Panel: Novel Behavioral Interventions to Improve Organizational Efficacy
(Public and Non-Profit Management and Finance)

Thursday, November 8, 2018: 10:15 AM-11:45 AM
8223 - Lobby Level (Marriott Wardman Park)

*Names in bold indicate Presenter

Panel Chairs:  Saugato Datta, ideas42
Discussants:  William Congdon, Urban Institute

Using Behavioral Interventions to Improve Service Access for Medicaid-Eligible Pregnant Women in Baltimore
Erin Sherman1, Amy Secrist2, Douglas Storey3, Jess Leifer1 and Suman Gidwani1, (1)ideas42, (2)Baltimore City Health Department, (3)Johns Hopkins University

Evidence for a Behavioral Approach to Increase Long-Acting Contraception Uptake Among Post-Abortion Clients in Nepal: Experimental Results of a Peer Comparison Feedback Tool for Service Providers
Jeremy T. Barofsky1, Sabitri Sapkota2, Pragya Gartoulla2, Saugato Datta1 and Karina Lorenzana1, (1)ideas42, (2)Marie Stopes International

The Effectiveness of Competition and Responsibility Assignment in Saving Energy: A Non-Residential Example of the Power of Nudging
Matthew Darling1, Saugato Datta1, Martine Visser2 and Rebecca Klege2, (1)ideas42, (2)University of Cape Town

A pervasive problem for public and nonprofit organizations is how to encourage providers to maximize social goals. Whether the context is health, education, or environmental conservation, providers must deliver services under constraints such as limited resources and attention, high client volume, and multiple or uncertain organizational outcomes. Understanding how to overcome these constraints is especially impactful when the organizational goals generate positive externalities.  

Given these constraints, there is increasing data that behavioral, non-monetary interventions improve outcomes in certain public and nonprofit settings. Evidence indicates that nudges generate sustained reductions in residential energy consumption of 2% (Allcott, 2011; Allcott & Mullainathan, 2010). Moreover, surgical checklists have been shown to improve care quality and health outcomes immediately after medical procedures (Haynes et al. 2009). Not all are effective, however, as shown by a safe childbirth checklist trial, which was not found to reduce infant mortality (Semrau et al. 2017).

The three papers in this panel employ peer-comparison interventions to shift provider behavior and ultimately improve organizational social outcomes. In addition, each paper investigates outcomes with positive externalities. The first paper uses social comparisons to encourage providers at a network of family planning clinics in Nepal to increase take-up of long-acting reversible contraception (LARC). In addition to providing protection for a longer duration, LARC is also more effective compared to short-acting methods. Using a stepped-wedge randomized design, we observe an increase in LARC uptake of 32% from control levels. The second paper applies nudges using social comparison and assignment of responsibility to reduce electricity consumption in a large provincial government office building in Cape Town, South Africa. Treatments are randomized at the office building floor level. Results show that floors participating in a treatment with inter-floor competitions and informational tips reduced energy consumption by 9%, while those that also included floor-wise ‘energy advocates” reduced energy consumption by 14% over a period of 5 months. The third paper investigates whether a series of social comparison and informational interventions can increase prenatal care provider submissions of prenatal risk assessment (PRA) forms for Medicaid eligible pregnant women in Baltimore City. The PRA is a referral mechanism to several services (such as WIC, smoking cessation assistance, and home visiting programs, among others) intended to improve outcomes during and after high-risk pregnancies. Although still in the field, the results will inform whether these behavioral interventions can affect administrative processes that are not salient to improve service access.

Each paper in this panel uses innovative behavioral interventions that were developed from formative qualitative interviews and user testing. The treatments apply principles of behavioral science instead of changing providers’ monetary incentives to improve organizational outcomes. In addition, each paper uses rigorous impact evaluation methods through randomized control trials to estimate effects. The discussion will explore how these insights could be applied to better manage public and nonprofit organizations and achieve their social goals at low cost.