The impact of text message (SMS) reminders on helmet use among motorcycle drivers in Dar es Salaam, Tanzania: A randomized, controlled trial (Preprint)

BACKGROUND Road traffic injury (RTI) is a pressing public health issue in Tanzania. Men are particularly at high risk of RTI because nearly all drivers of motorcycle taxis (“bodabodas,” in Kiswahili, or “bodas” for short), a major form of public transportation in the country, are men. Studies have shown that helmet use can significantly reduce disability and death resulting from road traffic injuries. Efforts have been made by the Tanzanian government to develop tighter helmet use laws. However, adherence to helmet use has remained dangerously low throughout the country. One promising intervention to promote helmet use is the introduction of persuasive short message service (SMS) reminders delivered to boda drivers. OBJECTIVE To evaluate the comparative impact of two different types text messages, also known as short message service (SMS) reminders, on motorcycle helmet use. METHODS Participants were 391 commercial motorcycle taxi drivers in Dar es Salaam, Tanzania. Participants were randomized into three groups, each receiving a different set of messages: 1) social-norming messages aimed at emphasizing society’s positive stance on helmet wearing, 2) fear appeal messages that emphasized the dangers of riding without a helmet, and 3) control group messages, which included basic road safety messages unrelated to helmet use. Every participant received the control messages. Adherence to helmet use was evaluated by self-report through surveys conducted at baseline, 3 weeks and 6 weeks. RESULTS At 6 weeks, the odds of self-reporting consistent helmet use was estimated to be 1.58 times higher in the social-norming group than in the control group (P=.043), though this difference is not significant after accounting for multiple testing. There was little difference between fear appeal and control group recipients (OR= 1.03, P=.466). Subgroup analysis suggests that both fear control and social-norming message types might have been associated with increased helmet use among participants who did not consistently wear helmets at baseline (OR= 1.66 & OR=1.84), but this was not significant (P=.109 & P=.071). Amongst those who were consistent wearers at baseline, the social-norming messages performed better than the fear appeal messages, and this difference reached traditional significance (P=.029), but is not significant after accounting for multiple testing. CONCLUSIONS The use of SMS reminders may improve helmet use among motorcycle drivers when framed as social-norming messages. Given that nearly half of the drivers in our sample did not consistently wear their helmets on every trip, strategies to increase consistent usage could be an important benefit to public safety. CLINICALTRIAL clinicaltrials.gov Identifier: NCT02120742 https://clinicaltrials.gov/ct2/show/NCT02120742

Backfiring, reactance, boomerang, spillovers, and rebound effects: Can we learn anything from examples where nudges do the opposite of what they intended?

The academic literature continues to amass a vast amount of empirical work examining the effect of nudges in a variety of contexts designed to improve life style choices in alignment with social policies. In fact, the literature is so vast, there are now meta-analytic studies designed to determine the overall effects of different types of nudges used in a variety of domains (e.g. chronic health, weight management, managing personal finances, pro-environmental behaviours). At the same time, there is also an amassing literature on backfire effects (of which 65 studies are referred to in this article). These are examples where the introduction of a nudge (e.g. a default, social norming, framing, information provision) generates behavioural change in the opposite direction of what was intended. The approach taken here is that there is much that can be learnt from when nudges go wrong, and the insights can be used to indicate where improvements can be made for designing nudges to support better decision-making.

Implementation of a Multi-Component School Lunch Environmental Change Intervention to Improve Child Fruit and Vegetable Intake: A Mixed-Methods Study

Nudge interventions are widely used to promote health in schools, yet implementation metrics are seldom used to understand intervention outcomes. A multi-component intervention consisting of cafeteria decorations, creative names, social norming taste tests, and flavor station components was implemented in three rural elementary school cafeterias by school nutrition services (SNS) and extension staff. Selection and consumption of fruits and vegetables at lunch were measured through monthly plate waste assessments over eight months (n = 1255 trays). Interviews were conducted with SNS staff (n = 3) upon completion of the intervention to assess implementation outcomes using validated acceptability and feasibility metrics. Consumption findings were generally inconsistent across schools and time points, yet fruit consumption increased at School 1 (p < 0.05) during the taste test and flavor station intervention months and School 2 (p < 0.001) during the creative names intervention months compared to baseline. Odds of selecting a vegetable at School 3 were three times higher than baseline during the taste test intervention months (odds ratio (OR), 3.0; 95% confidence interval (CI), 1.3–6.5). Cafeteria decorations and taste tests had higher reported implementation metrics for acceptability and feasibility than other interventions. Thematic analysis underscored the facilitating role of extension support, as well as systems factors, which served as facilitators and barriers across schools and interventions. These findings suggest that nudge interventions are a promising strategy to improve vegetable selection and fruit consumption in school meal programs.

SOCIAL MECHANISMS OF SCIENTIFIC MANAGEMENT

The article is devoted to issues of social management in the context of modern industrial and economic transformations. The main purpose of the article is to formulate the author’s concept of scientific management using social mechanisms. As a hypothesis, the possibility of implementing scientific management through the use of social norming is considered. The main research methods were general scientific methods of cognition, in particular, dialectic, system, comparative analysis, as well as the induction method in developing the author’s concept. The article considers the issue of labour management in conditions of the impossibility of applying quantitative labour standards for intellectual and informational activities. The methodological basis consists of the concepts of foreign and domestic researchers regarding the scientific organization of labour. The concept of social norming is formulated, according to which, managers must ensure the existence of two types of social norms in the organization: rigid (unchanging) and flexible (the content of which varies depending on the current tasks of the organization). Based on the specifics of the labour functions of specific workers, managers can model and implement social norms that stimulate certain social changes. Conclusions. Based on the proposed approach, the nature of managerial influence is determined, which consists of two parts: development and implementation of social norms; stimulation of its fastest assimilation by all members of the labour collective.

Perceptions of barriers and facilitators in physical activity participation among women in Thiruvananthapuram City, India

Background: Despite the known benefits of physical activity, very few people, especially women, are found to engage in regular physical activity. This study explored the perceptions, barriers and facilitators related to physical activity among women in Thiruvananthapuram City, India. Methods: Four focus group discussions were conducted among individuals between 25 and 60 years of age, in a few areas of Thiruvananthapuram City Corporation limits in Kerala, preparatory to the design of a physical activity intervention trial. An open-ended approach was used and emergent findings were analyzed and interpreted. Results: Women associated physical activity mostly with household activities. The majority of the women considered their activity level adequate, although they engaged in what the researchers concluded were quite low levels of activity. Commonly reported barriers were lack of time, motivation, and interest; stray dogs; narrow roads; and not being used to the culture of walking. Facilitators of activity were seeing others walking, walking in pairs, and pleasant walking routes. Walking was reported as the most feasible physical activity by women. Conclusion: Physical activity promotion strategies among women should address the prevailing cultural norms in the community, and involve social norming and overcoming cultural barriers. They should also target the modifiable determinants of physical activity, such as improving self-efficacy, improving knowledge on the adequacy of physical activity and its recommendations, facilitating goal-setting, and enhancing social support through peer support and group-based activities.

Analysis of the Freshmen Alcohol Abuse Program

The aim of this study is to assess outcomes of the Freshmen Alcohol Abuse Program in reducing BAC levels among freshmen students and to describe and learn about the patterns of drinking behaviors. This program is a combination of the “Wanna Know” and “Did You Know” campaigns. The Wanna Know campaign consisted of a blood alcohol concentration (BAC) test with a Breathalyzer® device and an interview with freshmen students on unannounced weekend “partying nights” on a northern California university campus. The interviews and breath tests totaled 1,314 in year one and 1,215 in year two. The Did You Know campaign was the component that focused on distributing social norming messages. Social norming messages were delivered through posters on campus, screensavers in student computing labs, mouse pads, brochures, table tent cards, and t-shirts. These messages were designed to curb drinking by making students aware of the actual drinking norms rather than the students’ perceived norms with the intent that students would adjust to the actual norm, resulting in a reduction in drinking. Results indicated mean BAC levels of .068 in year one and .056 in year two. This represents a drop of .012 BAC, or a 21.4 percent decline from year one to year two.