Linnea Gandhi

Linnea Gandhi, Benjamin Manning, Angela Duckworth, Effect Size Magnification: No Variable is as Important as the One You’re Thinking About—While You’re Thinking About It.

Abstract: The goal of psychological science is to discover truths about human nature, and the typical form of empirical insights is a simple statement of the form x relates to y. We suggest that such “one-liners” imply much larger x-y relationships than those we typically study. Given the multitude of factors that compete and interact to influence any human outcome, small effect sizes should not surprise us. And yet they do—as evidenced by the persistent and systematic underpowering of research studies in psychological science. We suggest an explanation. Effect size magnification is the tendency to exaggerate the importance of the variable under investigation because of the momentary neglect of others. Although problematic, this attentional focus serves a purpose akin to that of the eye’s fovea. We see a particular x-y relationship with greater acuity when it is the center of our attention. Debiasing remedies are not straightforward, but we recommend (a) recalibrating expectations about the effect sizes we study, (b) proactively exploring moderators and boundary conditions, and (c) periodically toggling our focus from the x variable we happen to study to the non-x variables we do not.

Linnea Gandhi, Anoushka Kiyawat, Colin Camerer, Duncan Watts (Working), Prospects for using hypothetical nudges to approximate real behavior change.

Abstract: Hypothetical scenarios provide an essential alternative to field experiments for scholars interested in nudging behavior change, comprising a substantial proportion of the literature. Yet the conditions under which hypotheticals more or less accurately estimate real-world treatment effects is not well understood. To investigate, we identified five recent field studies of real-world nudges in distinct domains and designed four styles of hypothetical scenarios to approximate each of those five studies. This setup allows clear comparison of old field data with new hypothetical data. Across our 20 pre-registered experiments (N=16,071, n>200 per cell), we find that hypothetical scenarios accurately estimated the direction of treatment effects, but varied widely in estimating the magnitudes of those effects. None of our four designs reliably reduced estimation error. Instead, hypotheticals appeared most calibrated when real-world treatment effects were extremely small, a promising direction for future study.

Linnea Gandhi and Duncan Watts (Work In Progress), Predicting the generalizability of choice architecture interventions.

Katherine L. Milkman, Linnea Gandhi, Sean F. Ellis, Heather N. Graci, Dena Gromet, Rayyan S. Mobarak, Alison Buttenheim, Angela Duckworth, Devin Pope, Ala Stanford, Richard H Thaler, Kevin Volpp (2022), A Citywide Experiment Testing the Impact of Geographically Targeted, High-Pay-Off Vaccine Lotteries, Nature Human Behaviour. https://doi.org/10.1038/s41562-022-01437-0

Abstract: Lotteries have been shown to motivate behaviour change in many settings, but their value as a policy tool is relatively untested. We implemented a pre-registered, citywide experiment to test the effects of three high-pay-off, geographically targeted lotteries designed to motivate adult Philadelphians to get their COVID-19 vaccine. In each drawing, the residents of a randomly selected ‘treatment’ zip code received half the lottery prizes, boosting their chances of winning to 50×–100× those of other Philadelphians. The first treated zip code, which drew considerable media attention, may have experienced a small bump in vaccinations compared with the control zip codes: average weekly vaccinations rose by an estimated 61 per 100,000 people per week (+11%). After pooling the results from all three zip codes treated during our six-week experiment, however, we do not detect evidence of any overall benefits. Furthermore, our 95% confidence interval provides a 9% upper bound on the net benefits of treatment in our study.

Mitesh Patel, Katherine L. Milkman, Linnea Gandhi, Heather N. Graci, Dena Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Jake Rothschild, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher F. Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie K. John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, M. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Seung Hyeong Lee, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin Volpp, Angela Duckworth (2022), A Randomized Trial of Behavioral Nudges Delivered through Text Messages to Increase Influenza Vaccination Among Patients with an Upcoming Primary Care Visit, American Journal of Health Promotion, 37 (3), pp. 324-332.

Abstract: Purpose: To evaluate if nudges delivered by text message prior to an upcoming primary care visit can increase influenza vaccination rates. Design: Randomized, controlled trial. Setting: Two health systems in the Northeastern US between September 2020 and March 2021. Subjects: 74,811 adults. Interventions: Patients in the 19 intervention arms received 1-2 text messages in the 3 days preceding their appointment that varied in their format, interactivity, and content. Measures: Influenza vaccination. Analysis: Intention-to-treat. Results: Participants had a mean (SD) age of 50.7 (16.2) years; 55.8% (41,771) were female, 70.6% (52,826) were White, and 19.0% (14,222) were Black. Among the interventions, 5 of 19 (26.3%) had a significantly greater vaccination rate than control. On average, the 19 interventions increased vaccination relative to control by 1.8 percentage points or 6.1% (P = .005). The top performing text message described the vaccine to the patient as “reserved for you” and led to a 3.1 percentage point increase (95% CI, 1.3 to 4.9; P < .001) in vaccination relative to control. Three of the top five performing messages described the vaccine as “reserved for you.” None of the interventions performed worse than control. Conclusions: Text messages encouraging vaccination and delivered prior to an upcoming appointment significantly increased influenza vaccination rates and could be a scalable approach to increase vaccination more broadly.

Katherine L. Milkman, Linnea Gandhi, Mitesh Patel, Heather N. Graci, Dena Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Jake Rothschild, Jonathan E. Bogard, Ilana Brody, Christopher F. Chabris, Edward Chang, Gretchen B. Chapman, Jennifer E. Dannals, Noah J. Goldstein, Amir Goren, Hal E. Hershfield, Alexander Hirsch, Jillian Hmurovic, Samantha Horn, Dean Karlan, Ariella Kristal, Cait Lamberton, M. Meyer, Allison H. Oakes, Maurice Schweitzer, Maheen Shermohammed, Joachim H. Talloen, Caleb Warren, Ashley Whillans, Kuldeep N. Yadav, Julian J. Zlatev, Ron Berman, Chalanda N. Evans, Rahul Ladhania, Jens Ludwig, Nina Mazar, Sendhil Mullainathan, Christopher K. Snider, Jann Spiess, Eli Tsukayama, Lyle Ungar, Christophe Van den Bulte, Kevin Volpp, Angela Duckworth (2022), A 680,000-Person Megastudy of Nudges to Encourage Vaccination in Pharmacies, Proceedings of the National Academy of Sciences, 119 (6). 10.1073/pnas.211512611

Abstract: Encouraging vaccination is a pressing policy problem. To assess whether text-based reminders can encourage pharmacy vaccination and what kinds of messages work best, we conducted a megastudy. We randomly assigned 689,693 Walmart pharmacy patients to receive one of 22 different text reminders using a variety of different behavioral science principles to nudge flu vaccination or to a business-as-usual control condition that received no messages. We found that the reminder texts that we tested increased pharmacy vaccination rates by an average of 2.0 percentage points, or 6.8%, over a 3-mo follow-up period. The most effective messages reminded patients that a flu shot was waiting for them and delivered reminders on multiple days. The top performing intervention included two texts delivered 3 d apart and communicated to patients that a vaccine was “waiting for you.” Neither experts nor lay people anticipated that this would be the best-performing treatment, underscoring the value of simultaneously testing many different nudges in a highly powered megastudy.

Katherine L. Milkman, Mitesh Patel, Linnea Gandhi, Heather N. Graci, Dena Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher F. Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie K. John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, M. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin Volpp, Angela Duckworth (2021), A Megastudy of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor’s Appointment, Proceedings of the National Academy of Sciences, 118 (20). 10.1073/pnas.2101165118

Abstract: Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were 1) framed as reminders to get flu shots that were already reserved for the patient and 2) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor’s appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.

Linnea Gandhi, “The Integrated Model”. In Building Behavioral Science in an Organization, edited by Zarak Khan & Laurel Newman, (2021)

Linnea Gandhi and Erik Johnson, 8 Things to Do Before You Run a Business Experiment in Harvard Business Review Online,.

Daniel Kahneman, Andrew Rosenfield, Linnea Gandhi, Tom Blaser, Noise: How to Overcome the High, Hidden Cost of Inconsistent Decision Making in Harvard Business Review Magazine,.