President-elect Joseph Biden has announced a stellar Covid-19 task force consisting of medical and clinical professionals. This incredible group of people will no doubt develop a medical, data-driven, and compassionate approach that will bring us closer to the finish line of this pandemic than we ever could have hoped for with the current administration. Unfortunately, however, this task force leaves out a critical set of experts: social and behavioral scientists.
If there’s one thing we’ve learned, it is that the Covid-19 crisis is as much a behavioral problem as a medical one. If we really want to beat this pandemic, we will need Americans to take a vaccine (and all doses of it) to achieve herd immunity. This itself is a huge behavioral task, if the statistics on the flu vaccine are anything to go by: Barely half of Americans six months and older got the flu shot in the 2018-2019 season — well below the target of 70% set by the U.S. Department of Health and Human Services.
In any case, given the challenge of vaccine development, manufacturing, and distribution, it could be some time before we see mass vaccinations — perhaps half a year or more. In the meantime, Americans will need to adopt and continue other behaviors, such as limiting the size of their social gatherings, participating in social distancing, and wearing face masks. These behaviors need to be adopted consistently — something we know that has proven hard to achieve. Mask wearing today across America is still highly variable — ranging from 75% to 90%. In our own research, we found that while people thought they understood social distancing, they were not consistent in its interpretation: For example, some didn’t consider visiting friends and family to be in violation of social distancing. Since every passing day means thousands more deaths and more strain on our health care system, persuading people to get and stay with the program is urgent. These behaviors must become habits.
So how do we address these challenges?
Based on their study of human behavior in a number of domains, health among them, social and behavioral scientists understand the task at hand. They know that despite our intentions, we don’t take flu shots or get preventive screenings done on time. Almost half of the people with chronic diseases don’t take their medications as doctors prescribe. And according to the U.S. Centers for Disease Control and Prevention (CDC), only one in 10 Americans eats enough fruit and vegetables despite decades of research and communication outlining the benefits of doing so.
These behaviors are driven by our own identities and contexts: the circumstances we’re exposed to; the constraints we have; the people with whom we interact; and our goals, beliefs, and values. And these factors may be very different for different people. For example, in the CDC study on vegetable consumption, the groups least likely to eat vegetables were men, young adults, and adults living in poverty. Potential explanations could range from contextual explanations — such as a lack of availability of vegetables or high prices — to identity explanations, such as the association of masculinity with eating meat.
A one-size-fits-all behavioral approach, therefore, cannot get us to 90% mask compliance or the high levels of vaccine uptake we need to achieve herd immunity (which means 65% to 70% of the population, according to the World Health Organization). We need to segment prospective mask wearers or mask avoiders based on the reasons behind their actions. In our previously mentioned research on social distancing, for example, we found that higher financial security, higher levels of information seeking, and higher levels of worry about the pandemic were key drivers of whether people engaged in social distancing.
Based on that criteria, we identified four population segments: “worried social distancers,” “non-worried rule followers,” “intentions unmatched with action,” and “skeptics who do not seek information.” A low percentage of the last two groups (the “skeptics” and the “intention unmatched with action”) practiced social distancing. Persuading them to change their behaviors would require targeted interventions. Providing stimulus checks, for example, to the “intention unmatched with action” group could ease the financial barriers preventing them from social distancing. For the “skeptics,” leveraging trusted public figures to whom they can relate — male Republicans, in this case — can get them to pay attention and be more receptive to this issue.
This is all to say that we will need a comprehensive and nuanced behavioral strategy. Such a strategy would recognize the heterogeneity of human behavior and segment the population, prioritize key psychological and structural drivers and barriers that may help or hinder adherence, and develop and continually refine a pragmatic portfolio of evidence-driven interventions. Social and behavioral scientists possess this expertise.
For example, to get people to comply with quarantining, some will need to receive the adequate social, financial, and psychological support to do so. For others, lack of transportation access may be the main barrier that’s preventing them from getting tested. The same goes for vaccines: While there will be people who will not trust the science, there will be others who trust the science but have no relationship with the health care system. Getting them vaccinated will require solutions that address barriers of access.
The addition of social and behavioral scientists, both academic and applied, to Biden’s Covid-19 task force can make a difference in three ways.
First, it will help the Biden administration deliver a consistent message to all Americans that behavior, individual and collective, is as important as medical innovation in combating this pandemic.
Second, it will ensure that we have a consistent, evidence-based behavioral strategy — one that is backed by research, rooted in medical science, and complemented by the necessary structural interventions required to change behavior. The group can review available behavioral data and evidence in a systematic and pragmatic way and ensure that research and testing of behavioral interventions is adequately funded.
Having applied behavioral scientists with experience in implementing interventions in the real world will be critical to translate recommendations into an operational “playbook” that helps states and local bodies turn the guidance into actions. Such a playbook would recommend tested interventions — including messaging campaigns (which also strive to counter misinformation) — to address each individual population’s precise set of behavioral drivers. It will help ensure that the right set of interventions are applied to the right people through the right channels.
Finally, adding social and behavioral scientists to the task force will help the Biden administration forge the partnerships required to effectively execute a behavioral strategy. This task is too huge and complex for a centralized team to carry out. It will require partnerships at all levels — global, national, state, and local — with federal and state experts and authorities, trusted community leaders, pharmacies, businesses, and even neighborhood associations working in concert. Just as Operation Warp Speed formed partnerships with the U.S. National Institutes of Health, pharmaceutical companies, and others to develop and distribute new Covid-19 vaccines, Biden’s new task force needs to bring in experts, organizations, and companies that know how to address such behavioral challenges at scale — both within the United States and from abroad.
The incoming Biden administration can help the United States tackle the worst health crisis it has experienced in more than a century. Its success in overcoming this scourge depends on its ability to deploy the right balance of medical, behavioral, and structural interventions. By doing so, it can save tens of thousands of lives.
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December 08, 2020 at 09:21PM
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Biden's Covid-19 Task Force Needs Behavioral Scientists - Harvard Business Review
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