INSTITUTIONAL INNOVATION

Applying Behavioral Economics to Public Health Policy

Curated on April 23, 2016August 3, 2018 by Stefaan Verhulst

Jennifer L. Matjasko, et al in the American Journal of Preventive Medicine: “From the beginning, health has been recognized as a fertile area for applying nudges. The subtitle of the bookNudge is Improving Decisions about Health, Wealth, and Happiness. In their discussion of health behaviors, Thaler and Sunstein propose new nudges in health, such as simplifying decision making in Medicare. In fact, section 1511 of the Affordable Care Act requires large employers to automatically enroll workers into health insurance; similar to the previous example on organ donation, this switched from an opt-in to an opt-out system in order to harness the power of defaults. We will provide examples in which concepts from behavioral economics were applied to public health policy and led to improvements in health attitudes and behaviors. A summary of these applications is provided in Table 1.

Nudges can be effective because people are influenced by stimuli that are visible and new; thus, at least in theory, small changes can lead to behavior modification. Several studies have found that simply prompting (nudging) individuals to make a plan increases the probability of the subject eventually engaging in the prompted health behavior, such as immunizations, healthy eating, and cancer screening. For example, one study found that e-mailing patients appointment times and locations for their next influenza vaccination increased vaccination rates by 36%. Another intervention was even simpler. Rather than assigning a date and time for the patient to be vaccinated, patients were simply mailed a card that asked the patient to write down the day or day and time they planned to get the influenza vaccine (they were also sent the day and time of the free influenza vaccine clinics). Relative to a control condition (people who only received the information about the day and time of the clinics), those prompted to write down the day and time they planned to get the influenza vaccine were 4.2 percentage points (12.7%) more likely to receive the vaccine at those clinics. Those prompted to write down the date but not the time were not significantly more likely to be vaccinated at the clinics. Decision heuristics, such as highlighting consensus, may also help. Highlighting descriptive norms among a group of trusted experts, or priming (e.g., that 90% of doctors agree that vaccines are safe) can significantly reduce public concern about (childhood) vaccines and promote intentions to vaccinate.

The significant influence of framing has been demonstrated in many public health domains, such as messaging about blood transfusion, smoking cessation, sunscreen use, and mammography utilization. In particular, gains-framed messages (i.e., emphasizing the health gains of a behavior or treatment) were more likely to have a positive impact on the attitudes toward activities targeting prevention (e.g., blood safety, sunscreen use, smoking cessation). Loss-based messages may be more effective at encouraging screening behaviors, such as mammography screening. This points to the importance of testing messages for the uptake of preventive services among varying subgroups, many of which are now covered without cost-sharing as a result of the coverage of preventive services mandated in the Affordable Care Act.

Detailed Illustrative Examples (More)”

The Open Data Barometer (3rd edition)

Curated on April 22, 2016August 3, 2018 by Stefaan Verhulst

The Open Data Barometer: “Once the preserve of academics and statisticians, data has become a development cause embraced by everyone from grassroots activists to the UN Secretary-General. There’s now a clear understanding that we need robust data to drive democracy and development — and a lot of it.

Last year, the world agreed the Sustainable Development Goals (SDGs) — seventeen global commitments that set an ambitious agenda to end poverty, fight inequality and tackle climate change by 2030. Recognising that good data is essential to the success of the SDGs, the Global Partnership for Sustainable Development Data and the International Open Data Charter were launched as the SDGs were unveiled. These alliances mean the “data revolution” now has over 100 champions willing to fight for it. Meanwhile, Africa adopted the African Data Consensus — a roadmap to improving data standards and availability in a region that has notoriously struggled to capture even basic information such as birth registration.

But while much has been made of the need for bigger and better data to power the SDGs, this year’s Barometer follows the lead set by the International Open Data Charter by focusing on how much of this data will be openly available to the public.

Open data is essential to building accountable and effective institutions, and to ensuring public access to information — both goals of SDG 16. It is also essential for meaningful monitoring of progress on all 169 SDG targets. Yet the promise and possibilities offered by opening up data to journalists, human rights defenders, parliamentarians, and citizens at large go far beyond even these….

At a glance, here are this year’s key findings on the state of open data around the world:

Open data is entering the mainstream.The majority of the countries in the survey (55%) now have an open data initiative in place and a national data catalogue providing access to datasets available for re-use. Moreover, new open data initiatives are getting underway or are promised for the near future in a number of countries, including Ecuador, Jamaica, St. Lucia, Nepal, Thailand, Botswana, Ethiopia, Nigeria, Rwanda and Uganda. Demand is high: civil society and the tech community are using government data in 93% of countries surveyed, even in countries where that data is not yet fully open.
Despite this, there’s been little to no progress on the number of truly open datasets around the world.Even with the rapid spread of open government data plans and policies, too much critical data remains locked in government filing cabinets. For example, only two countries publish acceptable detailed open public spending data. Of all 1,380 government datasets surveyed, almost 90% are still closed — roughly the same as in the last edition of the Open Data Barometer (when only 130 out of 1,290 datasets, or 10%, were open). What is more, much of the approximately 10% of data that meets the open definition is of poor quality, making it difficult for potential data users to access, process and work with it effectively.
“Open-washing” is jeopardising progress. Many governments have advertised their open data policies as a way to burnish their democratic and transparent credentials. But open data, while extremely important, is just one component of a responsive and accountable government. Open data initiatives cannot be effective if not supported by a culture of openness where citizens are encouraged to ask questions and engage, and supported by a legal framework. Disturbingly, in this edition we saw a backslide on freedom of information, transparency, accountability, and privacy indicators in some countries. Until all these factors are in place, open data cannot be a true SDG accelerator.
Implementation and resourcing are the weakest links.Progress on the Barometer’s implementation and impact indicators has stalled or even gone into reverse in some cases. Open data can result in net savings for the public purse, but getting individual ministries to allocate the budget and staff needed to publish their data is often an uphill battle, and investment in building user capacity (both inside and outside of government) is scarce. Open data is not yet entrenched in law or policy, and the legal frameworks supporting most open data initiatives are weak. This is a symptom of the tendency of governments to view open data as a fad or experiment with little to no long-term strategy behind its implementation. This results in haphazard implementation, weak demand and limited impact.
The gap between data haves and have-nots needs urgent attention.Twenty-six of the top 30 countries in the ranking are high-income countries. Half of open datasets in our study are found in just the top 10 OECD countries, while almost none are in African countries. As the UN pointed out last year, such gaps could create “a whole new inequality frontier” if allowed to persist. Open data champions in several developing countries have launched fledgling initiatives, but too often those good open data intentions are not adequately resourced, resulting in weak momentum and limited success.
Governments at the top of the Barometer are being challenged by a new generation of open data adopters. Traditional open data stalwarts such as the USA and UK have seen their rate of progress on open data slow, signalling that new political will and momentum may be needed as more difficult elements of open data are tackled. Fortunately, a new generation of open data adopters, including France, Canada, Mexico, Uruguay, South Korea and the Philippines, are starting to challenge the ranking leaders and are adopting a leadership attitude in their respective regions. The International Open Data Charter could be an important vehicle to sustain and increase momentum in challenger countries, while also stimulating renewed energy in traditional open data leaders….(More)”

Foreign Policy has lost its creativity. Design thinking is the answer.

Curated on April 21, 2016August 15, 2018 by Stefaan Verhulst

Elizabeth Radziszewski at The Wilson Quaterly: “Although the landscape of threats has changed in recent years, U.S. strategies bear striking resemblance to the ways policymakers dealt with crises in the past. Whether it involves diplomatic overtures, sanctions, bombing campaigns, or the use of special ops and covert operations, the range of responses suffers from innovation deficit. Even the use of drones, while a new tool of warfare, is still part of the limited categories of responses that focus mainly on whether or not to kill, cooperate, or do nothing. To meet the evolving nature of threats posed by nonstate actors such as ISIS, the United States needs a strategy makeover — a creative lift, so to speak.

Sanctions, diplomacy, bombing campaigns, special ops, covert operations — the range of our foreign policy responses suffers from an innovation deficit.

Enter the business world. Today’s top companies face an increasingly competitive marketplace where innovative approaches to product and service development are a necessity. Just as the market has changed for companies since the forces of globalization and the digital economy took over, so has the security landscape evolved for the world’s leading hegemon. Yet the responses of top businesses to these changes stand in stark contrast to the United States’ stagnant approaches to current national security threats. Many of today’s thriving businesses have embraced design thinking (DT), an innovative process that identifies consumer needs through immersive ethnographic experiences that are melded with creative brainstorming and quick prototyping.

What would happen if U.S. policymakers took cues from the business world and applied DT in policy development? Could the United States prevent the threats from metastasizing with more proactive rather than reactive strategies — by discovering, for example, how ideas from biology, engineering, and other fields could help analysts inject fresh perspective into tired solutions? Put simply, if U.S. policymakers want to succeed in managing future threats, then they need to start thinking more like business innovators who integrate human needs with technology and economic feasibility.

In his 1969 book The Sciences of the Artificial, Herbert Simon made the first connection between design and a way of thinking. But it was not until the 1980s and 1990s that Stanford scientists began to see the benefits of design practices used by industrial designers as a method for creative thinking. At the core of DT is the idea that solving a challenge requires a deeper understanding of the problem’s true nature and the processes and people involved. This approach contrasts greatly with more standard innovation styles, where a policy solution is developed and then resources are used to fit the solution to the problem. DT reverses the order.

DT encourages divergent thinking, the process of generating many ideas before converging to select the most feasible ones, including making connections between different-yet-related worlds. Finally, the top ideas are quickly prototyped and tested so that early solutions can be modified without investing many resources and risking the biggest obstacle to real innovation: the impulse to try fitting an idea, product, policy to the people, rather of the other way around…

If DT has reenergized the innovative process in the business and nonprofit sector, a systematic application of its methodology could just as well revitalize U.S. national security policies. Innovation in security and foreign policy is often framed around the idea of technological breakthroughs. Thanks toDefense Advanced Research Projects Agency (DARPA), the Department of Defense has been credited with such groundbreaking inventions as GPS, the Internet, and stealth fighters — all of which have created rich opportunities to explore new military strategies. Reflecting this infatuation with technology, but with a new edge, is Defense Secretary Ashton Carter’s unveiling of the Defense Innovation Unit Experimental, an initiative to scout for new technologies, improve outreach to startups, and form deeper relationships between the Pentagon and Silicon Valley. The new DIUE effort signals what businesses have already noticed: the need to be more flexible in establishing linkages with people outside of the government in search for new ideas.

Yet because the primary objective of DIUE remains technological prowess, the effort alone is unlikely to drastically improve the management of national security. Technology is not a substitute for an innovative process. When new invention is prized as the sole focus of innovation, it can, paradoxically, paralyze innovation. Once an invention is adopted, it is all too tempting to mold subsequent policy development around emergent technology, even if other solutions could be more appropriate….(More)”

GIS Research Methods: Incorporating Spatial Perspectives

Curated on April 17, 2016October 24, 2018 by Stefaan Verhulst

“GIS Research Methods: Incorporating Spatial Perspectives shows researchers how to incorporate spatial thinking and geographic information system (GIS) technology into research design and analysis. Topics include research design, digital data sources, volunteered geographic information, analysis using GIS, and how to link research results to policy and action. The concepts presented in GIS Research Methods can be applied to projects in a range of social and physical sciences by researchers using GIS for the first time and experienced practitioners looking for new and innovative research techniques….(More)”

A ‘design-thinking’ approach to governing the future

Curated on April 12, 2016August 3, 2018 by Stefaan Verhulst

Bronwyn van der Merwe at The Hill: “…Government organizations are starting to realize the benefits of digital transformation to reinvent the citizen experience in the form of digital services tailored to individual needs. However, public service leaders are finding that as they move further into the digital age, they need to re-orient their internal organizations around this paradigm shift, or their investments in digital are likely to fail. This is where Design Thinking comes into play.

Design Thinking has become a proven approach to reimagining complex service or organizational issues in the private sector. This approach of user research, rapid prototyping, constant feedback and experimentation is starting to take hold in leading business, like Citrix Systems, Ebay and Google, and is slowly spilling over into government bodies.

Challenges to Adopting a Design-Led Approach

Success in implementing Design Thinking depends on disrupting embedded organizational beliefs and practices, including cultural shifts, changing attitudes toward risk and failure, and encouraging openness and collaboration. Specifically, government bodies need to consider:

Top to bottom support – any change as wide-ranging as the shift to Design Thinking requires support from the top. Those at the top of design-led organizations need to be experimenters, improvisers and networkers who lead by example and set the tone for change on the ground.
Design skills gap – talent to execute innovation is in short supply and few governments are in a financial position to outbid private sector firms on pay. But the public sector does have something to offer that private companies most often do not: the ability to do meaningful work for the public good. Public sector bodies also need to upskill their current employees – at times partnering with outside design experts.
No risk, no reward – for government agencies, it can be challenging to embrace a culture of trial and error. But Design Thinking is useless without Design Doing. Agencies need to recognize the benefits of agile prototyping, iterating and optimizing processes, and that failings early on can save millions while costing little.

What Can Government Bodies Do to Change?

Digital has paved the way for governments and the private sector to occasionally partner to solve thorny challenges. For instance, the White House brought together the U.N. Refugee Agency and crowdfunding platform Kickstarter to raise money for the Syrian relief effort. The weeklong partnership raised nearly $1.8 million for more than 7,000 people in need.

But to effectively communicate with today’s digitally-enabled citizens, there are several key principals government bodies must follow:

Plain and simple – use simple language focused on content, structure, navigation, grouping and completion. Strip away the bureaucratic, government-speak and be transparent.
Take an outside-in design approach – by considering the entire ecosystem, and using research to uncover insights, service design reveals an outside-in view of the people in the entire ecosystem.
Be sensitive – too many government services, tools and processes are opaque and cumbersome when dealing with sensitive issues, such as immigration, making a tax submission, or adopting a child. Fjord recently took a human-centered design framework to the State of Michigan by designing a system that allowed caseworkers to convey the fairness of a child support order, while delivering excellent customer service and increasing transparency and accuracy to families in the midst of an emotionally-charged separation.
Work to digitize processes and services across departments – Governments should look to organize their digital services around the needs of the people – whether they are starting a business, retiring or having a child – rather than around their own departmental structures.
Address privacy concerns – The assurance of privacy and security is a critical step to encourage adoption of digital channels….(More)”

The internet’s age of assembly is upon us

Curated on March 28, 2016August 3, 2018 by Stefaan Verhulst

Ehud Shapiro in the Financial Times: “In 20 years, the internet has matured and has reached its equivalent of the Middle Ages. It has large feudal communities, with rulers who control everything and billions of serfs without civil rights. History tells us that the medieval era was followed by the Enlightenment. That great thinker of Enlightenment liberalism, John Stuart Mill, declared that there are three basic freedoms: freedom of thought and speech; freedom of “tastes and pursuits”; and the freedom to unite with others. The first two kinds of freedom are provided by the internet in abundance, at least in free countries.

But today’s internet technology does not support freedom of assembly, and consequently does not support democracy. For how can we practice democracy if people cannot assemble to discuss, take collective action or form political parties? The reason is that the internet currently is a masquerade. We can easily form a group on Google or Facebook, but we cannot know for sure who its members are. Online, people are sometimes not who they say they are.

Fortunately, help is on the way. The United Nations and the World Bank are committed to providing digital IDs to every person on the planet by 2030.

Digital IDs are smart cards that use public key cryptography, contain biometric information and allow easy proof of identity. They are already being used in many countries, but widespread use of them on the internet will require standardisation and seamless smartphone integration, which are yet to come.

In the meantime, we need to ask what kind of democracy could be realised on the internet. A new kind of online democracy is already emerging, with software such as Liquid Feedback or Adhocracy, which power “proposition development” and decision making. Known as “liquid” or “delegative democracy”, this is a hybrid of existing forms of direct and representative democracy.

It is like direct democracy, in that every vote is decided by the entire membership, directly or via delegation. It resembles representative democracy in that members normally trust delegates to vote on their behalf. But delegates must constantly earn the trust of the other members.

Another key question concerns which voting system to use. Systems that allow voters to rank alternatives are generally considered superior. Both delegative democracy and ranked voting require complex software and algorithms, and so previously were not practical. But they are uniquely suited to the internet.

Although today there are only a handful of efforts at internet democracy, I believe that smartphone-ready digital IDs will eventually usher in a “Cambrian explosion” of democratic forms. The resulting internet democracy will be far superior to its offline counterpart. Imagine a Facebook-like community that encompasses all of humanity. We may call it “united humanity”, as it will unite people, not nations. It will win hearts and minds by offering people the prospect of genuine participation, both locally and globally, in the democratic process….(More)

What works?

Curated on March 27, 2016August 3, 2018 by Stefaan Verhulst

Dan Davies at TheLong & Short: “Evidence-based policy is very much in fashion at the moment in all departments of government. Of course it’s a good idea; the main argument for it is summarised admirably by the name. But people who expect big things from evidence-based approaches ought to be really quite worried right now.

Because the methodology used in a lot of evidence-based policy analysis is very similar to that used in experimental psychology. And at the moment, psychology is a subject with some very serious methodological problems.

It’s being called the ‘reproducibility crisis’ and in summary, the problem is that large-scale and careful attempts to replicate some of the best-established and most important results of the last few decades are not finding the effects they were meant to find. This is even happening for effects like ‘ego depletion’ (the idea that resisting temptation requires effort and makes it harder to exercise willpower), which are the subject of dozens or even hundreds of research papers.

There appear to be two related problems. First, there is a knot of issues relating to methodology and the interpretation of statistical tests, which means that there is a systematic tendency to find too many statistically significant results. And second, it turns out that a lot of psychology results are just ‘fragile’ – they describe much smaller sets of individuals than hoped, and are very dependent on particular situations, rather than reflecting broad truths about humanity.

Both of these problems are likely to be shared by a lot of other areas. For example, the methodology of behavioural economics has a very big overlap with experimental psychology, and is likely to have many of the same reproducibility issues. So lots of ‘nudge’ schemes related to savings and pensions could be based on fragile results….(More)”

Innovation Prizes in Practice and Theory

Curated on March 24, 2016October 23, 2018 by Stefaan Verhulst

Paper by Michael J. Burstein and Fiona Murray: “Innovation prizes in reality are significantly different from innovation prizes in theory. The former are familiar from popular accounts of historical prizes like the Longitude Prize: the government offers a set amount for a solution to a known problem, like £20,000 for a method of calculating longitude at sea. The latter are modeled as compensation to inventors in return for donating their inventions to the public domain. Neither the economic literature nor the policy literature that led to the 2010 America COMPETES Reauthorization Act — which made prizes a prominent tool of government innovation policy — provides a satisfying justification for the use of prizes, nor does either literature address their operation. In this article, we address both of these problems. We use a case study of one canonical, high profile innovation prize — the Progressive Insurance Automotive X Prize — to explain how prizes function as institutional means to achieve exogenously defined innovation policy goals in the face of significant uncertainty and information asymmetries. Focusing on the structure and function of actual innovation prizes as an empirical matter enables us to make three theoretical contributions to the current understanding of prizes. First, we offer a stronger normative justification for prizes grounded in their status as a key institutional arrangement for solving a specified innovation problem. Second, we develop a model of innovation prize governance and then situate that model in the administrative state, as a species of “new governance” or “experimental” regulation. Third, we derive from those analyses a novel framework for choosing among prizes, patents, and grants, one in which the ultimate choice depends on a trade off between the efficacy and scalability of the institutional solution….(More)”

Participatory Budgeting

Curated on March 15, 2016August 3, 2018 by Stefaan Verhulst

Participatory Budgeting in Europe: Democracy and public governance by Yves Sintomer, Anja Röcke, and Carsten Herzberg: “Can participatory budgeting help make public services really work for the public? Incorporating a range of experiments in ten different countries, this book provides the first comprehensive analysis of participatory budgeting in Europe and the effect it has had on democracy, the modernization of local government, social justice, gender mainstreaming and sustainable development. By focussing on the first decade of European participatory budgeting and analysing the results and the challenges affecting the agenda today it provides a critical appraisal of the participatory model. Detailed comparisons of European cases expose similarities and differences between political cultures and offer a strong empirical basis to discuss the theories of deliberative and participatory democracy and reveal contradictory tendencies between political systems, public administrations and democratic practices. (More)”

Participatory Budgeting in the United States: A Guide for Local Governments by Victoria Gordon, Jeffery L. Osgood, Jr., and Daniel Boden : “Although citizen engagement is a core public service value, few public administrators receive training on how to share leadership with people outside the government. Participatory Budgeting in the United States serves as a primer for those looking to understand a classic example of participatory governance, engaging local citizens in examining budgetary constraints and priorities before making recommendations to local government. Utilizing case studies and an original set of interviews with community members, elected officials, and city employees, this book provides a rare window onto the participatory budgeting process through the words and experiences of the very individuals involved. The central themes that emerge from these fascinating and detailed cases focus on three core areas: creating the participatory budgeting infrastructure; increasing citizen participation in participatory budgeting; and assessing and increasing the impact of participatory budgeting. This book provides students, local government elected officials, practitioners, and citizens with a comprehensive understanding of participatory budgeting and straightforward guidelines to enhance the process of civic engagement and democratic values in local communities….(More)