Foreword
At TDL, our role is to translate science. This article is part of a series on cutting edge research that has the potential to create positive social impact. While the research is inherently specific, we believe that the insights gleaned from each piece in this series are relevant to behavioral science practitioners in many different fields. As a socially conscious applied research firm, we are always looking for ways to translate science into impact. If you would like to chat with us about a potential collaboration, feel free to contact us.
Introduction
Behavioral science insights can profoundly impact health outcomes — from encouraging prosocial handwashing behaviors during a pandemic to increasing the number of individuals who sign up for health insurance. As a socially-conscious applied research firm, TDL is interested in using empathy, technology, and design-thinking to promote better outcomes in many aspects of society, from health to education to the economic empowerment of disadvantaged groups. To amplify these impacts even further, leveraging digital tools to create health solutions can scale and achieve these desired outcomes more cost-effectively than traditional interventions.
The Decision Lab reached out to Dr. Erez Yoeli of MIT to learn more about his work on a project involving digital health tools for Tuberculosis (TB) patients and the future direction of similar areas of research in behavioral science.
Dr. Yoeli is a research associate at MIT’s Sloan School of Management and co-director of the Applied Cooperation Team (ACT), a team of researchers that applies insights from the social sciences towards increasing contributions to real-world public goods.
In this study, Dr. Yoeli and a multidisciplinary team of researchers developed a behavioral science informed digital health platform that provided TB patients with support and increased adherence to treatment plans.
A full version of the paper is available here: https://www.nejm.org/doi/full/10.1056/NEJMc1806550
Interview
Julian: What is the focus of your research?
Dr. Yoeli: My research focuses on altruism — understanding how it works and how to promote it. I collaborate with governments, non-profits, and companies to apply these insights to address real-world challenges like improving antibiotic adherence, reducing smoking in public places, increasing energy conservation, and promoting philanthropy.
Julian: What process did you follow for this piece of research?
Dr. Yoeli: Tuberculosis is the world’s deadliest infectious disease. It kills roughly 2 million people each year despite the fact that it has had an effective cure since the mid-1940s. Unfortunately, this cure requires a long treatment (6+ months), during which patients are required to take a strong antibiotic on a daily basis and return to a clinic for regular (typically weekly) visits.
Many patients, quite reasonably, stop this treatment prematurely with the hopes that they are cured. Unfortunately, they often are not by the time they stop, and this can result in the transmission of TB to others in their communities as well as the development of drug resistance. A further problem arises as the consequences of this resistance are borne not by the individual, but by the community as a whole.
We believed that individuals needed better support motivation to consider the consequences that ceasing treatment has on their communities. We built a digital health platform based on principles from behavioral science for this purpose.
The platform’s three guiding behavioral principles were:
- Increase accountability
- Reduce plausible deniability
- Normalize adherence
Each morning, the platform would send patients a reminder to take their medication and to log in and verify that they’d done so. If patients failed to verify, they’d receive another reminder an hour later, and then an additional reminder an hour after that.
