signing their name, and they'd start having a portion of every paycheck sent to their savings account. They just made a little change in the paperwork, and now you had to check a box and sign your name to say, I don't want that done. And overnight, they saw almost a 40% increase in enrollment in their 401k program, which led to huge increases in people's savings for retirement. And so now it's actually tax advantaged for companies to make savings

• 22:54Speaker 03

  in their 401ks. The default, there was a, the 2006 Pension Protection Act, I believe, passed that, that was nonpartisan, just everyone agreed, let's harness laziness to make sure that Americans have better financial security. And so it's a terrific example of a tool that policymakers can use. We can certainly also use it ourselves. Like, you can go into almost any bank account today and create a recurring deduction from one, or movement from one to another. And once you set it once, you'll never think about it again. No one's ever going and changing these things, right? Because you're lazier on the path of least resistance. So if you just one time, maybe at one fresh start, when you're feeling motivated to increase your savings rate, you set up that auto deduction from every

• 23:37Speaker 03

  paycheck into a savings account that you don't touch, you are going to accumulate more. So that's a really powerful tool.

• 23:43Kim Mills?

  That raises a question around how an individual can identify strategies that are going to work in a particular situation. I mean, how, for the listener who wants to make a change, what should they be going through mentally in order to find that strategy that's going to work for them?

• 24:00Speaker 03

  Yeah, I love that question. Honestly, that is the very question that I would say to some degree was the impetus for writing the book is that I felt like what I'd realized is when I talked to individuals, when I talked to organizations that were looking at behavior change challenges, which is what I often do in my research, there was this tendency to just sort of look for off the shelf solutions that sounded good and like, you know, maybe they'd been proven effective in some other situation, but there was very little effort made to diagnose what was the barrier to change. So there wasn't this matching, like there wasn't an appreciation that it mattered, that you understood what was obstructing you in order to choose the right tool to overcome that challenge. And so I tried to

• 24:43Speaker 03

  write this book to actually, you know, both share everything I knew about the science of behavior change after a career spending it, but also I organized it around, okay, there are a set of pretty predictable barriers that are actually very recognizable when you, when you are facing a problem, you will pretty easily, once you sort of have read the book or read through this list, you'll say, oh yeah, like, that's a forgetting problem. I'm not, the reason I'm not taking my medications at night is I always forget. It's not that they have awful side effects and it's miserable. It's not that I'm procrastinating because I'd rather do it tomorrow than today. That's a forgetting problem. Sort of once you recognize the types of problems that are systematic, it's actually very easy to see and diagnose what kind of barrier you are facing to change. And then once you know it, there's, there's

• 25:28Speaker 03

  a whole lot of science that suggests, okay, if it's a forgetting problem here, the kinds of reminders that work here, the tools and strategies. But if it's a barrier of procrastination, you need a really different, different suite of strategies. So I would say actually the diagnosis part is as simple as having a little bit of exposure and the book that I wrote provides that, but you know, getting a, getting a master's in psychology or even picking up a textbook and learning about the judgment and decision-making literature, it's not, it's not hard or complex at all. It's just a step we normally skip. We normally go right for the, oh, you know, I'm not achieving my goals. I must need to, you know, build tiny habits or I must need to set bigger, more audacious goals or visualize success instead

• 26:11Speaker 03

  of thinking, wait, okay, first, before I try to solve this problem, what is the barrier? And the barrier is going to guide me towards the right solution because there are many solutions. There's a whole slew of them. And as you said, there's self-help books. All over the place. And lots of their solutions are science-based, I should say. It's just rarely do they get into like, oh, this only, you know, this is really a solution for this type of problem.

• 26:36Kim Mills?

  What about peer support and the idea of making a commitment to another person? I mean, if you're held accountable somehow, are you then more likely to follow through?

• 26:48Speaker 03

  Yes. I'm like, this is the easiest answer I get to give you. Just yes.

• 26:53Kim Mills?

  Yeah, let's move on.

• 26:56Speaker 03

  Yes, of course, it's more complicated than that. But yes, yes, yes. Peer support is so powerful. There's a couple of components of peer support that matter. You touched on accountability and accountability absolutely matters because when we basically increase the price of our vice, right, whatever the thing is that's bad for you, like not studying or not saving for retirement or not eating a healthy diet or not, you know, getting your report to your boss in time. If there's a bigger cost than your general tendency to procrastinate and to prioritize what's fun in the moment instead of what's good for you in the long run, well, the bigger the cost, the less that is likely to happen.

• 27:37Speaker 03

  Right? So you can, you can up the cost of bad behavior and you'll see less of it. This is very simple math. And one way to up the cost is accountability because shame and feeling that you've let someone else down, those are big costs that we don't like to pay. So absolutely, one of the reasons peer support matters is because it can create accountability and it can create those extra costs for failing to follow through. But peer support has a lot of other benefits besides accountability. One of the biggest, I think, which has been studied, maybe most impressively by folks like Solomon Ash in the 1950s, and then more recently, sort of Robert Cialdini has studied social norms. And that is When we look around and see what other people, our peers are doing, what they're achieving,

• 28:22Speaker 03

  it gives us knowledge about what's normal and that tells us what's possible and what will be rewarded socially, like, you know, how we'll have friends, so you want to fit in. And you actually see what you're capable of in other people's achievements. So not only is there accountability when you have peer groups and you look to those peer groups and they know about your goals, but you can create peer support systems in other ways and you can gain valuable knowledge from your peers about what you can achieve when it comes to goals. So it's really important actually to think carefully, if you can, if you have the power to structure your peer group in some way, and, you know, moms know this and dads know this too, sorry to be sexist, my husband is a probably more engaged caregiver in many

• 29:06Speaker 03

  ways than I am shaping our sons' peer groups. So it's really important to think about who you're surrounded with. If you're surrounded with people who are role models, who are showing you this is possible, you know, you want to run marathons, they're running marathons, they're, you know, they're really doing a great job, or they're vegetarians, you want to be a vegetarian, that's the kind of lifestyle you aspire to lead, your peers show you the way and they can show you how to get where they are if you look and you can literally deliberately strategically copy and paste tactics that they use to successfully achieve their goals.

• 29:47Speaker 03

  So, anyway, that was a long answer after yes, but peer support has a big role to play in behavior change.

• 29:54Kim Mills?

  So that brings me then to vaccine uptake, okay? Because, you know, a lot of the thinking early in the pandemic, once we had vaccines, was that peer, pressure, peer support, peer example would make people get vaccinated. And we're finding, eh, it works for some people, not for a lot of people. What are we doing wrong?

• 30:16Speaker 03

  Oh, gosh. We could have a two-hour, we could have a two-day conversation about this.

• 30:21Kim Mills?

  Yeah.

• 30:23Speaker 03

  I don't, I don't think we were wrong that peer support, social norms would matter for vaccination. I actually think that's true. We just, it would have been naive to say, and here I'm coming back to problem solution matching, that for everyone, the barrier was going to be solved by seeing others around them getting vaccinated. Okay, so for some people, the reason you might not get a vaccine might be, well, gosh, this sounds sort of new and scary, I don't know, we'll see if other people do it. If other people do it and it works out fine for them, maybe I'll feel more comfortable. And their peer norms are going to be really important. Seeing lots of selfies of people you trust or in your community, taking this vaccine, that is going to help.

• 31:08Speaker 03

  And, and I think that did do a fair amount of work. If you look at surveys from a year ago, last September, only about half of Americans said they would feel comfortable getting a vaccine. And, and we're, you know, well past, we're, we're past 70% of adults now, having had their first shot. So that's more than half of Americans who had the opportunity to get a shot, doing it. Right, so we're way better off than we were a year ago. And I suspect part of that, I mean, there's so many things, but part of it may have had to do with seeing their peers, seeing, you know, hundreds of millions of people have done this, and now it feels comfortable. But the thing is, that wasn't the only barrier. There's misinformation, which is a major barrier.

• 31:50Speaker 03

  There's another barrier that I think is important to acknowledge, which is cost. There's real cost in terms of time off from work, having childcare, having symptoms, that is, is important to acknowledge and recognize, especially in a country where we have so much income inequality, so much inequality of opportunity more generally. And just making something available for free is not covering all of the costs associated with it. So, you know, really wide range of different barriers. And so we need a lot of different solutions to overcome all of that. And, and of course, it's been politicized, and that didn't help things.

• 32:33Speaker 03

  And I have lots of brilliant colleagues who could say much smarter things on this podcast about how to tackle that. That's not my specialty, but I do admire the great work being done in this field on, on the issues of polarization and.

• 32:47Speaker 03

  So what do we do from here? My team has spent a lot of time thinking in the last year and studying this problem and looking at different tactics from, we ran some, we call them mega-studies, really, really massive randomized controlled trials where instead of testing a single hypothesis, we test literally dozens at the same time in parallel. We've run these studies with Walmart pharmacies and with two large healthcare systems to test out different text messaging communications, encouraging people to get a vaccine and see what worked best. We found a tactic that did then prove useful. We were studying it in the context of flu shots last fall, hoping it would port over to COVID.

• 33:30Speaker 03

  And actually, I mentioned Heng Chen Dai when I was talking about flu shot, excuse me, I was talking about the fresh start. She took sort of a best performer from our two mega-studies on flu shots and proved that it then was effective in encouraging COVID-19 vaccinations and had a paper about that come out in Nature with Silvia Cicardo and some other co-authors in the last couple of weeks. And that message was, it's waiting for you, it's reserved for you, it belongs to you, come claim it. So an ownership message sort of conveys recommendation, uses the endowment effect or the fact that we value things more that we feel belong to us. And also probably makes it feel like it's not going to be a hassle because it's already been reserved for you. So I'm not going to have to fight to get mine.

• 34:13Speaker 03

  All of those things probably are part of what makes it work that we did not study the mechanism we just showed in multiple large trials that this was sort of the top performer in a big suite of things we tested. So we've been recommending using it's reserved for you language. I don't think at this point in the pandemic, that's going to solve the problem with vaccination. I don't think we just need text messages at this point. But, but it's like, it's one insight that we, and it may be helpful with things like second shots and booster shots to try to use that. Optimal language when we communicate about it.

• 34:47Kim Mills?

  And it may counter some of the thinking around the fact that in the beginning it was very hard to get a shot. I mean, it wasn't there. You know, you had to make phone calls and find secret ways.

• 34:57Speaker 03

  Beg. Yeah. Yes. Can I get on your waitlist? Could you please call me? I'll call you again tomorrow.

• 35:02Kim Mills?

  Yeah.

• 35:02Speaker 03

  Right. That's right.

• 35:03Kim Mills?

  So.

• 35:04Speaker 03

  Yeah. But it's a different moment now. And I think we need different tools and tactics.

• 35:08Kim Mills?

  Well, what about making lasting change for the long term? Are you recounted in the book, conversation you had with a physician friend, where you lamented that in one of your experiments, you were able to get participants to go to the gym more often, but the effect wore off. And we talked about that a little while ago. And your friend said, we wouldn't expect to give someone with diabetes insulin once and they're cured forever. And that makes sense. So what do we have to do to make lasting change? Does a change ever just stick without a conscious effort to maintain it?

• 35:40Speaker 03

  Yeah, it's a really wonderful question. I wish I had a really simple answer. I think, honestly, this is probably something I'll keep studying for the next, hopefully 40 years of my life, if I, if I eat right and exercise regularly and save well for retirement. So Kevin Volp is the scientist who made this great point to me. And it was sort of oh, glaringly obvious once he said it, but hadn't clicked for me before he pointed out that we shouldn't be treating behavior change as sort of a one and done, like we would, we would find a solution that was magical, the way that you want to cure a rash, but that we should think about behavior changes more like facing a chronic disease and trying

• 36:22Speaker 03

  to look for a suite of solutions, because human nature doesn't just turn off, right? All of the barriers to change that I write about in the book, they don't, you can't just make them go away. You're going to be struggling with forgetfulness and procrastination and laziness for your whole life. I do think there's wonderful research on habits that occasionally suggests we can put things on autopilot. And I just want to sort of point to Wendy Wood of University of Southern California, as I think the, the leading thinker in this area. And it does seem that there are certain things that we really, we can put on autopilot to some degree, following sort of.

• 37:00Speaker 03

  You know, the kind of reinforcement we've seen in animal models, right? That you, if you engage in the behavior and then you receive a reward and then you repeat and you do this enough times, certain things do become automatic, like making coffee in the morning or shampooing your hair, flossing your teeth, hand sanitizing if you're a caregiver in a hospital. These are the kinds of things that do seem to be where it is possible to really habituate it and have it, for the most part, continue. But I think most things require, most of the things we care about in life, and also you can put on autopilot, right? Your retirement savings. So there are some magic exceptions, but I do think a lot of the goals we have in life,

• 37:44Speaker 03

  a lot of the things that require effort and thought and deliberation, it's going to be very hard to autopilot them. I'm not sure it's possible. And instead, what I have come to appreciate as the right path to change is to create structures and strategies that you're okay relying on to help you get through the barriers just permanently, right? So for instance, I still temptation bundled to go to the gym and that works for me. Well, during COVID, I haven't been going to a gym, but to get my exercise in, I look for ways to do that and always will. And I don't feel like I needed to ever end that, that strategy, right? So some of the, I'll call them crutches that we can use to get ourselves to succeed,

• 38:28Speaker 03

  like accountability or temptation bundling, as we've talked about, there's no need to set them aside. There's no need to say, I'm going to use this for a month and then I'll be off to the races and I won't need this tactic anymore. Instead, I think we should expect to use them forever and, and not see that as a downside. It's just that's, you know, we need these tools to achieve our goals and we should keep using them and that's how we get where we want to be.

• 38:51Kim Mills?

  And there's always another good book to listen to.

• 38:53Speaker 03

  Absolutely, yes.

• 38:54Kim Mills?

  You'll never run out.

• 38:56Speaker 03

  That is a wonderful thing about, about entertainment. There's so much of it.

• 39:01Kim Mills?

  So what next? What are the big questions that you're looking to answer now?

• 39:06Speaker 03

  Thank you. That's a great question. I mean, the last year has been truly very focused for my team on the issue of vaccination and COVID-19. And we're, you know, working on some papers right now about that. We've been, we launched a vaccine sweepstakes in my hometown of Philadelphia in partnership with the city government that we designed using a regret lottery, which is a very specific type of lottery that capitalizes on people's fear of regret. So everyone in the city was automatically entered and they could get a phone call that their name had been drawn, but they would have to decline the prize if they couldn't prove they'd been vaccinated. So we were, you know, the idea is how, how much would you regret getting that call, finding out you had won the grand

• 39:49Speaker 03

  prize and having to decline it? That, just that visceral fantasy of the anticipated regret might motivate some extra people to go get a vaccine, above and beyond what you'd see in a typical standard lottery where you're only entered if you're eligible because you've gotten a vaccine. So we've done that and we had sort of randomly assigned zip codes that actually had extra probabilities of winning. So we're working on analyzing that and trying to be able to come out with some policy recommendations for what are the best practices that we can use at this phase in the pandemic and as we roll out probably booster shots and, and as other countries reach the phase we've reached. But, but really looking further forward than, you know, the next couple of months.

• 40:30Speaker 03

  I think we sort of touched on it a bit in your prior question. You asked about enduring behavior change. And I still, even though I gave you an answer that I do completely agree with, you know, I believe in very much that the answer is we keep using these tools. I still study often tactics that an employer or a school or, you know, a gym, you know, an organization that's trying to help people create positive lasting change can wrap around beneficiaries to help them achieve that durably. And so I'm looking into like, what are the tools that those kinds of organizations can offer to their

• 41:14Speaker 03

  employees, their members, their students that will carry them forward for as long as possible? And what are the kinds of features of programming that make it the most effective? You know, is it mindset? Is it social? Are there other tactics we haven't studied yet that do create more lasting change? So I'm really eager to explore that. I'm also really interested in understanding better when people have goal failure, how they stand up again. You know, fresh starts are part of it, of course, and there's other tactics in the book too. But I think recovering from failure is under, it's so important because we almost always fail when we set out to achieve a goal at least once. We have to get back up again if we're going to get to our final destination.

• 41:58Speaker 03

  And I think there's a lot more to know about how to do that.

• 42:01Kim Mills?

  Well, Dr. Milkman, this has been really interesting. I think you're doing extraordinarily important work, and I want to thank you for joining us today.

• 42:09Speaker 03

  Thank you so much for having me. This was a really fun conversation.

• 42:11Kim Mills?

  You can find previous episodes of Speaking of Psychology at www.speakingofpsychology.org or on Apple, Stitcher, or wherever you get your favorite podcasts. And please, where you can, leave us a review. If you have comments or ideas for future podcasts, you can email us at [email protected]. That's speaking of psychology, all one word, at apa.org. Speaking of Psychology is produced by Lee Weinerman. Our sound editor is Chris Kandian. Thank you for listening. For the American Psychological Association, I'm Kim Mills.

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