Gambling is considered a public health issue by many researchers, similarly to alcohol or obesity. Statistical risk warnings on gambling products can be considered a public health intervention that encourages safer gambling while preserving freedom of consumer choice. Statistical risk warnings may be useful to gamblers, given that net gambling losses are the primary driver of harm and that gambling products vary greatly in the degree to which they facilitate losses. However, there is some doubt as to whether statistical risk warnings are, in their current form, effective at reducing gambling harm. Here, we consider current applications and evidence, discuss product-specific issues around a range of gambling products and suggest future directions. Our primary recommendation is that current statistical risk warnings can be improved and also applied to a wider range of gambling products. Such an approach should help consumers to make more informed judgements and potentially encourage gambling operators to compete more directly on the relative ‘price’ of gambling products.

Prior research in the behavioral sciences has demonstrated that reminders can be an effective tool for encouraging health-related behavior changes. This article extends that literature by reporting the outcome of a randomized controlled trial of mailed vaccination reminders. In addition to making a substantive contribution regarding the efficacy of mailed reminders, this article also makes a methodological contribution: it illustrates how researchers can study the causal impact of an intervention even when a pure parallel trial is not possible. In this study, the Louisiana Department of Health sent postcard reminders regarding four recommended vaccinations (influenza, tetanus, shingles and pneumonia) to 208,867 senior residents of Louisiana. We used block randomization and a stepped wedge design to assess the efficacy of the intervention. Individuals were blocked by their prior vaccine record and randomized to receive the postcard in one of four consecutive months (October–January). The reminder postcard had an overall positive effect on vaccination rates. The statistically significant and substantively small increase in overall vaccination rates was driven by participants who received the postcard reminder early in the intervention period.

Toilet ownership in India has grown in recent years, but open defecation can persist even when rural households own latrines. There are at least two pathways through which social norms inhibit the use of toilets in rural India: (1) beliefs/expectations that others do not use toilets or latrines or find open defecation unacceptable; and (2) beliefs about ritual notions of purity that dissociate latrines from cleanliness. A survey in Uttar Pradesh, India, finds a positive correlation between latrine use and social norms at baseline. To confront these, an information campaign was piloted to test the effectiveness of rebranding latrine use and promoting positive social norms. The intervention targeted mental models by rebranding latrine use and associating it with cleanliness, and it made information about growing latrine use among latrine owners more salient. Following the intervention, open defecation practices went down across all treatment households, with the average latrine use score in treatment villages increasing by up to 11% relative to baseline. Large improvements were also observed in pro-latrine beliefs. This suggests that low-cost information campaigns can effectively improve pro-latrine beliefs and practices, as well as shift perceptions of why many people still find open defecation acceptable. Measuring social norms as described can help diagnose barriers to reducing open defecation, contribute to the quality of large-scale surveys and make development interventions more sustainable.

Regulators require lenders to display a subset of credit card features in summary tables before customers finalize a credit card choice. Some jurisdictions require some features to be displayed more prominently than others to help ensure that consumers are made aware of them. This approach could lead to untoward effects on choice, such that relevant but nonprominent product features do not factor in as significantly. To test this possibility, we instructed a random sample of 1615 adults to choose between two hypothetical credit cards whose features were shown side by side in tables. The sample was instructed to select the card that would result in the lowest financial charges, given a hypothetical scenario. Critically, we randomly varied whether the annual interest rates and fees were made visually salient by making one, both, or neither brighter than other features. The findings show that even among credit-savvy individuals, choice tends strongly toward the product that outperforms the other on a salient feature. As a result, we encourage regulators to consider not only whether a key feature should be made more salient, but also the guidelines regarding when a key feature should be displayed prominently during credit card acquisition.

A recent development within nudge theory is the concept of sludge, which imposes frictions on decision-making. Nascent literature adopts a normative interpretation of sludge: nudge good, sludge bad. However, this normative interpretation leaves much to be desired. A clear definition and treatment of sludge remains absent from this literature, as is a complete understanding of ‘frictions’. Furthermore, the relationship between nudges and sludges is unclear. This paper proposes the concept of nudge/sludge symmetry in an attempt to advance the conceptual understanding of sludge. Building from the definition of a nudge, three types of friction permissible under nudge theory are identified: hedonic, social and obscurant. Sludge is then positioned, in terms of frictions, relative to nudge: nudges decrease relative frictions, sludges increase relative frictions. A consequence of this proposition is nudge/sludge symmetry – where a nudge decreases the frictions associated with a specific option, sludge is simultaneously imposed on all other options available to a decision-maker. Nudge/sludge symmetry subsequently challenges the normative interpretation of sludge, and so a new framework drawing on the literature on nudges in the private sector is offered, with the choice architect placed at the centre. This new approach to sludge and emphasis on the role of the choice architect, in turn, reaffirms the importance of transparency in public policy interventions.

Nancy Cartwright argues that evidence-based policies should not only rely on randomized controlled trials (RCTs) to test their effectiveness – they should also use horizontal and vertical searches to find support factors and causal principles that help define how those policies work. This paper aims at analyzing Cartwright's epistemology regarding evidence-based policies and their use of RCTs while applying her findings to current research involving nudges as behavioral public policy interventions. Holding a narrowly instrumental view of rationality, nudge theory tends to neglect other expressive components. Policymakers, in their quest for causal principles, should consider the expressive rationality of individuals in their research. This inclusion would not only increase the effectiveness of nudges, but also address some ethical issues related to people's autonomy when targeted by these interventions.

We provide experimental evidence for the existence of “rent stigma,” a preference for owning goods or real estate to renting them. In one experiment, anonymous respondents preferred owning a car or house to renting them, even though the transaction was constructed to be identical in each case in terms of economic payoffs and risk. In a second experiment, a survey of law students who were asked how much they would pay to own rather than rent a laptop found similar results. However, we found little or no evidence for our hypotheses that rent stigma would decline in conditions in which the advantages of renting were made salient. The existence of rent stigma raises concerns that the framing of a transaction in terms of purchasing rather than rent may be used to manipulate consumers.

Do small wording differences in message-based behavioral interventions have outsized effects on behavior? An influential initial study, examining this question in the domain of political behavior using two small-scale field experiments, argues that subtle linguistic cues in voter mobilization messages describing someone as a voter (noun) instead of one who votes (verb) dramatically increases turnout rates by activating a person's social identity as a voter. Two subsequent large-scale replication field experiments challenged this claim, finding no effect even in electorally competitive settings. However, these experiments may not have reproduced the psychological context needed to motivate behavioral change because they did not occur in highly competitive and highly salient electoral contexts. Addressing this major criticism, we conduct a large-scale, preregistered replication field experiment in the 2016 presidential election. We find no evidence that noun wording increases turnout compared to verb wording in this highly salient electoral context, even in competitive states.

We evaluate whether people will outsource their opinion on public policy to consensus conference participants. The ideal consensus conference brings together a representative sample of citizens and introduces them to the range of perspectives and evidence related to some policy. The sample is given the opportunity to ask questions of experts and to deliberate. Attitudes about each policy are queried before and after the conference to see if the event has changed minds. In general, such conferences do produce opinion shifts. Our hypothesis is that the shift can be leveraged by simply communicating conference results – absent substantive information about the merits of the policies discussed – to scale up the value of conferences to the population at large. In five studies, we tell participants about the impact of a consensus conference on a sample of citizens’ opinions for a range of policies without providing any new information about the inherent value of the policy itself. For several of the policies, we see a shift in opinion. We conclude that the value of consensus conferences can be scaled up simply by telling an electorate about its results. This suggests an economical way to bring evidence and rational argument to bear on citizens’ policy attitudes.

A concern that people ought to be given what they deserve, in both positive and negative senses, lies deep within the human psyche. Views on the level of reward or punishment that a person deserves for their actions will differ across persons, places, and time, but, I argue in this article, depend substantively upon some combination of intentions and outcomes. Using these characteristics, I propose a taxonomy of actions, ordered from most to least blameworthy, with, for example, it being suggested that for any particular level of harm an intentional yet unrealized harm is more blameworthy than an unintentional yet realized harm (a similar taxonomy can be developed for the positive domain of praiseworthy actions). The taxonomy is focused upon people's actions toward others, but I finish the article with a discussion of desert in relation to people's intentions toward themselves. Ultimately, I contend that the strength and sustainability of public sector services and welfare systems, not to mention our private relationships, rely upon the recognition that desert underpins our notion of justice.

How can we stimulate policymakers to make strategic decisions that enhance public service performance? Traditional strategy theories have not enabled us to answer this question. These theories focus on strategy processes or content in public organizations and networks and directly link these to public service performance. This article defines and elaborates on a conceptual framework that uses theory from behavioral science to unravel how policymakers can make strategic decisions that actually enhance the performance of public organizations and networks. This conceptual framework is labeled ‘behavioral public strategy’ and conceptualizes public strategy as a social process shaped by the individuals, teams and tools underlying it. Behavioral public strategy thus focuses on the micro-foundations of public strategy and how these micro-foundations influence strategic decisions. Moreover, behavioral public strategy links meso- and micro-levels by proposing a bathtub model where the relationship between public strategy and public service performance at the organizational and network levels is explained by the relationship between the micro-foundations of public strategy and the ensuing strategic decisions at the individual and team levels. This article connects three research streams that have been like ‘ships that pass in the night’, namely public strategy, behavioral public policy and behavioral public administration.

Behavioral policies are increasingly popular in a number of health care contexts. However, evidence of their effectiveness, specifically in low-income and highly disadvantaged populations, is limited. Some positive effects have been found for adaptive interventions, which merge more personalized approaches with advances in data collection and modern analytical methods. These approaches have only recently become feasible, as their implementation requires a confluence of large-scale datasets, contemporary machine learning, and validated behavioral insights. Such methods have considerable potential to improve outcomes without requiring substantial increases in effort on the part of individuals. Using examples from health insurance choice, clinical attendance rates, and prescription of medicines, we present an argument for how adaptive approaches, especially those considering disadvantaged populations explicitly, offer an opportunity to generate equity in public health.

There is great potential for nudges to make gains in child health through improvement of lifestyle behaviors. In this study, I use an online sample of adults to test the acceptability of two nudges (one to address teenage smoking and the other to address pediatric obesity) when targeting one of three populations: adults, parents or children. The study shows that a majority of adult respondents would accept the use of nudges aimed at parents and children. The findings show that nudging parents or children directly has the same acceptability as nudging adults. These results suggest that when the objective of a nudge is to improve children's health, it is acceptable to target parents or children themselves. These results open the door to testing the efficacy of nudges in pediatric public health.

In the last few decades, conditional cash transfer (CCT) programmes have become very popular for addressing different development challenges. The use of CCT programmes to promote enrolment in schools, improve preventive health care and increase household consumption in Latin America has been well documented. However, the potential of CCT programmes to change more deep-rooted norms is not very clear. The Shubh Laxmi scheme, a CCT programme, was started by the Government of Rajasthan, India, to improve the status of health and education among girls. A study was undertaken to understand the changes in beneficiaries’ perspectives due to scheme. A total of 95 beneficiaries were randomly selected and in-depth interviews were conducted in order to understand the impact of the scheme. In addition, two focus group discussions were conducted with 30 non-beneficiaries in order to understand their awareness about the scheme and their perceptions of girls. The findings show that the CCT programme has helped in generating a positive attitude among beneficiaries towards the survival, education and well-being of girls. The key challenge was low awareness of the scheme and of the procedures for claiming its benefits. This study highlights that CCT programmes are useful for nudging people to address gender-based inequalities in health and education among children; however, effective implementation remains key.

The relevant literature notes a lack of applications relative to the theoretical impact of prospect theory. In this paper, I provide a brief review of this literature aimed at policymakers before developing an idea for lottery-based government subsidy policies. I consider the general conditions under which such policies could be effective in (1) increasing the performance of desired behaviours and (2) saving governments money. I provide two examples of current Canadian subsidies that I argue could be improved with the addition of a lottery option.

This paper explores “free-baiting” as a behavioral policy tool for reducing participation in socially undesirable activities. Empirical evidence establishes that when a good or activity ceases to be free, consumption plummets. A free-baiting policy creates conditions of freeness in order to subsequently take advantage of the discouraging effects of freeness removal. The initial free phase shifts consumers’ reference price for the target activity to zero. Subsequently, prices are returned to market levels – a staggering price increase. Behavioral factors enhance the salience of that price increase. It occurs along the steepest part of the money utility curve. It is especially salient because it is presented as a loss. In addition, it may trigger the endowment effect: forcing people to give something up in order to partake in the target activity once it is no longer free. Moreover, these discouraging effects can enhance the efficiency and effectiveness of other interventions. Free-baiting manufactures a policy window, creating a moment in which many consumers simultaneously confront obstacles to the target activity. The effects of free-baiting are illustrated using several hypothetical interventions, including rush-hour roadway tolls, sugary beverages, gasoline and tobacco.

The emergence of dominant companies that don't charge money to their primary consumers poses serious challenges to current antitrust law around the world. This paper suggests an approach to regulating these ‘zero-price’ companies that considers the data consumers give up to use them as the ‘price’ they pay. The ‘data as price’ model acts as a starting point to assess whether consumers are being ‘overcharged’ by Facebook in the status quo compared to how much data they would give up in a more competitive social media landscape. By surveying thousands of participants and assessing a litany of relevant behavioural considerations, this paper finds that customers are overpaying for Facebook, and that this may come at a serious welfare cost to millions of consumers. While further analysis is warranted, there is substantial cause for concern, and for critical re-evaluation of the standards generally used by antitrust regulators around the world to regulate companies such as Facebook.