BI podcast transcription: Hertfordshire

[00:00:10] Welcome to the latest episode of The Nudges, the Social Good podcast from the Local Governments Association. My name is Rhain Gladman and I'm the program manager for our Behavioural Insights program. And the aim of our podcast is, as we have explained before, is to demystify behavioural insights and help counsellors and officers who are looking to start their own behaviour or insights projects to give you some pointers and give you some practical examples of what other counsellors are doing in this space so you can start on your own projects. So I'm here today with Professor Jim McManus, who's the director of public health at Harvard. She counts council. I'm Michelle Constable, who's the head of the Behaviour Change Unit here at the council. Welcome, guys. Thank you so much for your time this afternoon. I'll leave it to you guys to introduce yourself and your background, your careers to date. And how did you become involved with behavioural insights work?


[00:01:06] Well, by background, I'm a chartered psychologist and I came into public health.


[00:01:12] I'm one of the things I have felt for a while is that the use of different types of behavioural sciences, behavioural insights, behavioural psychology, various other things has been quite lacking, I think, in public health in some ways. So I felt there was something missing. UNset about looking at how it could enrich what we do and I've been working on now for some years, including the seven years opinion whole future.


[00:01:44] Yeah, I'm a health psychologist by background. I've been working in public health for the last 10 years. My degrees are in health psychology and the application is very apparent and the need within public health to look at the behavioural aspects of the approaches that we're taking. And I've been working with Jim on this agenda in a behaviour change role for the last six years now and more recently in this new unit that we've just developed and set up in half a chair.


[00:02:18] So lots of experience and expertise in the room with us, which is fantastic. So first question really for me is how would you explain behavioural insights to somebody who is completely new to this? So someone is setting accounts or they may have had a colleague talking about nudge theory or the nudge Birchall behaviour change and how would you explain it to them, somebody who was just starting from scratch?


[00:02:41] I guess I would start by saying.


[00:02:44] Most of what we do in local government sooner or later came to some kind of human behaviour. And understanding better where behaviour fits in to something like how people use a school or how people navigate their way around a library or how people use social care. We'll help you design and commission your services better. And there are fundamentally different components to behaviour. Some of it is conscious. Some of it is not conscious. And just as you need different things to build a library. So you need them electrics plus heating plus equipment. So you need different things to build. A response that includes human behaviour and behavioural insights is one of those things where you can look up and analyze and break down behaviour and look at what types of things different types of people are likely to do in different situations and then devise different means of addressing that to get the kinds of behaviours you want out of it. And that for me is a who reason. It should be a core part of what the council does.


[00:03:56] I guess here is the council we are involved in people's lives in people's places is likely. So I guess we are good at, you know, that human part of behaviour we are going to come up against time and time again. So it's a really good point.


[00:04:09] Yeah, I think the key is that many of the aspirations of the organization rely on behaviour in terms of whether that's the culture in which you're working in and staff behaviours or resident behaviours. And that applies right across the organization. It's not just within public health, it's within environment. It's within our resources teams. It's within children, an adult social care. And the conversations that we're having and, you know, across Hertfordshire County Council involve all of those different directorates and everything that we rely on. Nice teams already alluded to does come back to an aspect of human behaviour so we can have the best service in the world. But how do we get people to use it and how do we get people to engage with us in the way that we want to?


[00:05:01] Bearing in mind, can you give the listeners some examples of behaviour change projects that you have undertaken in the county? And what was the behaviour you were trying to change?


[00:05:12] Well, this is an old one. Michelle was leading in all the new ones, but we moved about 20 percent of people out of using lifts in county council buildings. The outcome of that was our electricity bill went down and our carbon tax went down. But actually, the outcome for staff was that people felt they were using the stairs more, they were having more conversations going up and down the stairs with their colleagues. And actually, it it did slightly shift the culture a little bit because from that we started building on walks, organized and semi-organized walks, four different teams and a number will do them outside the building. So we looked at people's we got step jockey in, actually, and we did a number of things, including calorie labelling, using behavioural insights to shift people off, using the lift and identify what messages would work and what strategies. And we actually put counters on the left. The reason we know so many people change is we put counters on the lifts and we shifted them off. And that was an early demonstration project to demonstrate how well we could do that. The second thing we did was and this was used to build some appetite. We actually do some work on staff health where we actually did some stuff around taking a break, some stuff around stress, some stuff and how you design your working day and build a culture. So we started there because we wanted to show that there was something tangible we could do.


[00:06:57] I know we use behaviour change projects all over the place. Some of them are still aimed at staff. So I see, you know, in one of our services is getting staff to to ask the right questions and fill that out forms and fill the right documents in. And sometimes that leads to redesigning the process. So these things can cut both ways. And we're currently scooping how we use different types of behavioural sciences to improve people's smart working. So, you know, the idea that you can work from anywhere in the council because the bulk of it is about culture and culture at the end of the day boils down to behaviour and beliefs.


[00:07:36] So can I just ask the follow up question about getting people away from the lips? Did you use kind of visual and communication things to guide people towards the stairs? Like, what did you do here?


[00:07:48] Sorry, Charlie. Relabelled all the stairs now. Relabelled the stairs. Okay.


[00:07:53] And if you you may have noticed when you were coming up in the building that we've got still got covered in labels on the stairs. Yeah. Nancy. Yep. So we covered label them. We also put signs in the left to me, put signs outside the lifts. And we put footprints on the floor to guide people to the. I mean, they're not there anymore.


[00:08:14] But we put them there and we moved people. And then we did things like team talk. So we have on the inside tools of toilets in the county council building. We have news at your convenience. Pun intended. And we used several of those to say, you know, if you do, this is achieved. And here's a number of calories. And then we got a few champions, sugiura. I mean, I I think have not used the left in a county council building since two thousand and twelve.


[00:08:52] Sue and I try not to use lifts any way below the seventh floor.


[00:08:58] So that's what we do today. Any change? There was a kind of multiple sort of technique, visual word of both culture change, getting a few people to leader. And actually the people who wanted to shift and be more active friend were great leaders of culture change.


[00:09:18] I guess it forms that new habit, doesn't it? It makes a new routine in your workday. You go straight to the stairs rather than traditionally you would would've gone to the left. It's form in your brain. A new habit. Yeah. I of stock like that stock for me since 2012.


[00:09:33] So you've seen that with staff and it really works and people know make a joke of it. So it's part of the culture.


[00:09:39] No, she did notice we did come up the stairs on the way and actually to the to the meet with you guys today. There was no left involved. So yeah, it just changes the social norms doesn't it?


[00:09:49] Becomes normal in the organization that people are not relying on the left and they are actually going to, you know, use the stairs. And then if people see other people doing it and automatically follows, that's normal behaviour.


[00:10:01] Do you see any examples? I guess that's a really nice example. Like, say, working with staff, I know a lot of your staff will be residents of city as well, the council. But do you have any examples of working with residents outside of the county?


[00:10:15] Yeah. So what we've tried to do is you tried to look at all aspects of how we engage with the public.


[00:10:21] And we developed a program that was launched in the spring of 2018 courts never too late to be active, which was a physical activity campaign that was aimed at older adults, which terrifyingly means over55s. And what we've done was we apply behavioural science to every aspect of that. And we took it from being a information based campaign to actually ended up being a multi-layered intervention, which was really, really exciting to work on. So we the idea was to get people who were physically inactive, to do some activity and people who were doing some activity to do more. So we were looking at how we could engage with older adults. So we use a variety of different methods. We used social marketing approaches and we looked at how we might actually target older adults. So we realized that through Facebook that was the best way to engage with them. We also looked at using access to our Daily Mail scores, using motivations around young people in the schools who are doing the Daily Mail, bringing in older adults as part of our launch, making it easy for people to access the campaign, having people sign up on the day. But there was also a much broader launch around that. And we looked at incentives around schools and incentives for people taking part. And it was a fantastic campaign and it was hugely successful. And we'd originally anticipated maybe 500 people signing up and actually ended up with around 4000. So it was a real success story. We also, though, didn't just look at the behavioural insights aspect. We applied the cambie model to this, which is part of the behaviour change will. And we looked at the evidence and we applied behaviour change techniques to this that had been identified in successful physical activity campaigns for older adults. So it really targeted debt. We looked at social support for people so that they it was attractive for them. They could go along with a friend. Free activity passes to be able to access local facilities. And it was a really fantastic campaign and they exceeded our expectations.


[00:12:45] And moreover, when people did report back and we had the evaluation, their work was a change in behaviour. People were reaching their goals, which was just fantastic. So that was a much more residents based approach. And it was so successful. We're going to we're looking at rerunning it this year.


[00:13:02] So is that with The Daily Mail scores? So it was encouraging adults to join in with the kids while they're doing the run? Exactly. How did that work?


[00:13:12] It was that was just amazing. So we thought we were looking at people's motivation to get involved. And we knew that The Daily Mail was a really good way of accessing older adults. So an invitation was sent out through the young people for them to bring an older adult into school on the launch date. And that was so successful that a number of schools have actually continued to do that. So whether people bring, you know, somebody else in to do it, and it just it had a double whammy, if you like, because not only to support the launch of this, but it reinvigorated the daily Meile activities as well.


[00:13:46] Okay. So that's something that's happening anyway. A set time and it's about. We encourage more people to access that thing that's already happening. Absolutely. Ised and this thing nice about the inter-generational, you know, the role modelling, they're the kids or my saying that we do run. So come on, you come and do it without. Yeah. You can still do it as well. I like that. That's fantastic. So what kind of work did you do in both of those examples? Really to understand the behaviour, to understand what was driving the current behaviour by using the left or, you know, not being active over55. Can you speak a bit more about what activity you did to understand the behaviour with the physical activity campaign?


[00:14:30] We took insights from Sport England. There's a lot of work that's been done there. So we were looking at that. We also used our own hearts sports partnership and we had information that we're able to glean from there. We ran focus groups with this with this group around what we were trying to achieve around the messaging that we were using and which was invaluable because actually we did go down completely the wrong track without those insights as well. And so really we use the networks that we had. We also use the behavioural science evidence base because it was really good work that was done, systematic review that was able to help us identify the behaviours that we need to be targeting and also work on motivational messaging. So we used people were receiving a couple of messages a week targeted to their motivation for joining the campaign. And we looked we tried to very much hone in on people's own aspirations and motivation for taking part and maximise that to get them to engage, to change their behaviour.


[00:15:37] And in terms of the staff and the lift example, is there a way you kind of understood why people were not taking the stairs or, you know, sedentary at work?


[00:15:49] Yes. I think what we learned was, I mean, when we go in step jockey, they did a whole lot of talking to people that did a survey. They did some focus groups. And then they actually put sensors in the lift because they were they were part of a randomized controlled trial that they were running through lot videos years. And we baseline the number of people using lift. And what we learned was that people would like to. Do something that improve their health. Do something that was sustainable. Give them a little break from the office routine. But also that there were we found a number of people who actually were quite concerned about their fitness, but were to be really put off by going to a gym. So when I go to gym regularly, but it takes me a while to realise that when you do walk into a gym, everybody's too busy taking selfies of themselves in the mirror to bother looking at what you're in fact, you're not wearing the latest gym care, you know, and but actually getting to that point is quite scary. And this was a bit more sustainable and a bit bit of a way of easing into it. And that kind of moved us over after too kind of beginning to look at, I see understanding what people wanted before we did anything. And. Michelle, you may remember this, we trained up all our comms people in using proper social marketing methods. So some saw a lot of our big social marketing health programs actually do a lot of that background research know and proper behavioural analysis before we begin to do that kind of social marketing. And thus I think he's had has paid off big time.


[00:17:37] If you have an example of when you use that approach to social marketing recently, I don't know when you would use all of your bump.


[00:17:46] Example personally. So love you.


[00:17:50] Bump was a campaign that we designed with women who were pregnant and who smoked and their partners and families about getting. Women who are pregnant and their partners and families to stop smoking. And we developed a series of very targeted communications, very targeted messages. So, for example, for grandparents who smoke around moms to be and love you, Bump was actually. Named by women who were pregnant and the comms officers worked with them, developed the messages, find out what would work for them, find out what would turn them off, tested them, refined them, went back and kind of launched it and worked really well. I mean, our rates and of smoking and pregnancy are lower than the rest of the country and they are continuing to fall. And we've developed a new program with with women, which has been quite controversial for some people. But it's the incentivizing giving up smoking. Most people like it. We've got cross-party support for it. But that has come out of a two, three year programme of work on reducing smoking that has been informed by Buth analysis of the behaviours we want and the reasons and using things like the cambie model, but also designing the Combes.


[00:19:18] So there's several angles there that you're using, there's there's angles in terms of your own staff and encouraging behaviour change in your instar. There's actually working with your comms team to lead a behavioural led social marketing approach to your communications that go out there to local people around various public health issues. And then there's the work actually out there directly with residents. Those kind of the interventions, the randomized control trials, etc.. So all of that work. So what are the key lessons you've learned through doing this type of work over the past few years? Because you have got that good track record now. You've done a lot of this stuff. What are those key lessons that jumps out to you? Really?


[00:20:01] I think for me, one of the key lessons is that we need to collaborate and that's we need to be working with partner teams, partner organizations with our residents to really understand and co-produce different interventions, because otherwise we could end up doing lots of good things, but absolutely targeting the wrong places. And the other thing I would say is, particularly with our comms teams and other colleagues who are working in behaviour change, whether it's recycling and environment and, you know, or other areas of the business, none of us are experts on Iran. And by working together to develop this agenda, we can really, really have a much bigger impact. And bringing together those various skill sets is incredibly powerful.


[00:20:55] It's vital, isn't it, to survive? Cooperate and join up all of our experience and resource as well. Resource must be absolutely vital. And I think that's the case now. Yeah, yeah.


[00:21:05] But I mean, what we dont want to be doing is we dont want to be reinventing the wheel. So I think in the next stage for us in terms of understanding is how can we work together as local authorities across the country to understand what's best practice, what's working, what's not working, so that we are maximizing, you know, our resources at this time.


[00:21:26] I do agree with all of that. And I guess her dad.


[00:21:32] If you're a chief officer trying to do this, I'd probably add several golden rules, the first of all is you need to treat this like any other approach to improving core business. It is a set of two behavioural sciences, behavioural insights, the various varieties of psychology. Another. Another bit suicides are a set of techniques there to help you do business better and serve your residents better and serve your staff better. That means you need to discern which ones to use in which situations. That means you need some expertise. The number of people who've tried to sell us off the shelf solutions that wouldn't have been right for us. Now you need to do an in-house expertise. Who can really understand the organization and move with it. You need to treat it like any transformation exercise. So you need resources and you need some leadership. You need to really hone down on what it is you're going to do. So people will come to you with all sorts of things where they need improvement. But what they can't work out is, well, is it a behavioural thing you're trying to change or is a process thing or is a system thing? So if you are going to as a counsellor approach behavioural science, you do it with an improvement head on. Or you or I see you make false starts. And we did. And then I think you need to get the right kind of expertise on things, but it doesn't always sit in public health teams. So if you've got a public health team that's got a very medical model, biomedical individualist model, don't expect them necessarily to have many psychologists in, you know. And it is not about giving people information. So it is very easy to make all sorts of mistakes in this. And we made some of them ourselves to go round. And most people will try and sell you an answer. You should treat with a dose of scepticism, because what you're trying to sell you is their view, a more behavioural insight. Strict behavioural insights are really good for some things. They're entirely the wrong method for others and vice versa. Not the key thing.


[00:23:52] Yeah, I do agree with that. And I think it's about finding the right solution for the problem that you're trying to solve.


[00:23:59] And by taking a broader approach, it gives you the flexibility to be able to do that, to be able to look at how you can come up with the best solution to the problem by bringing together a variety of expertise and working together using the best evidence that's available from all of the different aspects and really coming up with a meaningful solution. But moreover, it's then evaluating the impact of that so you can actually demonstrate the change that you've made.


[00:24:28] That was going to be why my question actually, which I was even hitting out around this evaluation of impacts. What have you learned about that? That's obviously can be quite challenging in these projects. How do we evaluate the impacts of your behaviour change projects?


[00:24:43] I think you have to plan the evaluation from the beginning. It's not an afterthought. We need to be thinking about what we're evaluating because standard evaluation processes may not be the right ones. If we're looking at behaviour change, of looking at increases in, I don't know, some confidence to be able to go out and take part in some kind of fiscal activity or whether it's we're trying to increase somebody's ability to do things when we need to think slightly more broadly about what we're actually measuring and look at the psychological and behaviour change aspects of that and build them in at the start.


[00:25:25] It's easy working in a local authority to feel intimidated by people who have more knowledge than you do. So you will have people who will come in and use all sorts of sciencey words to get you to buy their product. And it's the same with evaluation.


[00:25:41] You will find an awful lot of people who will come in and who will overthink facts in the words of our next chief executive, John Wood, who retired last year over boffin.


[00:25:52] And if you you know, I know I have I have John ringing in my ears all the time. Is up on my buffeting this too much? Simple. Yeah. Keep it simple. And you do not need. I mean, you're not aiming to publish an evaluation paper that will stand up to systematic review standards. You know, in a peer reviewed journal with the highest impact factor in the work, because most people look at the moon of a clue. Well, I'm in anyway and is not fit for purpose. You're looking at what difference did this make? How do I measure that validly and meaningfully? Performance indicators and output indicators are one way of doing it. Outcomes for people in the organization or another. Financial hour a third. I've never come across a project that has been evaluated well without using all of those methods in train.


[00:26:46] And you know, you don't need to sit there talking about knowledge creep and double hermeneutics in order to be able to. What you need is a good, solid evaluation plan and not one of the spinoffs. Now, as we've actually invested in evaluation in supporting the organization to evaluate better, because if you do so, is that in terms of training its staff around how to do evaluation or resource several things, we've actually got a small evaluation team. Okay. Michelle. Michelle, one of the things Michelle said and forgive me, put words in your mouth is she needed an evaluation person to evaluate whether any of these behavioural projects were any good.


[00:27:32] And the evaluation team, which has two people on the phone, food director.


[00:27:40] Basically go around supporting people to design evaluation measures for their projects. They've done an evaluation kit which is actually being used by the voluntary sector and other agencies. And it's a way of helping the organization improve by being able to point validly and robustly to something that a project achieved or indeed failed to achieve. Which is just as important.


[00:28:04] So that is all about people to all this is public health. It's actually a core business improvement, I think.


[00:28:14] And I'll just add to that that what we're actually trying to achieve is, if you like, a cultural change within the organization where we are looking at embedding behavioural science approaches as as the norm. And part of that is evaluation. So we're looking to upskill people in both aspects of that. So looking at how people can apply behaviour science and take those views in the work that they're doing, how we can support them to do that. But part of that means upskilling them and working with them to do that. Because when people are unsure or if they're if they don't have the confidence to apply these methods, then we're not actually getting the best evidence out at the other end of program. So we need to make sure that we have a really rounded approach to support them so they're able to do their jobs.


[00:28:59] Really important. Very important. So my next question, Mary, it's the start of a new decade, the 2020s. Unbelievable. So if you think forward, you know, in 10 years time, if we're coming up to 20, 30 in local government, what do you think behavour insights will look like? What will the state of play be? What do you think the future trends for local government in this space could be?


[00:29:24] I think for me that the momentum around this agenda is growing hugely. There's so much interest. And even within the last few months where we've established the behaviour change unit, the interest across the organization is huge. And the engagement with this and the potential of it is enormous. So for me, I think it's going to become into business as usual, which is exactly where we want it to go. But there is a journey to go on across that period of time in which we are working with people in supporting them to understand the benefits of this and and demonstrating the value of the work that we're doing.


[00:30:05] Yeah, I'd agree with. I mean, I think it could go one or two ways.


[00:30:10] What I would like is to see behavioural insights, behavioural change, behavioural sciences, even things like leadership psychology being core business as usual.


[00:30:23] And when you think back, you know, 20 years ago, our approaches to data analysis were very different as we've adopted things. So that's why I would like to see I can see that happening if people think about what behavioural sciences they want to use.


[00:30:46] If people discern carefully and if people choose and use the right ones. Because if they do that, the more likelihood of success. And actually, if they realise that you won't succeed in everything.


[00:31:01] I think the other way it could go is that.


[00:31:05] People will believe some of the hype from companies trying to sell them the wrong thing. It won't work and they'll dismiss it as the latest fad. And I've seen that happen in a few places. You know, I've seen a few people saying to me why it doesn't work, does it? And it's like, well, that's probably because you've picked the wrong thing. I mean, you how many times have been ruined to block without other things? So. The work that the LGA are doing and the work the Behavioural Science and Public Health Network are doing are about equipping councils to do the right thing and not just. Pick the first thing that comes along that you think, could I do.


[00:31:46] It comes back to understanding the problem, doesn't it? That's where all this comes back to. You know, if you understand your problem and this work is slightly front loaded, it's easy to come up with a solution. But if we don't understand the problem in the first place, then we're not going to find the right solution.


[00:32:03] I think that's why your your work to set out and understand the behaviour in each of those instances you talked about so thoroughly. It's been so vital to the success of those projects.


[00:32:13] I agree. And I mean, if I look at sort of recycling behaviour. Then I think behavioural insights have probably been underused in art. And if I look at health behaviour, I think we're still working on old fashioned biomedical models will give people information in the Russian elite user behaviour Mustafa's online. Women don't know about you, but my brain switches off the minute I walk into a supermarket and I go on autopilot. So getting people consciously to engage with healthy eating is is actually a very different kettle of fish than the old biological. And there are there are options here for behavioural insights, but also for other things to kind of work. And so we really need to rethink so much better.


[00:33:03] And this is why it's important to understand the system that we're working in. So we have to understand the you taking your example of going into the supermarket. But we need to think about the wider system so we can tackle one behaviour. But we do need to think about where that sits within the system and make sure that we're not just moving problems elsewhere or ignoring other problems.


[00:33:23] So true. That's so true. What we've got in the room and the benefit of your experience and expertise, is there any other thoughts you'd like to kind of raise that and mention on the podcast?


[00:33:34] Aside from the questions we've asked you today, anything we've not covered, I think it's helpful to reflect on the competencies that we expect people who are delivering behaviour change interventions within local authorities to actually have and think about how we build that into our commissioning processes. And not everything has to involve huge sums of money. It can be about making sure that when we are commissioning programs of work or if we are procuring different services or whatever is that we're doing that we'll be thinking about what people need to be able to do and the skills they need to have to be able to deliver the outcomes that we're actually looking for and to make sure that they're receiving the support and the training that they need as part of that process.


[00:34:25] Well, I would say if there was one golden rule is to knee jerk into buying a solution. Because as Michelle's just pointed out, you may not need to spend any money at all. And so if you were a local authority director of services and you were about to build a new data centre or about to build 50 new schools or even buying and setting up a solar power field to reduce your energy bills, you wouldn't just go ahead and do it, would you? You do a proper options appraisal. You never think about what was the best provider out there, what was the best? Mekas was better. This is no different. Is just that a you may not know this field. And B, a lot of people are trying to convince you you'll understand it because it's too difficult to sciency. Well, I reject all of that. The discernment process is a key thing. And if people want help while we're on the end of the email, we're cohabited. Talk to them. They've got your stuff. There are a range of things. I think there will be more tools for local government coming up. Don't just trust the first thing you come across and actually add that to that.


[00:35:42] Talk to people, network, find out what else is going on. Reach out to academics who are working in the field. Reach out to other local authorities. And as Jim says, come and talk to us. We're really happy to share any thing that we have or any experiences that we have and learnings and hope other people will do the same so we can all move forward together.


[00:36:02] It's fantastic. Thank you very much for your time this afternoon, guys. Thank you so much. If you're interested in learning more about behaviour insights, projects within local government, you can go to the Local Government Association Web site w w w dot local dot gov dot UK and search behavioural insights. And on our web page that we have links to active hearts. So we have links to the Hartford you work that's being described today. Thank you for listening. And if you've enjoyed the podcast, please do pass on to your friends and colleagues and we can spread the word of behaviour insights far and wide.