How should we encourage people to adopt more healthy lifestyles?

Timothy Wilson’s book, ‘Redirect: The Surprising New science of Psychological Change’, is primarily about what he describes as ‘story editing’ – a set of techniques designed to redirect people’s narratives about themselves and the social world in a way that leads to lasting changes in behaviour. Some of this story editing involves writing exercises, such as becoming more optimistic by writing about the process by which you have enabled everything in your future life to go as well as it could. But story editing also involves such things as providing information about social norms to correct mis-perceptions about what everyone else is doing. I suggest that anyone interested in a brief overview of the book should take a look at theinterview of Tim Wilson by Gareth Cook, for ‘Scientific American’ and a reviewby Mario Popova for ‘The Atlantic’.

I want to focus here on what light the book sheds on how we should encourage people to adopt more healthy lifestyles. Some people who are reading this will be thinking that I must have worked in the public sector for too long and become addicted to the ‘we’ word. Why should ‘we’ encourage people to live healthy lifestyles? Shouldn’t ‘we’ mind our own business? Well, in this instance I am using the ‘we’ word because it is appropriate. I think we would all want members of our own families and our friends to live healthy lifestyles, and probably feel that it would be good to encourage them to do that.

A logical place for an economist to begin would be to consider whether incentives - rewards, threats or punishments - should be used to encourage people to adopt healthy lifestyles. The message that I get from Tim Wilson’s book is that while incentives can change behaviour, they are not likely to bring about a desired change in the way people see themselves or in their intrinsic motivations. For example, in commenting on incentive programs designed to encourage kids to read more, Wilson writes:

‘If we want kids to read more, then rewarding them can work – as long as the incentives continue to be available. Rewards can produce compliance, just as punishment can. But … we want our kids to internalize desired attitudes and values … . After all, we can’t reward them for reading a book for the rest of their lives’.

Wilson also refers to experimental evidence that rewards can actually undermine intrinsic interest in an activity by convincing kids that they are doing it for the reward and not because it is enjoyable. When the reward is removed, participation in the activity was lower than in the pre-reward baseline period.

The conclusion Wilson comes to is that parents should use rewards and threats that are minimally sufficient to get kids to do the desired behaviours, i.e. not so strong that the kids view the threat or reward as the reason they are acting that way. If the child is told you will be ‘very upset and angry’ if she does something wrong she will desist to avoid getting in to trouble. If she is told you will be ‘a little annoyed’ she will still desist because she sees herself as a good kid.

So, incentives are no panacea. What else doesn’t work? The book provides quite a few examples of programs that bring people who are considered ‘at risk’ or ‘potential delinquents’ together in various ways (boot camps, counselling sessions etc.) to try to change their behaviour. The experimental evidence suggests that such programs don’t work because people who are brought together learn from each other and identify with group norms.

Another form of intervention that apparently doesn’t work is to scare the hell out of people by showing them very graphically what might happen if they engage in binge drinking, smoke cigarettes, take drugs and so forth. Threatening people with dire consequences for doing things they don’t want to do in the first place can have paradoxical effects. For example, some people may get the message that maybe they are tempted to engage in the undesirable behaviour, after all, since people are going to extreme lengths to talk them out of it.

So, what does work? One approach that works is autonomy support.  This involves helping young people understand the value of different alternatives facing them and conveying a sense that they are responsible for choosing which path to follow.

Encouraging young people to become involved in volunteering seems to have desirable effects on many aspects of their behaviour. The author writes:

‘Involving at-risk teens in volunteer work can lead to a beneficial change in how they view themselves, fostering the sense that they are valuable members of the community who have a stake in the future, thereby reducing the likelihood that they engage in risky behaviours …’

It may be possible to encourage young people to adopt healthier lifestyles by correcting incorrect perceptions about the behavior and attitudes of other young people.  For example, there is apparently a tendency for young people to over-estimate the amount of alcohol their peers drink. When correct information is disseminated, they lower their estimates of how much their peers drink and reduce their own drinking.

I don’t think Tim Wilson makes any broad generalizations in this book about how we should encourage people to adopt healthy lifestyles. In fact, he doesn’t make many generalizations about anything. One of the important messages in the book is the need for appropriate experimental testing to see what actually works. It seems to me, however, that it would be fairly safe to conclude from the book that the best way to encourage people to adopt more healthy lifestyles is through subtle interventions that redirect the narratives that they have about themselves.