Where is the Checklist for Behavior Change Interventions?

Over the past two weeks I’ve been leading behavior change workshops for two very different groups of communicators: conservation biologists struggling to save species on the brink of extinction, and Ukrainian communications professionals working to improve conditions in their young democracy. As these two quite distinct groups dove into learning the basics, both had the same question: is there a checklist for behavior change interventions?

Checklists can be change-making. They have been successfully used to improve performance and safety in a wide range of jobs, from food preparation to auto repair to aviation and medicine. Peter Pronovost, a doctor at Johns Hopkins Hospital, saved hundreds of lives by distilling a 64-page federal document on hospital infections into a simple five-step checklist that doctors could actually follow. The 2008 WHO Surgical Safety Checklist cut mortality rates nearly in half. And in 2010, behavior change experts at the United Kingdom’s Institute for Government produced the M.I.N.D.S.P.A.C.E. checklist to help policymakers incorporate nine key behavioral effects into interventions on issues such as crime, obesity and environmental sustainability.Screen Shot 2018-11-08 at 10.00.49 AMThe problem with checklists, however, comes from the same human fallibility that can make them helpful in the first place. Doctors’ overconfidence bias can lead them to ridicule or resist implementation; as one physician complained in a National Institutes of Health study, “I’ve done this for thirty years, and now I’m supposed to play around with a checklist?”

Even more problematically, checklists can inadvertently encourage people to mentally check out, and default to rote box-checking (I once had a nurse rush through the post-op patient checklist with me before a minor surgery “to save time”). And more complex tools like the WHO Surgical Safety and M.I.N.D.S.P.A.C.E. checklists are designed not to provide prescriptive to-do’s, but instead to encourage more thoughtful approaches to the task at hand.

So is there a checklist for behavior change interventions? There are many checklists out there that can help guide campaign development, implementation and evaluation, including Six Steps to Behavior Change Marketing, a resource we created to share during our workshops.

Marketing in Six Steps resource cover

All effective behavior change campaigns must be grounded in theory, informed by research, guided by strategy, and must use measurement to track outcomes. But the bad news for my recent workshop participants at the ConsMark conference in D.C. and the Practicum course in Ukraine — as well as for others who would like a prescriptive methodology for behavior change interventions — is that there is no perfect checklist and no one right solution to the problems we are working to address.

As behavior change expert Rob Gould noted in a recent Fun Easy Popular blog post on social change theory and practice, effective interventions require a marriage of methodology and creativity. Using the more academic term “social marketing,” he notes: “Successful social marketing is as much an art as it is a science. It is an approach to influencing behavior that, by systematically integrating our knowledge of human behavior, marketing and effective communication, creates something new. Our clients recognize it. They don’t just say, ‘That might work.’ They say, ‘That is very clever!’ ”

Participants in Kyiv in workshop groupsParticipants at the Practicum Course at Ukrainian Catholic University in Kyiv work on choosing priority actors for a campaign to increase adoption of shelter animals.

However, the good news is that with just a little bit of training, participants at our workshops on two continents developed campaign ideas that were not only quite creative but grounded in a developing understanding of how behavioral science can be leveraged to drive real change in the real world.

Want to change behavior? Understand the methodology. Then bring your clever.

Sara is Principal + Director of Strategy and Planning at Marketing for Change.