Priming a town with mirrors

Cognitive dissonance research suggests that magnifying the gap between how a person really looks and their ideal state may lead to behavior change. I had the idea of placing full length mirrors all over a community so that overweight and obese people could see themselves the way others do. This is not to be cruel — it may lead to action such as eating smaller portions, exercise and so on. If I add a leading question to the mirror it may further increase temporary discomfort — and change.

Reminding others of past failures

Professor David Sprott wrote a paper in 2006 about how to motivate health-related behavior change. He suggested that the health care provider remind the patient of past failures, then ask what the intention to change is. This goes against the feel good counseling we read about in popular press.

The rationale is that an overt confrontation with past failure followed by intentions questions will increase cognitive dissonance. “I want to exercise everyday to feel healthy. I have failed to exercise. Should I continue to fail or exercise?”

Will you remember to pose motivational questions today?

The question-behavior effect results in changing a person’s behavior merely by asking a question about their intentions. Researchers found that if they ask people who belong to health clubs if they intend to go to the club today, a large number did this compared to those not asked the question. It is interesting that one need not answer the question to be motivated by it. The question “flies in under the radar” of arguments.

Another example by Morwitz et al. showed a more than 35% increase in automobile purchasing after asking 40,000 adults their intentions to buy automobiles. The staggering sizes of the effect are usual. 

What does this mean for public health?

I have started a list of motivational questions. Please feel free to add to the list.

1. Will you eat breakfast this morning?
2. Will you eat an apple this afternoon?
3. Will you sleep at least 7 hours tonight?
4. Will you go on a walk for 30 minutes today?
5. Will you take the stairs instead of an elevator each time today?
6. Will you floss your teeth this evening before going to bed?
7. Will you spend an hour today on your favorite hobby?
8. Will you sit down for dinner this evening with all your family members?
9. Will you drink 6 full glasses of water today?

The daring decision to let kids decide

When parents try to control their child’s eating practices, they unwittingly tantalize the child. Thus parents strip away child learning to self-regulate caloric intake. Research children start out with the ability to regulate eating based on the caloric density of foods – a skill taken away by parental controls.

E.M. Satter believes that parents must learn to make the best foods available and trust children to make correct decisions https://ellynsatter.com/about.jsp. Considerable research backs her up, though this flies in the face of conventional wisdom about parental responsibility. How can we cross the bridge?

Parent Eating Restrictions Cause Disorders

Many parents are frustrated when they try to promote so-called “good” foods such as fruit and vegetables, and restrict “bad” foods high in fat and sugar. Directive styles of teaching kids about food usually have unintended consequencesthat result in their wanting the forbidden foods, and disliking the very same foods parents want to promote. Psychologists call this phenomenon is also called reactance or the boomerang effect. Fisher and Birch give more explanation
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2548290

Consider that these food lessons set up eating habits for a lifetime. Although it may be hard for parents to accept, directives will hold back a child’s ability to exercise self-control over food in later years. The trick is to teach kids to make the best choices, rather than to choose for them. Research shows that kids learn more from observation of peers, parents and siblings than they do from parental controls.

Crazy boomerang effect

We have all experienced that feeling of wanting to do the opposite of what others expect or demand, even when it would be the clear best action for us to take. On the other side, we watch with amazement when our friends or family members do the opposite of what we ask. This is the boomerang effect, and psychologists know it as reactance theory.

Reactance theory gained some popularity back in the 60s when Brehm published. Then it disappeared until the late 1990s when communications experts rediscovered it. Perhaps reactance can make the greatest difference in public health, where the audience views messages to change behavior as threats to freedom, motivating more bad behavior than before. The unintended consequence of many health messages is to weaken public health.

Consider that the US spent over one trillion dollars on the war against drugs forged by Richard Nixon. Much of this was in public health messages. The war has been over for a long time. Drugs won. Teens reacted to authoritarian anti-drug messages the same way they do to a “hard to get” person of the opposite sex – they got turned on, not off.

Parents cause child obesity

Child obesity is a major problem in industrialized nations, increasing two to three fold in the last decade. Child obesity leads to adult obesity, along with high blood pressure, Type II diabetes, social scorn, and premature death.

A growing body of research pinpoints the role of parents who unknowingly contribute to the problem — often by their efforts to restrict food consumption by their children. How can this be? The Center for Childhood Obesity Reserach at Penn State demonstrated that parents restrict access to unhealthy foods, pressure kids to each fruits and veggetables, and limit intake of total food. This results in greater child preferences for restricted fatty and sweetened foods. See this paper for an example.

Behavioral economists have long focused on unintended consequences. Infants are born with the ability to self-regulate their caloric intake. Parents unknowingly override these mechanisms and teach kids to love the most harmful products. A better parental approach is to provide access to fruits and veggies in the household, and to model correct behavior by letting kids see them eating the right foods in proper  portion sizes. “Do as I do” trumps “do as I say,” regardless of good intentions.

Who is behind all this question-behavior research?

In 1980 Steven Sherman demonstrated the potential of using questions to motivate behavior as a purposeful activity. Since then, two groups of researchers built the knowledge base. The self-prophecy effect group led by Sprott and Spangenberg concentrated on socially normative behaviors such as improving health. the mere-measurement effect group led by Fittzsimons, Williams, Block and Morwitz focused on how to affect the purchase of consumer products. A few years ago, both goups came together to share experience, and called this the question-behavior effect. This synthesis was described in this paper.

I am focused on how QBE can aid public health efforts. Many well-meaning interventions are based on sound theory, yet they fall short in marketing — getting the message across. QBE may be a way to marry public health to markting, or it may need other tools.

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The answers do not matter

As a researcher, I always believed that the purpose of a question was to get an answer. The answer was the thing. With question-behavior effect, the question is all that really matters because the goal is to motivate a behavior, not to get an answer.

This seemed a minor point until I realized that we could scale up a communications program by just asking the right intentions questions of the right people. No need to wait for their answers.  Reading or hearing the question alone is sufficient to start the mental processing and access to attitudes, leading to a behavior shift (at least in most cases so far).

This aspect of question-behavior effect clearly removes it from the realm of marketing researchers, and delivers it into the the hands of marketing practitioners. Speaking as a researcher, the most successful marketers are action-oriented — they want a behavior such as consumers selecting their products. On the other hand, most marketing researhcers seem more fascinated with asking questions and getting answers.  This is a less aggressive form of action-orientation.