Alumni

Unlocking the Incentives to Drive Healthier Behavior

How do you uncover effective levers that can incentivize people to, in a phrase, do the right thing? For self-professed “Econ geek” Erez Yoeli (Research Associate; Co-Director of the ACT: Applied Cooperation Team), that very question became both relevant and career defining early in his journey. Particularly, it arose during Yoeli’s PhD study when he undertook what appeared would be a side project from a public utility. The utility’s ask: increasing participation in an energy efficiency/blackout prevention program. “I had assumed [the assignment] would entail quantitative fieldwork,” Yoeli recalls. “When I learned it was about changing consumer behavior, I remember wondering: ‘Isn’t that what marketers do?’”
 

The task, it turned out, was deceptively challenging, and did indeed entail fieldwork and analysis—especially as the utility had sent out letters urging their customers to join the program with anemic results. Yoeli shares, “Based on promising results from lab studies on increasing the observability of good deeds, I proposed that they alter the mechanism: Instead of letters, use an actual sign-up sheet in residential buildings—placed somewhere where everyone can see it.” The measurable outcome was a surge in sign-ups. “We gave people a way to get public credit for doing the right thing—in this case, using less power at peak blackout risk times.” He adds, with a smile, “after taking on that challenge, I was hooked.”

Yoeli has since expanded his research and his area of impact to global public health—from tuberculosis treatment and prevention in sub-Saharan Africa to co-founding ACT (Applied Cooperation Team), a research group that was recently acquired by MIT Sloan. Taking behavioral economics insights from the lab to the real world, Yoeli has dedicated himself to “working on field experiments and thinking about how to motivate good behavior.”

Despite what Yoeli would profess, he’s in pursuit of no less a goal than developing a toolbox of techniques to help humankind do the right thing: more often, more predictably, and at a greater scale than ever before attempted.

FROM ECONOMICS TO PUBLIC HEALTH, AND BEYOND

After obtaining his PhD degree in economics, Yoeli quickly found work with the Federal Trade Commission addressing information economics problems where markets just weren’t working well in the service of consumers. From there, and through research posts at Harvard and Yale, Yoeli consistently pursued theory and data-backed strategies to motivate large populations to good.

Co-founding ACT in 2015 with David Rand (Associate Professor of Management Science and Brain and Cognitive Sciences, an affiliate of the MIT Institute for Data, Systems, and Society, and the director of the Human Cooperation Laboratory and the Applied Cooperation Team), the team’s first project was conducted with the Harvard T.H. Chan School of Public Health and a local property management company to introduce a “smoke-free” policy to public housing. Here, as with Yoeli’s early body of work, individual “good” actions (like abiding by the smoking ban) and their context within a larger community (e.g., benefits to children, social rewards) came to the fore.

“We developed a scalable, three-part checklist that’s become the basis of so many of the interventions we work on today: (1) increase observability—so individuals can get the community credit they crave and deserve for their good behavior; (2) eliminate excuses—remove the “easy outs” for not participating; and finally, (3) set and communicate expectations, so that the individual knows the weight of the community is behind the ask.”

A REAL-WORLD MODEL WITH REAL-WORLD IMPACT

At what kind of scale has Yoeli’s model found success, so far? What about tackling the world’s most lethal infectious disease: tuberculosis (TB)? “Here’s a disease where we’ve had a cure for literally 70 years, and yet so many are still dying and suffering—and medication compliance problems have made drug-resistant TB a truly devastating threat.” In his current work with Keheala, a mobile health company dedicated to addressing the non-medical drivers of disease that exist outside of clinical settings, Yoeli and his colleagues have found dramatic success in building cost efficient interventions to help TB patients in Kenya take their medicine—consistently, and effectively. Using a non-smart phone, text-based approach, the Keheala system sends repeated reminders to patients urging them to take their medications while framing the need for doing so as a benefit to the community as well as the individual. Yoeli explains, “We used the checklist as a basis for our work. We increase observability and eliminate excuses by requiring daily verification. To set expectations, we leverage the language of community, with slogans like ‘Together, we’re kicking TB out of Kenya.’”

Having recently completed a pilot study, during which the proportion of patients in their study dropped from 13 to 4.3 percent, Yoeli and his team are now in the midst of a much larger three-year study to replicate and build on their results, with a population upward of 15,000: comprising nearly 20 percent of all of Kenya’s tuberculosis patients. Yoeli has high hopes that, having achieved success in a region with such medical infrastructure challenges, their approach might work nearly anywhere in the developing world—for HIV, other infectious diseases, and more.

Yoeli professes that his time in the field has “opened my eyes to the fact that the public health world really seems to have forgotten about the ‘public’ part of the equation.” Citing the example of vaccinations, he elaborates: “I had been exposed to work on vaccines at the time I worked on this project, and there has always been this emphasis on the importance of the action for the individual, but a bit of a fear of emphasizing how important an action is for the community—the ultimate beneficiaries. As Yoeli quips, his ongoing mission and litmus for his endeavors going forward is “to put the ‘public’ back into ‘public health.’”

ACT-ING FOR GOOD

As to the future of ACT, Yoeli cites the group’s founding DNA as indicative of their future trajectory: a model built on applying diverse vantages and models from economics, psychology, sociology, anthropology, and marketing directly to issues of real-world impact. ACT’s team currently works with government agencies, nonprofits, and for-profits on a range of challenges, including charitable donations, volunteering, energy conservation, compliance with smoking bans, and antibiotic compliance, with the common goal of sparking mass altruism.

And though Yoeli is a fairly new arrival to MIT Sloan, he is quick to identify the unique strengths he’s already seen on display. “The folks here are motivated by advancing technologies; advancing ideas that improve the human experience in some way. MIT is built for that. I love that—and that orientation has been critical to advancing the work of ACT.”

He adds, “I have been truly struck by this community’s widespread commitment to making a better world. It’s something that I’ve never experienced before, at any other institution.”

Committed as he is to uniting mens et manus for the greater good of humankind, it would seem that at MIT Sloan, Yoeli has found his place.