Interview with Michael Hallsworth, PHD and Meredith Jones [Podcast]

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Show Notes

• [00:00] Intros
• [01:30] Finding Their Way Into Behavioral Science
• [06:30] Vaccine Hesitancy & Conversational Receptiveness
• [12:13] Using Metaphors to Shape Public Understanding of Health
• [17:22] Reducing Unnecessary Antibiotic Prescriptions
• [24:23] Building Behavioral Science into Health Insurance
• [29:00] Insights from The Hypocrisy Trap
• [33:06] Michael and Meredith’s favorite well-designed tools
• [35:05] Outros

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Transcript

Intro:

You’re listening to in Network Nordics podcast series, where we explore health care and technology with experts from around the globe.

Craig Joseph MD, FAAP, FAMIA
Hello and welcome to the network podcast feature designing for health. I’m Nordics Chief Medical Officer, Doctor Craig Joseph. What do vaccine hesitancy, antibiotic overuse and the psychology of hypocrisy have in common? They’re all tractable problems. If you understand how human behavior actually works, and this episode, I’m joined by Michael Hallsworth and Meredith Jones from the Behavioral Insights Team, one of the world’s leading applied behavioral science practices.

We dig into how simple, evidence based communication tools can change clinician prescribing behavior at a population scale. Why the most relatively imperfect doctor may be more effective than the perfectly healthy one. And how metaphors shape patient beliefs about health responsibility more than any education campaign ever will. If you’re leading a health system and wondering why your quality initiatives keep stalling, this conversation will reframe the problem in ways that are both uncomfortable and immediately actionable.

Let’s plug in.

Craig Joseph MD, FAAP, FAMIA
Hello and welcome to the podcast. Where do we find you both today?

Meredith Jones
I’m in Brooklyn, New York, downtown Brooklyn, looking out over a beautiful sunny winter day

Craig Joseph MD, FAAP, FAMIA
Is there snow?

Meredith Jones
No. that would make it not very beautiful.

Craig Joseph MD, FAAP, FAMIA
Okay. That’s fair. And Michael, where are you? You’re in a more in a very different place.

Michael Hallsworth
I’m in a, recording booth in a studio near Times Square in Manhattan. It is, windowless and, quite small to make me sound good. I’m here recording the audiobook version of my book. So there’s a weird, weird timing that we just happen to be, doing this on this very day when I’m in this very strange place.

Craig Joseph MD, FAAP, FAMIA
You say it’s weird timing. I say it’s just, I’m really good at what I do when it comes to scheduling, but it’s probably more of the former. So tell us about your book. So you have a book that just came out a few months ago. I think, and you’re now recording the audio version of it. Tell us about it. The Hypocrisy Trap.

Michael Hallsworth
Yeah, it’s a book about hypocrisy. Why it bothers us so much, how we need to rethink it, actually, because our relentless desire to sort of stamp out all hypocrisy is actually causing problems in society. It’s leading people to have nowhere to go to sort of display those inconsistencies that actually lead us to be human.

And it can lead to us thinking the concept is meaningless because if everything, supposedly nothing, is, and that can lead to a kind of really cynical world in which all that matters is, the degree of power you have and principles go out the window.

So, you know, I spent a long time thinking about this, and I realized that actually, hypocrisy was a way of understanding a lot of what’s going on in society. And, the way we deal with each other.

Craig Joseph MD, FAAP, FAMIA
Well, I look forward. We’re definitely. You’re going to get into it a little bit more. Let me take a step back and let’s talk about your background. So, Meredith, why don’t we start with you? Your interest in behavioral science began in, nursery school. Is that accurate?

Meredith Jones
So in undergrad, I studied cultural anthropology and human physiology. Eventually, those came together to be public health. And when I was getting my master’s, I had to do a lot of research study into different health behavior theories. And they never really, really clicked for me. Like something was always a little bit off about them. And then I took, health economics class, and I learned about behavioral science.

And, I think it was like, finally the this is me. I eventually I found my way to it. And so I’ve been here for almost seven years, and I think that what I really enjoy about it and about April Science, is that it just challenged me to think about public health a little bit differently. I think it really radicalized.

I think about access and making things. And I think it really pushed me on seeing outside of kind of like the more classic public health interventions and approaches like education. And also really helped, I think, reframe kind of individual health failings as, as failings of a system that’s not designed for us, rather than, failings of a person.

Meredith Jones
So I came through, came to behavioral science through public health. And I really love what behavioral science has to offer.

Craig Joseph MD, FAAP, FAMIA
Okay. That’s awesome. So to unpack that a little bit, you said bit, which is, I believe abbreviation of behavioral insights team. That’s the name of the company that you work for. And, as I understand, it kind of started out as part of the UK government. So, Michael, why don’t you tell us a little bit about how you got to, behavioral, science and then also your involvement with the Behavioral Insights Team?

Michael Hallsworth
Sure. So I came at this from the perspective of public policy and how to improve the evidence. We can use, when we’re making policies, when government is trying to make decisions. So back in 2008 nine, there was a book that came out called nudge, which sold a lot of copies. It, generated a lot of interest among policymakers, but it wasn’t very clear how you’d apply any of this stuff in practice.

I was at an organization called the Institute for government, which is like a think tank in the UK, and we were commissioned by the government of the time to say, how would you actually apply this stuff in practice? You know, the thing that we read in the book this interesting. Well, what do we do? And that became a kind of influential framework, which also helped set up the behavioral insights team bit in 2010.

At that point it was part of the UK government. Since 2014, it’s been a separate organization. That kind of expanded around the world and now has around 250 people. I kind of joined the team early on and tried to, you know, put this stuff into practice and show what difference it could make in the real world by running tests as well, showing we can make this much improvement for this, cost. And that proved pretty interesting to people and quite effective as an approach.

Craig Joseph MD, FAAP, FAMIA
All right. Well, that’s super interesting. So you kind of both came from different perspectives, but ended up at the, at the same place. I think one of the first projects that I, that I read about that I think would be interesting to kind of dig down deeper into is, is vaccine hesitancy. Never could it have been more appropriate than now to kind of to talk about that.

One of the things that your group has done is, is work with physicians and other providers about having effective conversations with vaccine hesitant patients. I’m a pediatrician. I’ve had to do this from time to time. Let me now go into all the training that I had to discuss that. Okay. We’re done with that now. So that was all the training as in there was no training.

How at least, in my in my day kind of made that stuff up as, as we went along. So, Meredith, why don’t we start with you? Like, how should you have those conversations? What have you and your team learned about vaccine hesitancy and helping people explain why vaccines are so beneficial?

Meredith Jones
Yeah, that’s an interesting question. I think that we’ve done a lot of different work in the space thinking about ways to increase vaccine uptake, you know, both in improving the conversations between patients and providers and in other avenues. But something that the strikes me as a really interesting project is something that we’d love to find ways to kind of scale is a training around conversational receptiveness.

So conversational receptiveness is the use of language to communicate your willingness to engage with someone who might have opposing views. Someone who might, disagree with you. And you can imagine that with a patient, a parent, or, you know, an adult who is vaccine hesitant. So a few years ago, we worked, with the University of Louisiana, Lafayette to design a training for vaccine canvassers.

And the content of the training was based off of, original work paper done by Dr. Julie Benson and her team at Havard on conversational receptiveness. And so what we did is we use a mnemonic called here. And I can describe kind of the four different elements of that to help them prepare to have conversations that might be a little bit heated or, you know, they might be engaging with somebody disagreed with them.

So the mnemonic here, and it’s that for first heads, your claims to find ways to demonstrate, to demonstrate humility and show that you’re aware of the nuance. So you could, you know, use words like might or most of what you want to try to emphasize agreement.

So while the focus of the conversation, you know, is on vaccines and getting vaccinated, you can also look for other kind of points to agree on and point them out in the way of emphasizing agreement about more than just propaganda.

You know, for example, you’re both concerned about the health of your family members. A sincere acknowledge other perspective. So paraphrasing what others said, but not but doing that in a genuine way, not trying to do kind of a report back that sounds robotic, but trying to do that in a way that that really conveys the sentiment that you hear them.

And then the last piece is reframing a positive. So framing ideas and messages, in a more positive way to express that you have like come to terms with wherever that discussion is going. And so the idea was that we, the training had here’s this pneumonic. Try it.

It was a lot of role playing. Try and get folks ready and prepared for these conversations. But we want to move that into a more scalable model because they think that there’s a lot of benefits. And not just giving people tools to talk about vaccines. Right. But there’s probably a lot of spillover into other topics. So when a patient really wants antibiotics, that’s not the best course of treatment. There’s we can use these tools to have a better conversation.

And it might not change the behavior in that particular appointment. Right. But the idea is that it has built a more trusting relationship that ultimately shifts behavior down the road. So that was a long answer to your question, that I think vaccine hesitancy is really difficult. And in terms of one kind of behaviorally informed conversational tool that you can provide that you can provide providers, I think that it has a lot of promise.

Craig Joseph MD, FAAP, FAMIA
I love that concept of consent. I can’t say the concept conversational receptiveness that, you know, you really have to be in a position where you’re ready to, to hear the words and acknowledge where, you know, both sides are on, on the at least coming from different, viewpoints with potentially different, you know, basic understandings of what’s going on.

It would be great if that kind of got into training for physicians and nurses and all kinds of clinicians, because your points well taken. This is not just vaccines. This is everything. You know, I saw this, medication, advertised on TV, and they said I should talk to my doctor about it. I want it. Why would I not want it? Right. And, so there’s going to be lots of things where that kind of mindset, and coming to the middle, are very helpful.

Michael, you were nodding along. Anything you wanted to add on conversational, receptiveness or other work around that, those kinds of topics.

Michael Hallsworth
I think consent conversation, reception of us highlights the fact that often behavioral science is about taking practices that already exist. Some people doing well and sort of systematizing them, because I think there are people out there who will be doing this stuff already, maybe not thinking about it so much, but they know.

They know it works. Maybe their colleagues copy it as well as a tactic. And I think what behavioral science can do is sort of say why that works, and package up in a way that makes it easier for others to use as well. So it may not be a completely new thing and maybe good practice that already exists, but then is, used more widely.

Craig Joseph MD, FAAP, FAMIA
Yeah, that that does make a lot of sense. I remember as a, as a resident, someone came to me in the middle of the night and said, can you go and explain this to this parent? I’ve been trying and it’s not working, and I’m not sure I did it any better, but I probably came at it from a slightly different viewpoint.

And, sometimes that’s all it takes. Yeah, I do love that idea of kind of systematizing it so that it’s more available to lots of other people. Michael, one of the things that you mentioned when we were preparing for this call was your work with the Robert Wood Johnson Foundation about metaphors and how they can kind of shape, beliefs about health care and health care responsibility.

And so let’s kind of dig in to that. Isn’t it true that, I’m just a patient and I don’t have any responsibility, and it’s just all on the clinician to do everything for me? Is that not accurate? Am I am I misstating anything here?

Michael Hallsworth
So yeah, the thing that we, we did with the Johnson Foundation was around narratives and how people present issues to themselves and to others. So in behavioral science, we talk about framing the idea that you emphasize certain parts of an issue more than others, and that really, really affects how we think of solutions. The different kind of metaphors that we used to talk about, for example, crime or a different kind of issue can lead to completely different natural seeming remedies.

And so it’s the work with Robert Wood Johnson we were looking at how do people think about the responsibility for their own health? This is back during Covid 19, for example, was one thing we looked at, whether it was seen as your is your fault that you got Covid, or whether you were put in a situation that meant you were exposed to other people.
More. This really affected whether people had supportive views around things like paid leave for sickness and so on, how they kind of apportioned blame and so on.

All of these ideas about how we blame some people or we think that some people are responsible, not responsible, are formed by simple kind of narratives that we use about health, and we what we did was basically vary these narratives.

And we found that, yeah, that a different narrative led to a different view about what what who was responsible, but also then what policies are appropriate to deal with the health issue, depending on who was responsible for it. And that was things like the amount of leave people have, you know, other shoe funds. What the role of health insurance.

So zooming out, you know, these metaphors, these framings that we have all the time in our lives influenced what we think is right and what we think is appropriate without even realizing them. And so just simply using different metaphors point people in different directions.

Craig Joseph MD, FAAP, FAMIA
Can you give us some examples of one metaphor that was particularly illustrative of this idea?

Meredith Jones
The narratives kind of asked about, they put they had a character I believe his name was Nathan. He was a fast food worker who goes to a barbecue and is exposed to COVID-19. And they varied in how they frame the causes of and the solutions for his subsequent kind of health and financial situation, the for a fallout of not go to work, etc., etc.

And so, you know, as Michael said, we asked folks about their various beliefs. We presented them with one of four different narratives that had variations. And then we measured whether or not any shifts in beliefs or attitudes or support for some of the policy or broader policy, the policy changes that he recommended, or that he’s invested That’s kind of what they varied on.

I thought what I found really interesting was that maybe this is not so exciting, but like a more middle of the road approach seemed to work the best for a wide variety of folks. So I think that what we found was that people can see the system. You can use a narrative approach, position someone’s behavior in the consequences in this larger system and world that we live in, and people see those things, but they don’t want to fully shift the responsibility from Nathan to the system.

They want it shared throughout. I think that one finding was that narratives that are either all focused on Nathan or all focus on the system didn’t resonate as much. People kind of recognize that there was some shared responsibility among all the different layers and levels. But what I found really promising is that we didn’t see evidence of a backfire effect.

What we were really interested in was that. How does someone’s pre-existing beliefs impact their ability to absorb the new narrative? And what we did not see evidence of backfire effect. And so I think that’s promising, right? It means that even if you have a more conservative audience or a more progressive audience, they can receive a new narrative about something without having a dramatic backfire effect, at least in our experiment.

Craig Joseph MD, FAAP, FAMIA
Yeah. Okay. Well, that’s, that’s actually really important. You don’t want to end up in a worse place than we started with. Meredith, one of the things that you mentioned when we were talking about, you know, different ways of having a conversation was antibiotics. And so let me kind of dig deeper into antibiotic stewardship. I know the team, I’m not sure which of you is working on this is has worked on decreasing overuse of antibiotics and in the UK, Australia, New Zealand.

Michael, this is for you. So what happened? We all know that if you get antibiotics when you’re not, when you don’t need them, not only is it harmful to you, but it can also be harmful to others by promoting organisms that become resistant. So we don’t we don’t want to use antibiotics unnecessarily. So how do you get that message out?

Michael Hallsworth
The use of antibiotics has been increasing in recent decades. And that drives and antimicrobial resistance, which you mentioned in is, you know, a real threat to medicine as we know it. You’ll get people dying of, of, small kind of infections, small cuts and so on. If antibiotics stop working, surgery will become much more dangerous. There have been various attempts to reduce unnecessary use.
antibiotics.

One of the main ways has been to pay physicians to reduce their prescribe of antibiotics. The problem is that it’s like a collective action problem in every individual instance. It may be rational for a doctor to just prescribe antibiotics, maybe because they feel like the patient wants them. It’ll be awkward if they don’t. But collectively, as we do this, we all lose.

And so we thought about addressing this issue in a different way. But drawing on the concept of social norms, and this is where you are influenced by what others do in a similar situation. And there’s evidence that medical professionals may be particularly influenced by what their peers do. I mean, it’s maybe a natural part of the process. Like what?

How do you treat this, this particular case? And so we took the data and this is back ten years ago now in the UK. We took the data on how much doctors were prescribing. And we isolated when people were outliers. You know, they were prescribing much more than their peers. And we told them that fact. We gave them what’s called social norm feedback about how they compared to similar others.

And then we measured to see if you got that lesser, did you end up prescribing fewer antibiotics? Perhaps than someone who didn’t get it? It was a randomized trial. Now consider this. Usually if you come up with this idea and this was done with the UK government, the default would be send it to everyone. Right. Because it’s like a general communication.

We convince them to randomized. And this revealed that sending the letter did reduce antibiotic prescribing by about 1% in overall in the whole country. So England’s prescribe antibiotics went down by 1%, one percentage points as a result. And that was roughly equivalent to the effect they had got from a multi-million pound incentive scheme. So social norms messaging can actually make a difference to real world physician behaviors.

And this approach has now been used in many different countries, has had similar results, and is kind of incorporated as part of the standard approach to antimicrobial stewardship in many countries. It’s not going to solve the problem overall like completely. You need to do other things as well, but it was a part of the jigsaw that was really absent until we did this work, I would say, or at least is what was a major part of the evidence that that led to this, this approach being used in many different countries now.

And the you really do need a worldwide response to this, because the bacteria don’t care which country you’re in, that they will develop regardless. So yeah, it was a really big piece of work for us.

Craig Joseph MD, FAAP, FAMIA
I’ve certainly seen it. Physicians in general are so competitive. At least I’ll speak in the US, but I don’t think it’s very much different in the UK. We’re so competitive, and I’ve certainly seen physicians who have gotten that kind of feedback that you just described. You know, hey, here’s this thing that we want you to do and you’re not doing it as much as this other these other people.

And it’s often, I should say often the few times I’ve seen it happen. It’s very effective, actually, when you get a list of your peers who are doing this thing better than you. So it’s not just your outside of the average, but no, here’s a list of doctors that are doing this thing that we think is good and you’re not doing it as much.

They’re doing it better than you or more often than you. I have seen physicians say, you know, I don’t really believe that this is important. This whole antibiotic, overuse thing that you talk about, it’s all flimflam science. I don’t really believe it. I don’t think it’s important. However, I will not let that person do better than me on anything because that other that guy over there is just no good.

I don’t like that guy. He can’t be a good doctor. And if there’s anything that you’re measuring that’s important, I’m going to beat him on it. Yeah. I’ll prescribe fewer antibiotics just to spite that guy.

Michael Hallsworth
We had to be really careful, though, and make sure that the figures were correct and give some transparency on how we treated them, because you have to do a few things to make sure the comparison is valid, because we knew that physicians care about this stuff and they would question it, and we didn’t want it to be undermined with the idea that it was questionable in some way.

So, you know, to that flimflam point, you’ve really got to underpin it with something real. And if you oversell it, then you run a risk because people may find out. So yeah, this is about good, reliable evidence presented in a reasonable way. I think that works better over the long term. Yeah.

Craig Joseph MD, FAAP, FAMIA
And transparency is really what I think a lot of people are asking for. I’ve never seen a doctor who, when given almost any criticism, didn’t instantly want to reject that and say, well, my yeah, the reason I’m not doing as well is this my patients are sicker, my patients are more complicated.

One of the things that I’ve seen technology really help with is with some of the year now, you can say, here’s a list of your patients who haven’t met the criteria that we’re looking for.

Oh, no, I know that guy and that guy. This is wrong. Your data wrong. These people have had it all. And then being able to kind of like, click through the list and go like, well, let’s open up the chart now. This one’s right. Look, this is where that information would be. It’s not here. So that meant you didn’t do it. That’s really been kind of transformational.

Michael Hallsworth
I would say though Craig, that what you what you need as well is to give people an offramp. The point here is not to sort of say, look, you were wrong because that may not lead to the change in behavior. It may actually much better to provide an off ramp so people don’t have a confrontation, and they can just quietly go and make some adjustments themselves.

That’s some of the evidence we see this this reactance, where you do a public challenge is actually the problem and saying to be really careful about how you, you do that to get to the best place overall.

Craig Joseph MD, FAAP, FAMIA
And that’s why you two work a bit. And I do not, that I can get you 75% of the way. It’s that last 25% that you really need help with. Michael, one of the things that that your team has worked on, or at least bit has worked on is, helping, an insurance company, create an internal nudge unit.

And so you would kind of reference, the book nudge, at the beginning of our conversation. So what’s the nudge unit? And why does an insurance company in Massachusetts need one?

Michael Hallsworth
A nudge unit can be many different things, but in essence, it is a collection of expertise and knows about behavioral science and works to apply that, knowledge to practical issues within your organization. And so, in a health insurance context, you might have instances a bit like the one we just discussed where you’re trying to get to better performance by the health care system.

You know, you’re trying to reduce unnecessary wait times. You’re trying to for example, prevent overprescription of antibiotics and other things like that where this may affect the ratings you get, the way the funds are allocated, all that kind of thing. At the same time, you may also be looking at your health system users and do they understand what they need to be doing?

Well, do they go to preventative care screenings, for example? Do they, take advantage of some of the benefits that are on offer in both those kind of categories when it whether it’s health system focused is in the people running the health system, whether it’s in terms of people delivering care or the people receiving care, there are many opportunities to influence behavior.

And so what we’ve done over the last five years is helps. Blue Cross, Blue Shield, Massachusetts build a nudge unit that can can do these things. They can provide the internal advice to other parts of the organization. For example, you know, how do you do marketing and so on that ensure that you’re doing it. So it’s aligned with behavioral science, but also running projects themselves to test and improve how the insurance company itself functions.

And I think that mentality of bringing in, an experimental mindset, thinking we don’t just do something, but we also try and think about how we can test it and then continually improve, really kind of pays off. This is something we’ve helps them do. And we’ve seen, you know, results in a whole range of areas, whether it’s, you know, colorectal cancer screenings or collecting demographic information, stats in prescriptions.

And also say, you know what? Sometimes we found things that didn’t work. We identify problems. So one example might be one time we included a deadline, saying, please respond. Bye by this point. And that can often work. But the realities of implementing things may be quite different. So for example, what we found is the delays in the letters actually being sent out in the postal system meant the deadline had already passed for some people at the time they got the letter.

And so obviously then the deadline made it worse. And we, we just noticed this stuff in the, in the data, the what is going on here? And we eventually pieced piece it together that actually deadlines can backfire because the postal services is unreliable as a crucial kind of insight. But we wouldn’t have got it if we hadn’t been testing to see how these communications were landing.

So basically building that behavioral science capability in, into the way a health insurer works can get some really tangible outcomes.

Craig Joseph MD, FAAP, FAMIA
Yeah. Hit it with a real world gets in the way of the ideal workflow.

Michael Hallsworth
This really happened once about 15 years ago. I actually was in the UK Tax Authority, and I was running these experiments about how to pay, how to get people to pay the taxes. I spent ages setting one up, and then two days before it was meant to happen, the department ran out of paper for the first time in its entire never happened before since they can send any letters, say they’ve forgotten to order paper. I was like, you know, you cannot anticipate some of this stuff.

Craig Joseph MD, FAAP, FAMIA
That sounds well, it’s good to know that it’s not just in the United States where things like this happened.

Michael Hallsworth
Yep. Incompetence everywhere, I don’t worry. Yeah.

Craig Joseph MD, FAAP, FAMIA
Oh it’s great. Well let me. Well, well, why have you why don’t we talk a little bit more about the hypocrisy trap. Are there are there areas of that of your book that, are more specific to health care that you would say, you know, this really hit home with regard to how hospitals are run or how physicians communicate with their patients.

Michael Hallsworth
Yes, so one example that comes to mind is I talk about how sometimes we like hypocrisy or we think it can be effective. And so I talk about the relatable hypocrite. And the example is from, health context, where there’s some evidence that some doctors are really health focused and advertise how healthy they are, and they have an active lifestyle and all these kind of things.

The evidence shows that people who are overweight or obese actually will avoid those doctors and find them less effective. As advocates for losing weight, because they these people feel like they’re going to get judged and looked down so that you will avoid that conversation. Avoid those doctors, because those are design hypocrites, right? That they’re doing what they’re preaching, but that actually makes them more unrelatable. And like, they can’t.

Craig Joseph MD, FAAP, FAMIA
Wow.

Michael Hallsworth
Sympathize with the kind of the struggle of things. So actually they haven’t was that maybe you’re not completely perfect yourself. You can have a more constructive conversation because you’re not seen as unrelatable. Y

ou often get this in the kind of climate advocacy space. We have this thing called do-gooder derogation where, yeah, we don’t like hypocrites, but actually the person who’s super consistent, super sustainable, incredibly healthy is also not the best advocate because we can’t relate to them.

Michael Hallsworth
And we they make us kind of feel a bit bad. So yeah, it comes up in this instance where sometimes folks, you can feel like not necessarily the right thing to do, but it can make you more effective.

Craig Joseph MD, FAAP, FAMIA
Yeah. What I’m taking away is that I should go get a hamburger and some french fries.

Michael Hallsworth
Yeah I think yeah, absolutely.

Craig Joseph MD, FAAP, FAMIA
That is that is that the wrong message? Is what I’m saying right?

Michael Hallsworth
Yes, is what I’m saying all right. What I actually what I’m saying is it can work the other way as well. So if you are someone who is advocating for something that you maybe someone suspects you’re not doing yourself, what you should do is this tactic called honest hypocrisy, where you acknowledge this and, you say that you think it’s important.

You don’t always manage to live up to it yourself. And here, but here are some tactics to make it more likely you can live up to it yourself. Whereas if you just pretend everything’s fine, you don’t acknowledge the struggles and the issue, and yet yourself, you’re not doing it. That also can be a problem. So yeah, there are many tactics we can use to try and be more consistent with our goals.

And in the book I talk about how we can do that, like setting commitments for ourselves to make it more like we follow through, or even this tactic called induced hypocrisy, which is where you do something like you get someone to commit publicly to a, an issue. Like maybe you could say everyone should, I don’t know, get, screened for a particular disease.
And then in private, you, you remind people of all the times they didn’t do that. Like, did you did you get a flu shot yourself? You just made it. You just made this big statement saying everyone should do it. And there’s some evidence that if you do this, people change their behavior. As a result, they come into line with that public attitude, they stated.

But the key is don’t confront people in public, because if you do it in public, you get that kind of reaction. So I spoke about Craig, whereas with doctors confronting them, you need to provide this off ramp. If you do it in public, it can backfire. And you say, well, maybe I didn’t really care about that anyway, and I’m just going to keep what I’m doing, doing what I’m doing.

You do in private, you give people space to reflect, and then that’s more likely to lead to change.

Craig Joseph MD, FAAP, FAMIA
Yeah. Oh, that’s, that is excellent advice. Well, we have gotten to the end of our time, and I always want to, end with the same question we ask our guests, which is, is there something that’s so well-designed that it brings you joy and happiness whenever you interact with it? Meredith is nodding your head. So, Meredith, go ahead.

Meredith Jones
Yes, I have a toddler. He’s very, very messy. And they have these bibs now that are pretty ubiquitous. They’re everywhere. But every time I put this bib on him, I get such a deep sense of gratitude because it’s like a bowl at the end of it. And so it catches, I would say like 70% of the mess that he’s going to make.

And not only that, he actually loves putting it on because he knows it’s almost the second bowl after his dinner. Like there’s the dinner on his plate, and then there’s the dinner in his bib. And every time I put it on I’m thankful for whoever made it.

Craig Joseph MD, FAAP, FAMIA
Excellent. All right, Michael, anything come to mind?

Michael Hallsworth
The first thing that came to mind was the kitchen knife I use. But then I think that may seem a bit weird, because the handle feels right. Right. So I’m actually going to say the front cover of, my book, which actually is really a beautiful design. That some call Jack story created, about this kind of interlocking pattern in of blue and white hands pointing each other. I think it’s really, really, quite satisfying to look at.

Craig Joseph MD, FAAP, FAMIA
Excellent. Well, I think both of those answers, knife that feels good in your hand is completely acceptable. So we could have gone with that, but, I think the, the cover design of your, of your book is, is equally good. Well, Michael Holsworth, Meredith Jones, thank you so much for joining us. I think we learned a lot.

Craig Joseph MD, FAAP, FAMIA
There’s a lot to, contemplate there. And, Michael, good luck with your book. I hope it gets continued. Good reviews. I know already you’ve had some and, you get a lot of people thinking about those ideas.

Michael Hallsworth
Thanks, Craig. I really appreciate that.

Outro:

Craig Joseph MD, FAAP, FAMIA
Thanks for tuning in. We hope you enjoyed today’s episode. For more on Hull’s worth and Jones, follow them on LinkedIn or see some of their work online at B-team. Also, you can find Doctor Hallsworth’s latest book, The Hypocrisy Trap, for sale online or at many bookstores.

Check back for more episodes of Designing for Health wherever you listen to podcasts or on Nordicglobal.com. We’ll see you again next time on Designing for Health.
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