Public health campaigns aiming to change behavior are often ineffective because intuition about what works is unreliable; however, by analyzing brain activity related to self-relevance and value, we can predict campaign effectiveness and design messages that resonate more deeply.
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Morning. We all want those that we love
to be around longer, right? So maybe
you've tried to convince someone that
you care about to eat a healthier diet,
quit smoking. And on a broad scale,
public health officials tried to do this
as well. They do this with health
campaigns because there are a lot of
data showing that behaviors that we can
change like smoking, sitting around too
much or for teens, car crashes are the
leading causes of death. So if we could
change these behaviors, if we could
motivate people to want to change them,
it could have a really big impact. If we
have an effective campaign, it could
save many, many lives. Whereas if we
have an ineffective campaign, it could
waste millions of dollars or even make
things worse. But figuring out what's
going to be an effective campaign is
actually a really challenging task. For
example, if you think back on the
various anti-smoking messages you've
seen in your lifetime. Now consider the following
ad. I quit when yesterday
girl. But I could always quit again
tomorrow. Quitting is hard but dialing
1800 quit now is easy.
Okay. Okay. So, if you are a public
health official considering whether to
spend your budget on a series of ads, a
campaign made up of fingers that look
like people encouraging people to call a
tobacco quit line, you might first start
with your own intuition, right? What do
you like? What don't you like? Do you
think this will be an effective
ad? And in a study that my colleagues
and I ran, we started out with some
similar information. We went and talked
to a number of different professionals
about what kinds of televised
antismoking campaigns they thought would
work and not work. And their intuition
suggested that this group of ads, these
finger ads in a campaign probably
wouldn't be that
effective. But next, you might go and
talk to your target audience. And we did
this as well. We recruited a number of
smokers and we surveyed them. We said,
"Which campaigns, which ads do you think
are the best and which do you think are
the worst?" Their intuitions also
suggested that these finger ads were a
little bit annoying. They might not work
that well. But the problem with both of
these methods, expert and lay intuition
alike, is that people are actually
notoriously bad at guessing what's going
to be effective for themselves. So for
smokers, what's going to motivate them
to change their behavior? And for other
people, what's an effective campaign on
the whole? So to get around this issue,
my team asked a question that hadn't
really been asked before. Namely, is
there hidden information in the brain
that can help us figure out things that
are hard to figure out otherwise? Maybe
our brains are smarter than our
intuitions. And what we found in my lab,
I direct a lab at Penn where we spend a
lot of our time trying to go behind the
scenes in the brain and figure out how
it makes decisions. And we've discovered
that by knowing what's happening in
people's brains, we can actually predict
the effectiveness of campaigns,
different kinds of persuasive messaging
better than just by knowing what people
think is going to work. So to give you a
little bit of an example of this, I told
you we asked a number of different
people for their opinions about those
smoking ads. And actually, the finger
puppet ad that I showed you was one of
several in a campaign that I'm going to
refer to as campaign C. So, I'm going to
refer to campaign A, campaign B, and
campaign C. There are three campaigns
that we are comparing. And as I said,
first we asked what people thought would
be effective and ineffective. And the
height of the bars here represents how
much they liked the campaigns. So, they
thought campaign C would be the worst
and campaign B would be the
best. Next, we looked at what happened
in their brains when they were watching
the three different campaigns. And
there, we saw a slightly different
pattern. We saw the greatest amount of
activity in response to campaign C, then
B, then A, in a part of the brain that
sits right here behind your forehead and
tracks how relevant and valuable people
find information, how much it really
resonates with them. Finally, we went on
to say, how much did these campaigns
actually affect something that we care
about in the real world? So, we looked
at how much they changed calls to a
tobacco quit line. What was the
population level effectiveness? And
there what we found was that although
all three campaigns increased calls to
the quit line, they did so at different
rates. So campaign C increased the calls
the most, then B, and then A. So one
thing you might notice is that the
pattern that we saw in the brain was
similar to what happened when we looked
at what actually worked in the real
world. And that was different than what
people told us they thought would happen.
happen.
So this highlights one of the
limitations of just asking people what
their intuitions are as well as one of
the potential promises of understanding
how the brain works and using that to
try to make better
campaigns. We then went on to run
another campaign to see if we could get
this to happen again. And so we looked
at images this time, images that
highlight the dangers of smoking. And we
partnered with the Michigan Center for
Health Communications Research in the
state of New York. And we took dozens of
different images. Here, I'm just showing you
you
two. And you can see that on the
surface, these two images look pretty
similar. But in order to figure out
which were the good images and which
were the bad images, we formatted each
of those images into an email. And at
the top of the email, there was the
tagline, "Stop smoking, start living."
And at the bottom there was a link where
smokers that we
emailed could click to get help
quitting. So our real world measure of
effectiveness here is going to be how
many smokers once they see one of these
images click to get help quitting. But
first what we did was we collected brain
data on a really small group of smokers
in Michigan. We showed them all the
different images, the dozens of images
that we were comparing, and we looked at
what happened in this brain region that
tracks self-relevance and value. Then
next, in collaboration with New York, we
sent an email with one image per smoker
to hundreds of thousands of people, and
we looked at how much they were willing
to click and think about getting
help. So, first, what we found was that
there were some clear winners and losers
here. And what I'm going to show you on
this slide is images that did really
well, that were the winners, that
generated a lot of clicks in the email
campaign. I'm going to show those higher
up on the slide. And then I'm going to
show you the brain activity in terms of
how far to the right it
is. And what we discovered was that
there was a clear relationship between
the brain activity and the email clicks.
So the images that generated the most
brain activity in our small group of
smokers in Michigan then went on to get
the most clicks in the real world
campaign in New York. For example, if we
go back to those two images that we were
comparing, although they look pretty
similar on the surface, you can see that
the one in the upper right generated
both a lot of brain activity in our
small group of smokers as well as many
more clicks in the email campaign. So,
so far what I've shown you is that da
that data from this part of the brain,
information from this part of the brain
that tracks the self-relevance and value
can predict behavioral outcomes that we
care about. It can predict what people
are going to
do. But how do we use this in practice?
Right? Assuming we're not going to run
every single campaign, every single idea
that we want to air going forward
through a brain scanner. We have to
understand what the brain is telling us
about why some messages are effective
and why some messages are less
effective. So what's the brain telling
us? Well, first I've mentioned a few
times now that this part of the brain
that we've been focusing on tracks
self-relevance and value. So how do we
make campaigns resonate? How do we make
campaigns feel self-relevant to our
target audience? You may have given
advice to someone you care about, right?
And you know that it's easy to give
advice, but it's hard to give that kind
of advice that resonates. So let's think
about one reason that messages fail.
Well, one reason that messages fail,
even though we could all exercise more,
eat healthier diets, right? Maybe you've
tried to convince your kids to study
harder, right? We could all do these
things, but when we ask people to do
them, you might have found that people
don't like having this kind of
information pointed out about
themselves. We get defensive. We come up
with reasons why the information doesn't
apply to us. Why do we do this? Well,
one of the reasons that we do it is
because we all want to feel good about
ourselves, right? We want to feel like
we're behaving in reasonable ways. We're
reasonable people, right? So, when we
have it pointed out that the way we're
behaving isn't
optimal, this can threaten that sort of
self-image. Psychologists have been
studying this phenomenon for a long
time. And what we now know from a few
decades of research is that actually if
you give people a chance to first think
about sources of broader meaning and
purpose in their lives, things like
their friends or family, other core
values that they care about before you
deliver this potentially threatening
information like a health
message. What this can do is highlight
that our sources of self-worth aren't
tied up with any particular behavior,
whether we're a smoker, whether we
exercise enough. And so then that can
make the specific message less
threatening and can open us up to behavior
behavior
change. The kinds of values that work
the best are things that really give us
that wider scope. So for a lot of people
this is their friends and family, maybe
their religion. For me, if I were going
to engage in this kind of values
affirmation or what psychologists call
self-affirmation, I might think about my
husband and our now four-week old twins
and all of the meaningful things that
I'm hoping that we get to do together going
going
forward. And what our lab has found is
that if you first give people a chance
to do this kind of
self-affirmation, it fundamentally
changes the way the brain responds to
the information that comes next. For
For
example, we studied this in the context
of people sitting around too much. And
we found that self-affirmation can
change that. Sitting around too much has
a number of negative health consequences
from feeling worse on a day-to-day basis
to increasing your risk for heart
disease and
cancer. But if you get a chance to
self-affirm first, that can change the
way you process information about the
benefits of getting more active. The way
we've studied this is by bringing people
in whose level of couch potato dum or
for many of us desk potato dum puts us
at increased levels of risk. And some of
the people we've given a chance to first
self-affirm to think about these sources
of broader meaning and purpose in their
lives whereas the other people don't. We
have them just think about something
that's less important to them first.
Then while we look at what's happening
in their brains, everybody's exposed to
messages like the more you sit, the more
damage it does to your body. Or
according to the American Heart
Association, people at your level of
physical inactivity are at increased
risk for heart disease.
And we've discovered that the people who
get to self-affirm first, the people who
think about these sources of meaning and
purpose before we show them the health
messages show much more activity in
these self-relevance and value regions
in the brain than people who aren't
affirmed. And then the people who are
affirmed go on to change their behavior
more in the month following. So
something as simple as reflecting on
core values that we all have. There are
things that are important to all of you.
Reflecting on those kinds of things can
fundamentally change the way our brain
responds to the information that comes
next. And as we think about how to
change ourselves, our loved ones, and
our communities for the better, the
brain is helping us understand how this
kind of focus on meaning and values has
benefits not only in itself, but also in
opening the brain to positive
change. And even
though health and happiness are areas
where we feel like we know ourselves
really well, we feel like we know what's
going to help us take the next step and
do better. Our intuitions about these
things often turn out to be wrong. But
data, including secrets that are hidden
in the brain, can help us figure out
what works and what doesn't work and can
also help us figure out how to create
the conditions that make people more in
open make people more open to
information that can help them lead
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