Nudge

Here’s a surprising story from the San Diego International Airport.  For 10 non-consecutive days, signs were posted at the bottom of a set of stairs and escalators urging people to take the stairs.  The signs read: ‘Please reserve the escalator for those who need it’, or ‘Don’t lose time, lose weight. Use the Stairs’, or ‘Don’t waste Time, trim your Waistline. Use the Stairs’, or ‘You’ll get more stares if you use the stairs’, or ‘If you want to feel younger, act younger. Step it up! Use the stairs.’  On alternating days there were no signs posted. 

Researchers from the San Diego State University counted how many people took the stairs versus the escalator on days with and without the signs, and also interviewed people atop the stairs about their health and level of physical activity.  The research was headed by John Bellettiere, at UC San Diego, who is working on ways to help people sit less and move more.   On days when one of the signs was present, about twice as many people took the stairs compared to a no-sign day.  An important finding was that people who never exercised also used the stairs. People used the stairs even if they were in a rush and carrying luggage.  Bellettiere concluded that having even a small amount of exercise early in the day may lead to getting more later.  When people see others taking the stairs they are more likely to do so themselves, creating a ripple effect. 

Social science research has shown that there are many ways we can be ‘nudged’ into acting in ways that may be positive, or negative, for our well being.  Some utility companies get people to conserve power by sending out comparison notices, telling people how their use compares to others in the area who are using less.  This is a carefully designed strategy encouraging people to use less energy, and it has been successful.  If we believe other people are doing the right thing, we will want to do so also. The approach originates from the sociological concept of social norms, which holds that group members will respond to appropriate – or inappropriate  - values and behaviors held by others in their group.  The recent  Nobel Prize winner in Economics, Richard Thaler, wrote about these ideas in a book with Harvard lawyer Cass Sunstein – titled Nudge.  They consider their concepts to be from neither left nor right on many hot button issues, since a nudge does not restrict freedom of choice.

Be on the lookout for ways you are being subtly nudged by the culture around you.  Candy at the checkout counter at Safeway.  Signs urging you to walk up the stairs.  Wait a minute – that’s a good one.  Think of ways you can nudge yourself in a beneficial direction to exercise more.  Form a walking group; tell your friends what you plan to do; pay money to join a gym; write signs in your house that will inspire you to move, eat healthy food, or reach out to friends. 

Sadja Greenwood, MD, MPH  back issues on this blog