As a public health practitioner, contact tracing is a vital tool and measure used to track and contain the spread of COVID-19. A few countries are using tracking apps to help with contact tracing and slowing the spread of COVID-19. But even within those countries, more participation is needed in order for the apps to be most effective. Given participation is voluntary, how to you increase their popularity and usage?
Summed up, here are top tips for applying behavioural economics for uptake in contact app tracing, and my own tips using other behavioral science theory.
Top Social Marketing Nudges for Contact Tracing Apps
1. Repetition in Messaging. Repeat consistent messaging. Messages are reminders. Applying the Transtheoretical Model, if people have made a commitment (the Maintenance Stage), reminders are important to keeping commitments. “They” say it takes 30 days to form a habit. A one time decision doesn’t seal a long time behavior change.
By repeating messages, you are also reminding potential users in the “Preparation Stage” to try out the app and can motivate users in the “Contemplation Stage” to move into the Preparation stage.
2. The Messenger. Chose them wisely. They are vital. In order to build trust with users, you must have a trustworthy messenger.
3. Social Influence. Normative beliefs. Observational Learning. Communicate what people are doing and how they are doing it. It educates and informs while shaping the social norm. For increasing users on tracking apps, now would be a good time look at how the Diffusion of Innovation theory could increase new users. Tap into what “innovators” are saying and doing to generate new buzz around the product.
4. Incentivize. Insurance companies using tracking apps can offer discounts on insurance or products for amount of trips taken and distance traveled. I know if my health insurance company offered me a $5 monthly rebate to use an app, I would. What if we got a coupon or rebate for ordering groceries and local food take out online? Count me in! Already companies are wavering delivering fees and restaurants are offering special discounts for curbside pick up.
If you are curious what COVID-19 tracing apps are available for you area, here is a list of a few I have found:
Australia – CovidSafe
Hong Kong- StayHomeSafe
Signapore – TraceTogether
Israel – Shield
Utah, US – Healthy Together- COVID-19
North Dakota and South Dakota, US – Care19
PrivateKit (MIT) – allows you to share your tracking if you would like, can you where ever you are.
Norway – Smittestop
UK (currently under trial in Isle of Wight) – NHS Covid-19
South Korea – Corona100m
Other articles related to contact tracing include:
Curbing Coronavirus With a Contact-Tracing App? It’s Not So Simple.
Recently I read a great article, “Marketing Meets Mission” https://hbr.org/2020/05/marketing-meets-mission on how companies, such as Carling Black Label Beer, are using their brand to help promote social change. Written by Myriam Sidibe for the Harvard Business Review, she explains how marketing can be used to change social norms and adopt positive new behaviors, such as handwashing. This growing corporate trend generates “shared value” or when companies build economic value in ways that promote social good. Creating social impact does not just equate with brand awareness and profit, but it can “energize employees”, promote positive social norms, and improve social, environmental and physical well being. Take a look at the article to see some great examples from companies doing great social good, and how other companies can incorporate the “purpose tree” to create “brand advocacy”.
Behavioural Science application in the UK. Interview with Dr. Rowena Merritt.
Dr. Rowena Merritt is a research fellow from the University of Kent, a Doctor of Philosophy from the University of Oxford, an affiliate professor at the University of South Florida, and Director of the National Social Marketing Centre.
Today she sat down to a Zoom meeting with me where I was able to ask her some questions relating to how the UK has applied behavioural science towards its policy and strategy during the current COVID-19 pandemic. She graciously answered some questions and we were able to compare applications of social marketing between the two countries, as well as hopes for ongoing lessons learned.
A big thank you to Dr. Merritt and I apologize for the rushed editing. I wanted to get the interview out as soon as possible, and I am not an expert on Premiere Pro…yet 🙂
The very helpful Mike Flick from @HillsboroughCounty Traffic Engineering called today to give me an update on some of the requests we made in New Tampa and near the University of South Florida at Bruce B. Downs Blvd. and Fletcher Ave.
The counts for the Cross Creek Blvd. and Bruce B. Downs Blvd. intersection study were completed before COVID-19. This is good news because driver numbers have significantly dropped since the pandemic outbreak and slow counts would prevent the county from continuing with the study. However, the study is not complete. JMP, the consultant to Hillsborough County is still completing this survey. FYI, these are the improvements we are asking the county to make at the intersection of Cross Creek Blvd. and Bruce B. Downs Blvd.:
1. Reassessing pedestrian clearance interval for the crosswalk along Cross Creek Boulevard on the east leg of the intersection
2. A “No-right-on-red” light when the Crosswalk button has been activated for both the right onto Cross Creek Blvd. from BBD and the right onto BBD from Cross Creek Blvd.
3. Adding barriers or bollards in or near the bike lane on Bruce B. Downs right hand turning lane into Cross Creek Blvd. to prevent cars from cutting into the right hand turning lane
4. Extending the median on Cross Creek Blvd. to create a Median Refuge Island for pedestrians and cyclists trying to cross Cross Creek Blvd. at the intersection;
5. Adding appropriate signage. For example changing the current sign that says yield to pedestrians to include cyclist (symbol of bike and pedestrian, as shown on other BBD signs).
1. The Kinnan Street pedestrian/cycling/emergency vehicle path construction starts in May! Lighting has begun on this new path by TECO.
2. Plans are in the works to continue adding lighting poles on Kinnan between Wild Bassett Creek and K-Bar Blvd.
3. Advent Health is working with the City to create a 10ft. wide concrete path from Fletcher Ave. to 138th! In addition, 1 pole/2 luminars will illuminate the path and Fletcher Ave.
I might be heading into work on a bike after all this is said and done.
Thank you to Mike Flick with Hillsborough County Traffic Engineering for your help and follow-up!
If you haven’t discovered it already, the use of social marketing for behavior change is kinda my public health bag, baby.
So right now during this pandemic my big, beautiful brain is working over time, watching, observing and creating my own social marketing public health response to slow down the spread of COVID-19.
In this post, I am having a sort of brain dump of observational what’s working and what can be improved upon. I love to see social marketing used effectively in action. For public health practitioners, this is a very informative time. Here are some of my initial thoughts.
Dr. Fauci is a messenger. My perception is that people stop and listen to what he is saying, and feel more comfortable following his directives, than say, President Trump? When the two don’t see eye to eye in a press conference, I am going to go out on a limb here and say Americans feel Dr. Fauci is the more transparent, knowledgeable and respected expert related to COVID-19. Which brings me to point #1. A messenger is a highly effective tool to change health behaviors.
On the other hand, we have another messenger who probably didn’t mean to make such a personal impact on social distancing behaviour in his own country but he did.
Making it social. In my opinion, the media has done a very good job in making #selfisolation and #stayathome messaging a positive and collective social norm. They have used the power of networks and social media to frame social distancing in a positive light, encourage good behavior, encourage commitments and build altruism. The One World: Together at Home concert is a great example of this. Not every day, you get a free concert in your living room, with famous musicians, comedians and performers, all promoting the same messages and supporting each other in a new behavior. Here are some popular COVID-19 hashtags (#’s): #COVID19; #socialdistancing; #coronavirus; #ShelterInPlace; #FlattenTheCurve; #StayAtHomeChallenge; #ViewFromMyWindow; #TogetherAtHome #MyPandemicSurvivalPlan; #QuarantineAndChill; #HealthyAtHome
Defaults and cues. Even though some have been slow on the uptake, most urban grocery stores have jumped on board with creating defaults and cues on how to social distance. For example, employees are wiping down carts, check out lines are taped off at every 6ft. and aisles have directional arrows. Cruises were doing in even better job of this before the pandemic became one. Royal Caribbean had hand washing stations before each dining area. They added guitarists and singers at each entrance to basically force passengers into washing their hands (do you really want to be called out for not washing your hands before dinner?). Upon exiting and entering the ship, you had to have your hands squirted with hand sanitizer by a cruise member. Not getting past them in a single file line. These defaults also helped define social distancing as a norm. It’s hard to not practice something when everyone else is without being embarrassed and socially shamed.
Making it easy. A lot of public health messaging for COVID-19 has been broken down into simple, easy actions. One of my favorites is how to grocery shop safely. Everyone still needs to eat and everyone is still using this essential service so creating a clear, step-by-step guide on how to grocery shop is vital for pandemic control and should be a top priority for health communicators. This leads me to another point on making it timely. (See “Not Ideal” #3 below.)
The challenges.Making it attractive. Humor, storytelling, images, music, and dancing make social distancing and self-isolating attractive, fun and social. They are great prompts and effective “openings” to public health issues that are immediate and chronic, from pandemic mental health to trying healthy cooking recipes, a new exercise routine or simply, enjoying quality time for your loved ones. #healthyathome #getmoving
Even when our governments weren’t responding quickly (or accurately), public health did a good job making COVID-19 salient. Information was going out to people on what is was and what to do. Most people were jumping on board even when they were not directly targeted, i.e. not immune-compromised or not 65+.
Not Ideal-The Lessons We Are Learning.
Media blowing up the protests. The number of people who are protesting vs. the number of people who are adhering to public health measures are not comparable. Drawing attention to the number of non-compliance protesters does not help create a social norm of social distancing in a pandemic.
Social distancing vs. physical distancing. First, one can be social and still physically distant. With self-isolating comes increased mental and emotional health risks. It is confusing to raise the importance of maintaining social contact through web chats, Zoom, Facetime, etc. while at the same time using words like social distancing. Second, you are asking people to physically distance themselves, specifically 6 feet of distance between you and another person. If you could only impart one step that a person should take with words, you want to make sure that the word you use is the most effective in communicating what you want. In this case, actual physical distancing of 6 feet. One hashtag that has not taken off the ground on twitter but conveys physical distance is #healthyspacing but the best one would be #physicaldistancing .
Timeliness. As much as I appreciate the step-by-step guide on safely grocery shopping, the messaging did not come out until people asked how to grocery shop safely. It took governments a little too long to jump on the pandemic board. Thankfully, corporations took it upon themselves to create their own pandemic measures.
The timeliness of social distancing measures, monitoring, feedback, and evaluation could have been improved with Cooperation and Collaboration across multiple sectors. A lot of creative ideas have come out of the business sector, but unfortunately, these weren’t public health nudges, and we can learn a lot from others ingenuity. And local governments are doing a lot of mind changing it seems. People are looking for ways to cope. We need to identify touch points and capitalize on prompting people when they are actively looking for information. As different organizations, governments and corporations are navigating this pandemic, we need to share information and ideas.
The #safehandschallenge or #handwashingchallenge. I don’t like “The Happy Birthday Song” method and messaging. I like my own one better. It is not only attractive (b/c of its use of music, not me) but because I give steps on HOW TO EFFECTIVELY WASH YOUR HANDS. Especially with children, it’s important not to just teach them to wash their hands, but how to do it. And the steps are right there in the lyrics.
We failed in targeting specific audiences. All social marketers should know that one size does not fit all. Early messaging was targeted to the most vulnerable populations but we failed to identify audiences that were the least likely to adopt behaviour change. We must use behaviour change theories in order to create effective social marketing campaigns. Using the innovative adoptive curve for example, we would have seen that immunocompromised individuals and their families would be early adopters, the 65+ population would be the early majority. For a pandemic with such high viral loads, shedding efficiency, and incubation period, health communication should not have stopped there but continued to identify measures and build a campaign to target the late majority and the laggards. I can think of one target audience here in Florida, the spring breakers on the beach. And now with the growing politicization of the pandemic, the conservative right-wing protestors.
Public health is prevention. We need to plan. Prepare. Prevent. Not react. We cannot effectively treat without prevention. We need local governments to think and apply the social determinants of health in a systematic way before a problem occurs. Healthy equity and access to services should be embedded into planning, not just a reaction. Which leads me to another connection. People are searching for information from multiples resources. A person may be looking on how to use public transportation during this crises. Another may be looking for a cycling route with closed parks. By applying a social determinants of health framework, changes can occur simultaneously and in conjunction with each other. Teamwork makes the dream work. Hopefully individuals, practitioners, organizations, businesses and governments are all learning from this pandemic and will use this experience to improve. Health communicators especially can use this pandemic as an “opening” for behaviour change beyond #handwashing and #COVID-19.
Let me hear your thoughts! Please comment below with any other behaviour change or social marketing observations and ideas from this pandemic, or previous research that can help going forward! Looking forward to learning more and applying lessons learned to creating an effective social marketing campaign!
Animated, acting and movement really bring children book characters to life. My favorite children’s author is Mo Willems. And my favorite series of books by him are Piggy and Elephant. Getting to know their friendship has helped me shape their personalities in my head, as well as the lessons they themselves are learning. When voicing over for a children’s book, it’s important to understand the emotional intelligence and physical development of a child reader or listener. It’s also important to look for the lessons the stories are teaching, especially in children’s fiction, as the story characters are teaching little listeners noble and helpful character traits and values.
I hope you enjoy my voicing of this story and please feel free to share, especially to your little one.
Here is another blog article I ran across on how to pass pedestrians while walking, running or cycling outside. It’s always good to get other people’s opinions and ideas, as well as the science behind it.
10 “RULES OF THE CORONA ROAD” and tips for safely exercising outside while practicing social distancing.
“Imagine a person laying down across the street the sidewalk”. If you saw someone laying horizontally across the sidewalk or road, more than likely you would move around them or make an effort not to touch them.
Choose a less trafficked time. Personally, right after work hours (5-7pm for me) is a nightmare. So many people. And so many groups of people. I now run in the mornings.
#besafebesmartbekind Not only will you demonstrate good behaviour by moving over, if you smile while you do it, you will help others positively associate with this action, as well as make them feel better.
Remember, pedestrians (someone on foot) have the right-of-way on a sidewalk. When we ride bikes, we use the sidewalk because it is so dangerous to use the roads here but we still move over for pedestrians. Cyclist should move around a pedestrian(s) on their left side. Pedestrians if you see or hear a cyclist coming at you, or from behind. Stay to the right.
Not exercising alone?- Switch to single file. Just like in elementary school.
Walk on the grass. “Grass is not hot lava”. Most sidewalks are not wide enough for someone to safely pass you without someone moving onto the grass and dirt.
Give way to people with strollers, walkers and wheelchairs.
Imagine everyone is smoking and you are trying to get around the smoke;
If a child or children are alone- walk, run or cycle 6 feet around them. You are setting a good example, helping them feel more safe, and children don’t always act like the mature adult that you are showing them to be.
And finally, you can always wear a t-shirt like mine or run with a 6 foot pole, lightsaber or cat toy 🙂
How to protect yourself and others while walking, running and cycling outside.
I have been “exercising” social distancing, stay-at-home, and shelter-in-place behavior for the past week now. I am working from home while my child plays and learns online like hopefully, most Americans who are able, are also doing. Now I do go outside as a daily runner and dog owner, and also so my child and I can get some much needed exercise and stress relief. Before we started to go off, I told my son that if he sees another person on the sidewalk to ride around them in the grass so we can maintain at minimum a 6ft distance between us and others.
Now at the beginning of our daily lunch break bike rides, my son was practically falling off his bike while trying to ride around each person he saw. We came across a lot of families and friends walking side-by-side and in small groups on the sidewalks, Mom’s and Dad’s with strollers, couples with multiple dogs, etc. and none of them were moving over, moving aside, or moving into the grass. When we moved over there were a lot of looks of surprise, which got me thinking. Do people not believe in social distancing? Do people know what social distancing entails? Are people wondering who should move over? Do I move over too? Do they know social distancing means 6 feet? Do they know what 6 feet is? One thing I do know, my running shoes were soaking wet!
So I decided take this observation of sidewalk etiquette in the new era of social distancing to the internet and more specifically, to my community on NextDoor. This is what I posted:
“May I respectfully request that if you are walking, running and cycling on the sidewalk that you please make an effort to move away from others who are passing you. I have been walking, running and cycling every day since this outbreak hit Florida and I am practicing social distancing and working from home, as a socially conscientious citizen and neighbor. Every time I see someone approaching me or my child, we both make every effort to move 6 feet away. Unfortunately, we have only been given the same due respect a couple of times. Like the beaches, if we cannot abide the recommendations, we will lose the privilege of being able to go outside. If you don’t believe in the current pandemic and social distancing, than please respect the people who do. Speaking my truth with love. Thank you”.
And the responses have really gotten me thinking….
“This needs to happen in grocery store lines”. (People aren’t social distancing in grocery stores either. Grocery stories aren’t communicating to customers or organizing how to social distance in our local grocery stores).
“I walk everyday since I stopped going to the gym and given that the width of the sidewalk is less than 6ft, it would be impossible to do so without one or both getting on to the lawn. But I do walk as far to the right of the sidewalk that I can without getting on the lawn”. (Some people don’t want or think they can walk on grass?)
More people than ever are outside exercising because their gyms and pools are closed.
“Speaking for myself I’m more than happy for anyone to walk on my lawn if it helps them maintain that distance from someone else walking past!” (This person outweighs the the benefit of social distancing with the cost of trampled grass.)
“I run daily with my dog and if I see anyone come near us I make it a point to run on the lawn.. not sure why it’s difficult for some? It’s grass… it won’t bite.”
My response- “Me too. I will add, people please pick up your dog poop. Now that I am running and riding more in the grass, it is harder to avoid!”
Stepping in dog poop is a barrier to social distancing and social distancing increases the probability of stepping in dog poo 😦
“April Ingram that is really important since more people are outdoors now.. thanks p For pointing that out”. (The majority of comments were polite and people were appreciative of my request and bringing up the issue).
Which brings me to my conclusion, this is new territory. We as a community, as neighbors, as people, don’t know what to do EXACTLY. We don’t know what the rules of etiquette or engagement are for social distancing on sidewalks and outside and we need some help if we want people to social distance.
So here are my suggestions from my community…
“yes I agree and they also have the other side of the street’s side walk. It’s not like it’s that packed most of the time. However it seems like I’m the only one volleying from side to side. Also you can still say hello to neighbors instead of looking away (kinda creepy/apocalyptic to me). People can be very weird during times like this but I think we just need to practice common courtesy, common sense and common kindness. Be well.”
“I like to walk in the evening, so here are my general rules of (dis)engagement: If I see people walking dogs or pushing baby carriages, I move off the sidewalk into the street until I go past them. It is easier and safer for me to do this than for them to do so. If I am walking with a friend and people are approaching us on the sidewalk, we line up single file on the very right side of the sidewalk so we can move past quickly without touching each other. What is frustrating is when others do not line up single file but rather continue walking abreast so that we all have to crowd past each other or trample people’s lawns. I have even seen groups of people just congregating on the sidewalks with their dogs and baby carriages, chatting away so that other walkers are forced to make a wide berth around them, going into streets or onto lawns. We need to all be considerate of others and not expect others to always move out of our way.”
Two keys points here I agree with: groups walking together should line up single file behind each other; and move to the right. I cannot emphasize moving to the right enough. Just like when you are cycling and trying to pass someone from behind, you always announce politely, “On your left”. Or if you are walking, running and cycling, keeping to the right so others can pass you.
Here are some of my “rules of social distancing” that I completely created in my head but that I accept as common courtesy:
If I see someone or people who look elderly or has a physical impairment, I move off the sidewalk when passing them;
2. If I see someone with a stroller than I move off the sidewalk;
3. If I see kids by themselves, I move off the sidewalk and away from them. I think every parent or guardian can appreciate this. It cannot be assumed that kids are mature enough to know how to safely and politely move away 6 feet from someone;
4. Who am I kidding, I move off the sidewalk for everyone.
UPDATE: Since I posted on NextDoor I have noticed people moving off the sidewalk for me too 🙂 Yeah! This may be from leading by example. Another way to guarantee some ongoing compliance? Say, “THANK YOU!” and smile.
I’d love to read your comments about unspoken rules of sidewalk engagement and social distancing outside! Please comment below and let me know what you are doing and what you would like to see done when you or your family members are outside walking, running and cycling on sidewalks.
Finally for all my public health practitioners out there, I saw this today in regards to health communications. “Social distancing” is a new term to the majority of people. Most people don’t know what it entails. As health communicators, we need to help define what it means and communicate in messages that give people clear, known, specific, doable and concrete behaviors and actions. This is our challenge. I feel a social marketing project coming on….
We had to go to Las Vegas to cheer on family at a basketball tournament so I thought I would take a detour and to go see the Hoover Dam, the Grand Canyon and Sedona. What an amazing trip! Keep reading and scrolling to see our highlights!
First stop from Las Vegas, the Hoover Dam. All I can say is get there early. We were fine and we went in July. But by the time we were done at lunchtime, it was a-blazing outside! You do have to park a little ways from the entrance and it can be dangerously hot if you aren’t hydrated and able.
There are two types of tours. Unless you are a engineer nerd (nothing wrong with that), the basic tour is good and informative.
From the Hoover Dam, we decided to take the longer but more historic Route 66 to the Grand Canyon.
There are few stops on the drive so make sure you are stocked up on water and snacks just in case.
Needles? I think this was a town but my first thought was that it was a place to dispose of intravenous needles 😦 So I was like, “peace out”.
The scenery was at times beautiful and it paints a picture of a different landscape of America, not one that I am use to coming from the east coast. And I added a quarky stop along the way…Grand Canyons Caverns.
Very interesting back history here. It’s amazing what risks people use to take. This beauty greets you upon entry. It doesn’t look like much from the outside but I will say this was a great little stop and lots of fun. If you can get past the dodgy looking elevator, you are in for a simple, little treat. There was also a little diner and shop inside for refreshments and tourist gifts.
This is where you can book a night stay inside the cave (NOPE). Apparently people get married here too. Whatever floats your boat.
Wide open paths that any beginner could navigate.
I think this was a replica of an ice age groundhog? Haha.
Grand Canyon Southern Rim
Next stop the Grand Canyon. We stayed in the Grand Canyon Village. If you aren’t taking a tour, I would definitely recommend that you book a hotel here early and stay in the village. Guided tours don’t have to wait in a big line but individual cars do. By staying in the village you have a jump start on early morning visitors and can get it early. We stayed at the Holiday Inn Express and it was clean and comfortable. They have an indoor pool which we enjoyed and offered coverage from the sun.
We decided to go beyond the look out sites and do some guided hikes. Again, I was traveling with a child under 8 and did not want to do anything dangerous or too extraneous. We chose All Star Grand Canyon Tours and we had a wonderful guide, lunch (provided) and day https://www.allstargrandcanyontours.com/ . We did a 3- hike day tour and would have done more if we had more time. The three different hiking trails were uniquely different and we were able to see a variety of landscapes and walk down into the canyon (not all the way down!). We also got to see some fossils.
I want to caution hikers, if you have unruly children or think you may fall or slip, DO NOT do any hiking tour into the canyon. There are no handrails, etc. so if you jump or fall off, that is the end of you. I am scared of heights and there were times that I was hugging the wall side with my child in between me and the wall. He was fine. And when the donkeys come by you have to move over for them, and not to the inside but the outside! Don’t let me alarm you though, most accidents happen with rafting inside the canyon.
Our guide showing us some points at the Grand Canyon visitor center.
One reason I like tours, besides the safety of traveling with others, is that tour guides are so informative and they are usually experts on the locations. That and tour guides can gain your child’s attention better than we can. Why stress yourself out trying to educate yourself before a trip only to have your child tune you out? Try and tour, save yourself stress, learn a lot and make friends!
There was so much to do and see that it all won’t fit into one blog post! So continue reading more from Flagstaff to Sedona to the Meteor Crater Natural Landmark in the blog post “Continued…Grand Canyon to Sedona Road Trip.