Winning Nudges Announced in "Designing for Better Health" Competition

Jun 3, 2009, 11:55 AM, Posted by Paul Tarini

The winners of the "Designing for Better Health" competition we held with Ashoka’s Changemakers have been announced.  The competition was inspired by the book Nudge, which was written by behavioral economics experts Cass R. Sunstein, J.D. and Richard Thaler, Ph.D.  Nudges are simple pushes that can induce someone to change their behavior.  My favorite entry didn’t win.  If you tracked the competition, it was “Just an Idea.”  This entry suggested a way to help more women conduct their monthly breast self-examination—put a reminder symbol in birth control pill packages on the optimal exam day.  I thought this idea was elegant.

There were 285 entries from 29 countries.  The three winners were all international:

  • GOONJ (India) - GOONJ (means “echo”) collects donated cloth and creates clean sanitary pads that it then distributes to women, while at the same time bringing out in the open the taboo subject of menstrual hygiene.
  • San Francisco Saludable (Peru) - This unique waste management program nudges people to change their traditional habits to improve their health by producing compost for family gardens. 
  • Fundación Boca Sana (Venezuela) - Children are nudged to better oral health because they receive training to act as scholar/promoters who share what they have learned about proper oral hygiene and care with other children, parents and relatives. 

After reading through all of the entries, I came to the conclusion that nudges, as conceived by Thaler and Sunstein, are a subtle concept.  The folks at Changemakers tried hard to explain the concept on the competition site and, to my eyes, they did a good job.  But looking at the entries, a lot of them weren’t even nudge-ish.  In designing the concept of nudges, Thaler and Sunstein were trying to walk a fine political line to come up with an approach to policy that would be acceptable to the right and the left—Libertarian Paternalism, they call it.  One thought as to why a good nudge is hard to find is that it requires a lot of discipline on the part of the designer.  You set up the nudge and then stand back.  If people aren’t nudged to do the right thing, that’s get your answer pretty clearly as to whether it worked.  For people who are driven to solve problems, that may be a very hard stand to take.

That said, there were some wonderful entries and I offer my sincere congratulations to the winners—well done!  Also, I thank Changemakers for their good work and my fellow judges for their efforts.  We’re glad to have sponsored the competition and we hope those who entered, commented and otherwise participated continue to explore the power that well-designed nudges can have in driving better health decisions, behaviors and outcomes.

This commentary originally appeared on the RWJF Pioneering Ideas blog.