The Behavior Change Podcast by Lirio explores the various ways humans can leverage behavioral science to personalize our messaging, engage our audience, and drive better behavior at scale.

Host: Greg Stielstra (GS), Senior Director of Behavioral Science at Lirio

Guest: Chandra Osborn (CO), Chief Behavioral Officer at Lirio

Summary: Greg welcomes Lirio’s new Chief Behavioral Officer, Chandra Osborn, Ph.D., MPH to The Behavior Change Podcast. Listen as they discuss Chandra’s background in behavioral science and psychology, her experience working at Vanderbilt University and One Drop, her exciting position at Lirio, and her affinity for pineapples.

 

Transcript

Greg Stilestra:

Hello and welcome to The Behavior Change podcast by Lirio, the program where we explore the marvels of behavioral science and ways of applying it to make a better world.I’m your host, Greg Stielstra.

On today’s program we’ll speak with Chandra Osborn, the former Assistant Professor of Medicine and Biomedical Informatics at Vanderbilt University, former VP of Health and Behavioral Informatics at One Drop, and the current Chief Behavioral Officer at Lirio.

It’s a wide-ranging discussion, covering the experiments she’s run over an impressive career, insights she’s gained, and perhaps most importantly, we’ll answer the question: Why is there a pineapple on her head in her Twitter profile picture?

But first, as always, we’ll begin with a Bias Brief.

 

Lirio Bias Brief 140 – Availability Bias

What kills more people in a typical year: tornados or asthma? If you’re like most people, you probably said tornados. Here’s why: As you tried to answer the question, the first thing you did was attempt to remember examples of each, instances of people dying from tornados came easily to mind because those violent storms are eagerly covered by news media. But you may have struggled to remember examples of people dying from asthma, a quiet killer that attracts less attention.

Next, you reasoned that, because deaths by tornado were easier to recall, they must also be more likely to occur. But, they’re not. Asthma kills about 100 times more people every year than tornados.

As with so many other heuristics, availability bias occurs because our brain substitutes a different question, one that’s easier to answer, for the one that was asked. Instead of answering, “Which takes more lives?” your brain answers the question, “Which can I more easily remember?”

By leading people to misjudge probabilities, availability bias can cause people to take unnecessary risks or doctors to misdiagnose patients.

Whether people take preventative measures to avoid conditions like the flu or breast cancer depends in large part on how susceptible they believe they are. It’s important, therefore, to consider availability bias when planning behavior change interventions, so you can anticipate how people may judge or misjudge their probabilities.

If their perceived susceptibility is lower than their actual risk, you can apply availability bias to reconcile the discrepancy. Read the rest of this bias brief at Lirio.co.

 

GS:

All right, let’s talk about your education because, it’s extensive. You earned your bachelor’s in psychology and sociology at Cal State, a master’s and Ph.D. in social psychology from The University of Connecticut. And, because clearly that wasn’t enough, you earned a master’s in public health from North Western and did postdoctoral fellowship there as well. Are you done going to school for a while?

Chandra Osborn:

I am.

GS:
How was it that you came to follow that particular educational path?

CO:

It wasn’t scripted. I realized during my undergraduate work at Cal State, working with Wesley Schultz who is a well-known conservation psychologist that understanding human behavior and figuring out ways to promote desirable behaviors was something I was really curious about.

I got into psychology because I wanted to help people. I thought I wanted to be a counselor. I didn’t realize there was this very vibrant and rich path of doing research in psychology until I started working with Wes.

GS:
And you were hooked?

CO:
I was hooked.

GS:
What were some of those experiments?

CO:
Yeah, we had some great opportunities to collaborate with the San Diego Wild Animal Park. And so, there were a few projects I was involved in at the Wild Animal Park. One included researching kids and their pro-environmental behaviors and attitudes along with their parents’ pro-environmental behaviors and attitudes.

These kids were attending their fourth and fifth grade, elementary school, on a satellite campus that was housed within the Wild Animal Park. There was some crowding at a nearby elementary school and so they put these temporary classrooms on the property of the Wild Animal Park and we had the opportunity to understand whether or not the Wild Animal Park was supplementing their education that they were receiving every day, sort of their standard curricula and making them pro-environmental as a result of that exposure. And, whether or not there was a spill over to their parents, if they were coming home and kind of talking about these opportunities that they were having at the Wild Animal Park.

GS:
So, you’re at the Wild Animal Park studying wild humans? What did you learn?

CO:
Interestingly and, unexpectedly, we learned that there wasn’t a benefit to being associated with the park or housed within the park, and we tried to understand why. And a few thoughts include the fact that maybe they were resentful that they were now in their fourth and fifth grade and they were removed from their school that they were accustomed to and they had to go to this place that was outside of that community.

Another possibility is that there wasn’t a formal connectivity with the Wild Animal Park. The Wild Animal Park did, every month, bring animals to the small school within the park to showcase the animals, but there wasn’t a lot of day-to-day bridging between the school and the park.

There was a fence surrounding the portable classrooms, so there was a clear barrier, physically and also with how the curriculum for these fourth and fifth graders was laid out. There wasn’t as much integration as we had hoped or thought that there could be given the proximity.

GS:
I should ask, what were you trying to study? What was the experiment?

CO:
Yeah, we were hoping that just having that access would sort of create these norms of, we should be taking care of these animals, we should be taking care of the environment, this is a beautiful property and we have a chance to learn how to take care of natural habitats, because this is the San Diego Wild Animal Park. It’s not a traditional zoo.

The animals are living in their natural habitats, they’re not caged up and so, we were hoping that what we would find is that these kids and, in turn, their parents were having more favorable attitudes and behaviors towards the environment as a result of this exposure.

GS:
But you didn’t find that? That’s too bad.

Do you think things like the fence made these students feel separate from rather than integrated into the park?

CO:
I would suspect that that’s a possible reason. Context matters. The environment matters. It provides these subtle cues to us of what’s a part of our environment and what’s not.

For these kids who are on the inside of this fence, there’s a visible disconnect with the park and what it is that they’re there for. It is a message to them that this is not accessible to me.

GS:
I hear you say this, and I think of in-group/out-group behavior, where these kids define themselves as being a part of the in-group and the animals as part of the out-group, where you compete against them and you see yourself as different from the out-group.

CO:
Yeah, and it reminds me of those experiments they did quite a while ago where they had the buses. If you recall, some of these experiments, they would have these in-group/out-group scenarios with these kids that were on this bus, and one of the ways that they tried to overcome that was to have them work toward a collective goal. So, that’s one of the ways in which you overcome that.

So, if there was more opportunity built in to come together and work together, these kids and park workers, there might be a way to reduce that physical and psychological barrier to accessing the park. One of the ways you overcome that bias is to find a shared goal and together figure out how to work to achieve it.

GS:
I’m going to ask you to speculate, but I think about in-group/out-group in healthcare and I wonder whether some of those forces aren’t at play between the group called “patients” and the group called “caregivers,” and whether knocking down some of those walls might improve the quality of care?

CO:
Yeah. Caregivers as in healthcare providers?

GS:

Yes.

CO:
Absolutely. Yes.

GS:
Do you think the same could be true in energy, where there’s the “utility” and there’s the “customer?”

CO:
Yes.

GS:
Just off hand, what would you recommend to a utility that wanted to knock down some of those walls between it, as a provider, and its customers, as consumers?

CO:
Sure. Dialing up what sort of value systems and shared goals that the customer has and the utility has.

So, we’re in this together. We’re not trying to make you pay more. We have these commonalities. Sort of creating a bridge in the language that’s being used, as well as framing a shared target—that we are moving in a direction that’s not about getting you to give us more money. But is in a way to actually get us both to the same benefit.

GS:
That’s really the only industry, I can think of, that routinely asks its customers to buy less of its product. Using that as a starting point for the commonality.

CO:
That’s right.

GS:
So, it turns out you’re an award-winning behavioral scientist. Every year the American Psychological Association awards prizes to promising graduate students for the completion of their dissertation research. And in 2004, you were selected for one of those awards for your dissertation entitled “Using the IMB Model of Health Behavior Change to Improve Glycemic Control in Puerto Rican Americans.”

CO:
Yes.

GS:
What did you learn?

CO:
That’s 15 years ago. Wow, a lifetime ago.

GS:
But you remember.

CO:
Yes, I do.

I made the leap from conservation psychology and applying behavioral science principles to understanding pro-environmental and pro-attitudinal behaviors among humans. And, I made the switch to health.

GS:
A logical next step.

CO:
I wanted to help people improve their health outcomes or to stay healthy, and largely because I was diagnosed with pre-diabetes when I was 20. So, it both became a personal passion, but also, forced me to reflect on how I can apply the skills that I was learning to this new area.

So, fast forward, I go to graduate school and I’m getting my Ph.D. and my graduate advisor, Jeffrey Fisher, who is a world-renowned behavioral scientist. He had been doing research on the IMB model in HIV for many, many years. And I went to him and said, “Hey, no one’s applied this model to diabetes, could we do that?” And he was very supportive, so I decided to kind of take some of this work and see how it worked in diabetes.

I’m an ethnic minority, and so one of the passion points or passion places for me is improving the health and preserving the health of racial/ethnic minorities. And I looked around in Connecticut and thought, who’s a population that I could potentially help, and low and behold, Puerto Rican Americans became that population.
Yeah and so, here we go, applying a behavioral science model on a new domain with a population that I do not speak the language.

GS:
So you thought you’d start with an easy one?

CO:
That’s right.

GS:
Good idea.

CO:
And do it in a healthcare setting, which we had no formal existing relationship with.

GS:
And you won an award for this. For your effort?

CO:
I like to think so.

But what a great exercise and experience to be able to have the support that I needed to be able to pull that off. It was a great opportunity and a lot of fun.

What we learned was that the IMB model did a great job kind of predicting that with increased knowledge of what the exercise recommendations are, increased motivation, it increased behavioral skills, which is self-efficacy, that exercise increases in this population.

GS:
For those who are listening that may not be familiar with the IMB model, you just sort of named it’s three parts.

CO:
I did.

I for information, M for motivation, and the B part is for skills, so your ability to apply your information and, you leverage your motivation to act on the recommendation. So, we saw those pathways predicted physical activity, and those same pathways predicted improvements in nutrition.

We saw an improvement in glycemic control among the intervention conditions, so those who received the IMB-based intervention. We did not see a difference between the intervene group and the control group in their glycemic control.

Could have been because of the small sample. It was a dissertation project, it wasn’t a large, resourced type project. But we certainly got a lot out of doing it, and that really laid the foundation for my career in diabetes.

GS:

So, let’s talk about that. You, prior to coming to Lirio, worked for a company called One Drop.

CO:
Yes.

GS:
What do they do, and what did you do for them?

CO:
One Drop is a digital diabetes therapeutic solution. There is a mobile app available on all the things: Android, IOS, Amazon’s Alexa, Fitbit Ionic, Apple’s watch. And there’s also diabetes educators that coach people through this app.

One Drop has the first, and I believe the only, digitally delivered diabetes education program accredited by the American Diabetes Association. So, instead of having to go to a healthcare setting to be educated about your diabetes, you can look at your phone and receive all the information and support that you need to be able to have that same experience, but in a more convenient and accessible way.

GS:
Greater convenience, lower stigma.

CO:
That’s right, sort of overcoming some of these things that get in the way of people becoming educated about their diabetes, so they can begin to act on some of those recommendations.

GS:
A behavioral solution. Surprise, surprise.

CO:
That’s right.

And then, there’s also an FDA-approved meter that’s Bluetooth connected to the app. So, you can essentially use this meter, check your blood sugars, automatically goes into the app. You can also, there’s so much connectivity that you could tell Amazon’s Alexa, log my carbohydrate grams, so that you don’t even touch the app.

You can get your activity from your wearable devices coming into the app, and you can even use a smart pen, insulin pen, and inject your insulin and it goes into the app, so that you have all these data points that you typically use to inform how you take care of your diabetes displayed to you, so that you can make some choices.

GS:
And interpreted for you?

CO:
And interpreted for you.

So, data science is being harnessed in this product where recommendations are appearing. “Hey, we see a trend here, looks like your blood sugar is going to go up in a few hours. Here are some things that you might want to do.”

GS:
Almost like having a diabetes coach follow you around.

CO:
Yes. There is a live human being diabetes educator who is following you around in the app. But then, there is also machine learning and AI that’s taking in some of that additional data and providing some additional support.

GS:
So, that sounds really cool.

CO:

It is cool.

GS:
Why did you leave it and come to Lirio?

CO:
Yeah. I adore One Drop. I believe in the company and the mission and what they’re doing. I have had a great experience working with them and was able to do science with the company and even run randomized control trials.

My reason for joining Lirio is that I very much wanted to apply the other hat that I wear as a behavioral scientist, which is to do more behavioral design. With One Drop I was very much leading the research initiatives and performing science and understanding the product and being able to use the efficacy that we found and present that in the peer-reviewed outlets, present that at big international meetings, like the American Diabetes Association. But I very much wanted to apply behavioral science principles to product, and was able to do that to some degree, but I see Lirio as a place where I can really dial that up.

GS:
Now speaking of behavioral design, you just attended a behavioral economics workshop in San Francisco where the focus was behavioral design. What were some of the insights you gleaned from that experience?

CO:
Yes. I’m going to put a plugin for Irrational Labs and Kristen Berman and Evelyn … and the entire Irrational Labs team. They did a phenomenal job helping to educate 20 attendees from a variety of sectors, energy, health, education, a lot of areas where people are trying to influence humans to do positive activities.

And, this bootcamp was a nine-week course educating on a lot of the cognitive biases that humans bring to the table when they’re asked to make a choice or a decision.

So, I left that bootcamp with reinforced existing knowledge, but a lot of other additional pearls that have direct application to product. And we were taught in a way that would allow any attendee to have that capacity to influence product in a behavioral science based way, which is different from my Ph.D. training, which is a little bit more opaque and obtuse and …

GS:
Theoretical and less hands-on application.

CO:
That’s right.

GS:
Now, what I see when I see people trying to apply behavioral science to commercial pursuits, quite often I see them think only in terms of the end goal. One of the things you learn at that bootcamp is breaking it down, mapping an entire journey with the need to apply behavioral science at each friction point along the way.

CO:
Yes. Absolutely.

And what is described as a behavioral diagnosis. So, really defining what the behavior is that you’re trying to see. Defining what that is first.

So, do start with the end in mind. Where are you trying to go? What do you want the person to do? And then, from there, understand the journey. What does the person have to do to actually perform that behavior? What are they seeing? What is their environment like? Going back to the Wild Animal Park, what are the things that are in the way?

Is it a physical fence or is it a cognitive fence? And what are some things that we need to be mindful of there when we’re designing?

So, is there a barrier, cognitive barrier, or a bias that we need to make note of? And what are some tools in our toolbox that we can use to take out the tool and knock down that barrier? And do that along the human’s journey to the desired behavior. Recognizing that, if we knock all those blocks in the way and we really dial up the benefit of doing the behavior, it is more likely that the person will do the desired behavior.

GS:
I think one of the surprising things for people about behavioral science and its application many times is how tiny changes can have disproportionately large outcomes.

CO:
Yes.

GS:
The good news is, when you think in these terms and find these behavioral solutions, they’re pretty easy to apply.

CO:
Yes, that’s right.

GS:
So, preparing for this conversation, I found myself wondering, what is Chandra thinking? And so, the easiest way to answer that question was to look at, what is Chandra Tweeting?

GS:

So, I spent a little time on your Twitter page and, you can find CO, @ChandraOsborn and, that’s Osborn with no “E” on the end.

CO:
Correct.

GS:

The first thing I wondered was about your profile picture on Twitter.

CO:
Yeah.

GS:

There’s a pineapple on your head.

CO:
That’s right.

GS:
Care to explain that?

CO:
Sure.

CO:
Yeah, there is a pineapple on my head. It is not an actual pineapple, it is a coffee mug. A few stories go into that. One, I’m half Polynesian and I’m proud of that part of who I am, was a former professional Polynesian dancer.

GS:
You were?

CO:
I was for many years.

GS:
A bold admission.

CO:
And, you know, now that I live in Tennessee—I’m originally from California—you don’t see many Polynesians.

GS:

Tennessee’s sort of the epicenter of Polynesian dancing.

CO:
That’s right. That’s right.

CO:
So, in order to make it very visible I walk around with a pineapple mug on my head. No.

GS:
Raising visibility of Polynesian dancing by wearing pineapples on your head.

CO:
I love coffee to the point I can’t function without it, which is probably not a good thing, so hence the mug. The Polynesian pineapple, of course. But also, there’s a saying that, “When life gives you pineapples, make piña coladas,” and I think I’ve done that a lot in various areas of my life, and continue to do so.

Also, that mug is balanced on my head and I tend to be juggling things. I’m a mom. I’m a wife. I’m a daughter, my mom lives down the street. There’s a lot of hats that I wear, and pineapples, apparently.

GS:
Way more symbolism wrapped up in that pineapple coffee mug than I ever imagined. I’m glad I asked.

CO:
Right? Right?

GS:
On your Twitter feed you shared several different articles, some of which I thought were quite interesting.

One was about, the mind may trump DNA when it comes to exercising and eating habits; that if you tell people they have a genetic predisposition to a low capacity for exercise, or a tendency to overeat, their body starts to respond accordingly—mere suggestion.

My grandmother used to say, “Address the king and the king replies,” and I always love that phrase. But it turns out, the way you talk to people begins to shape how they see themselves.

CO:
Yes, that is true. And how you talk about the environment begins to impact how people take care of it. There was a recent study looking at that. Yes, you know, people internalize. They internalize the messages. They internalize the suggestions. And they respond. They respond subtly, and sometimes it can even be so impressionable that it has a really profound impact on how they behave.

GS:
So, would you advise companies to speak to their customers with the expectation that they’re going to take the desired action? That they’re capable of it, that it’s almost a pep talk, a coach at half time.

CO:
Yes. The potential is there. The potential is there and details matter. One of the biggest lessons to be learned in behavioral science is that knowledge alone is insufficient for behavior change. It’s necessary, but insufficient.

GS:
I was picking up on that earlier when you talked about the surprising outcome of your wild animal park study and it occurred to me that that’s sort of the story of behavioral science. That you start out with an assumption about how the experiments going to turn out, and then it doesn’t.

CO:
That’s right.

GS:
And that’s where the knowledge comes from.

CO:
Absolutely.

GS:
So, experimentation, a pretty important part …

CO:
Critical.

GS:
Of success.

CO:
Critical. You need to know what levers to pull, and you need to know what not to do. And then you need to test that out, and then become increasingly more informed and better positioned to have the effect that you want.

GS:
Or, where possible, rely on content that’s already been proven.

CO:
That’s right. Absolutely.

GS:
I saw on your Twitter feed that you recently staged a marriage proposal with someone who is not your husband. So, I’m glad you said no and your husband’s probably glad of that too.

What on earth is going on?

CO:
Oh yeah, that will go down as one of, I think, my most favorite and funniest moments.

 

CO:
A throwback to Irrational Labs, one of the activities that we did which, I think, is by far one of the most enjoyable activities I’ve ever done, is to do a scavenger hunt and apply behavioral science. See them in the wild, you know, identify sort of, hey, at this restaurant we see that this bias is there. And these are some of the strategies that they’re applying to try to overcome this bias. And take pictures of it and upload it into the scavenger hunt app.

And so, we had teams of attendees at this bootcamp and we went on this mission to find behavioral science in the wild, but also to act out and to experiment. Because, that’s a part of being a behavioral scientist.

So, we were charged with doing something that elicits a particular reaction in someone who might be watching. You know, what do you do when you see a marriage proposal? And then, what do you do when it’s not real, or when the person says no?

GS:
Oh my goodness.

CO:
How do people react? And so, one of my teammates and I staged this proposal and a woman nearby who overheard what was happening went and positioned and pulled out her camera to take this picture. You know, perfect opportunity to Instagram something. I witnessed this.

GS:
Anticipating YouTube celebrity.

CO:
Yes, yeah, that’s right.

But when I turned him down, she immediately backpedaled into position, into her original state. And seeing that play out was really fascinating.

GS:
Was she disappointed?

CO:
I don’t know. I didn’t ask her, but the non-verbal messages looked like she clearly no longer wanted to be involved.
What’s funny about this is, my husband and I have a shared Google photos account, so we can immediately see what pictures and things people … And, we do that because of our kids, you know, one of us might take a picture of our kids and the other one wants to see it. My husband sent me a text, pretty soon after saying, “Are you getting married? Did you get engaged?”

GS:
Is there something I should know?

CO:
He thought it was quite funny.

GS:
Have you become a polygamist?

CO:
That’s right.

GS:
Do you really own moose antler eggnog glasses like the kind Chevy Chase and cousin Eddie used in Christmas Vacation?

CO:
Yes, I know exactly what picture you’re referring to.

My husband owns them, so piggybacking on my husband.

GS:
Kudos to your husband.

CO:
Yes.

CO:
And that photo was from a local establishment in our neighborhood who, we had heard had those mugs.

GS:     
Well that was my next question. Where can I get some?

CO:
Yes, so we had to go see them in the wild and use them in the wild and so that’s what we did.

GS:
I’m going to ask you one more question about what you hope to accomplish with Lirio?

CO:
It is an absolute privilege being a part of this team. For quite some time, the large part of my career, I have seen the value of useful data and analyses and experimenting and behavioral science coming together to do really powerful things that can have a huge positive impact on how people behave and, in turn, on the world.

What I love about Lirio is that that potential is being realized.There are very few entities that can genuinely say that. Behavioral science is baked into what we do, it is not lip service, it is real, it is active and, it is an essential ingredient to our product, and it works.

Also, with the power of machine learning and data science, it’s no longer analytics, but now, there’s so much horsepower with what you can do with the volumes of data that is available. And so, to be able to marry that with behavioral science active ingredients, there’s a huge potential to move the needle. And Lirio is realizing that potential.

GS:
Now that you work for Lirio, you’ll be learning new things, experimenting with new things, discovering new things, I hope we can have you back sometime.

CO:
I would love to be back. This is really a pleasure.

GS:
You’ve been listening to The Behavior Change podcast by Lirio.

Lirio provides an email based behavioral engagement solution that uses machine learning, persona based messaging and, behavioral science to help organizations motivate the people they serve to achieve better outcomes.

On the web at Lirio.co (L-I-R-I-O dot C-O) or follow us on Twitter @Lirio_LLC. 

 

The thoughts and opinions expressed in this podcast are solely those of the person speaking. The opinions expressed are as of the date of this podcast and may change as subsequent conditions vary. There is no guarantee that any forecasts made will come to pass. Reliance upon information in this podcast is at the sole discretion of the listener.

© Lirio, LLC

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