BookPDF Available

NUDGE: Improving Decisions About Health, Wealth, and Happiness



Every day, we make decisions on topics ranging from personal investments to schools for our children to the meals we eat to the causes we champion. Unfortunately, we often choose poorly. The reason, the authors explain, is that, being human, we all are susceptible to various biases that can lead us to blunder. Our mistakes make us poorer and less healthy; we often make bad decisions involving education, personal finance, health care, mortgages and credit cards, the family, and even the planet itself. Thaler and Sunstein invite us to enter an alternative world, one that takes our humanness as a given. They show that by knowing how people think, we can design choice environments that make it easier for people to choose what is best for themselves, their families, and their society. Using colorful examples from the most important aspects of life, Thaler and Sunstein demonstrate how thoughtful "choice architecture" can be established to nudge us in beneficial directions without restricting freedom of choice. Nudge offers a unique new take-from neither the left nor the right-on many hot-button issues, for individuals and governments alike. This is one of the most engaging and provocative books to come along in many years. © 2008 by Richard H. Thaler and Cass R. Sunstein. All rights reserved.
Inside this Issue:
Message from the Scientific Director………………………………………….. 1
Invited Book Review—Nudge: Improving decisions about health, wealth and
happiness ……………………………………………………………………….
Applied Public Health Chair Feature: Dr. Janice Sargeant.……………………. 4
2010 IPPH-PHAC Cafés Scientifiques………………………..…....………….. 5
Student Corner: Chris Connolly………...……………………..…...…………... 6
Ottawa Celebrates 100 Years of Public Health in Canada……………………... 7
2010 CIHR-IPPH-CPHA PPH Research Milestones………………………….. 3
February 2011 Issue 24
For general inquiries, or to be added to our e-
bulletin listserv, please contact us at
search Initiative on a second
casebook highlighting concrete
examples of the value of global
health research towards improv-
ing health and health systems to
share with research and policy
communities and civil society
(scheduled for release in
late spring 2011) We will
include announcements
about their release in our
monthly e-bulletin.
After months of prepara-
tion, we will be meeting
with members of the inter-
national review panel dur-
ing February and March.
In preparation for our In-
stitute’s site visit, we held
a mock review at our No-
vember Institute Advisory
Board (IAB) meeting in
Vancouver. I want to thank Drs.
Morris Barer and John O’Neil
who agreed to be our mock re-
viewers, and Dr. Penny Hawe
who chaired the mock review.
(continued on p. 8)
Welcome to our first edition of POP News for
2011. The Institute started off the new year
with a co-sponsored event in the Ottawa mu-
nicipal council chambers. The Canadian Public
Health Association Expo, documenting Can-
ada’s 12 greatest public health achievements
for the last century, was put on public display
and I officially announced our winning popula-
tion and public health research milestone
teams. The event was well attended, with open-
ing remarks given by Debra Lynkowski (Chief
Executive Officer, Canadian Public Health As-
sociation), Ottawa’s Mayor, Jim Watson, Dr.
Vera Etches (Ottawa's Associate Medical Offi-
cer of Health), and Krista Outhwaite (Associate
Deputy Minister, Public Health Agency of Can-
Congratulations to our four Milestone winners
(please see p. 3). Each of these teams has made
outstanding research contributions to the field
of public and population health. They have
advanced the science and importantly, brought
health benefits to Canadians. For those inter-
ested in learning more about these exceptional
teams, articles describing their work have been
published in the Canadian Journal of Public
Health and are accessible on the IPPH website
Our much anticipated Population Health Inter-
vention Research (PHIR) Symposium and
Workshop was held in Toronto at the end of
November, 2010. These two successful events
were jam-packed with excellent presentations
and stimulating dialogue among leading scien-
tists, decision-makers and research funders
from Canada and several other countries. High-
lights from these events will be captured in
proceedings, which should be available
on our website within the coming
weeks. Most of our Applied Public
Health Chairs were in attendance pro-
viding an opportunity for a lively and
fruitful discussion with colleagues from
the Public Health Agency of Canada
during an invitational
dinner. Follow-up events
on population health
interventions are cur-
rently being planned
with international part-
ners – more to come in
future newsletters.
As part of our knowledge
translation activities,
several of our staff have
been working on two
new casebooks. Emma
Cohen has led the prepa-
ration of a casebook on
population health interventions with
colleagues from the Canadian Popula-
tion Health Initiative at the Canadian
Institute for Health Information. This
will be available in March. Erica Di
Ruggiero and Ashley Page have been
working with the Global Health Re-
Dr. Nancy Edwards
Scientific Director
PHIR Symposium
Page 1
By Dr. Patricia Martens
Population health researchers
grow up with the concepts of
‘upstream, midstream and
downstream’, and the Rose
(1) change will best occur at
the population level when
there are simultaneous
strategies at all levels –
downstream (individual
clinical or curative), mid-
stream (education and
promotion), and upstream
(healthy public policy
and built environment);
(2) small changes over large
populations are extremely
important from a popula-
tion perspective, when
the entire bell curve is
influenced (the Rose
Theorem); and,
(3) upstream measures are
best suited to affecting
the whole population, but
midstream measures can
sometimes leave a por-
tion of the population
So we need to look for popu-
lation health interventions that
work for everyone. That’s
where the book Nudge may
offer us insight.
Different people, cultures and
countries have very different
tolerance levels for govern-
ment interventions. If we do
the usual comparison of Can-
ada versus USA, differences
may be in our cultural DNA,
or maybe our BNA—British
North America Act, that is
(actually, it recently changed
its name to the Constitution
Act of 1867). Remember the
USA’s Declaration of Inde-
pendence and its key ideas –
life, liberty and the pursuit of
happiness. Contrast our Cana-
dian BNA Act – peace, order
and good government. Guess
which citizenship may be
more comfortable with legis-
lation as a means of affecting
healthy changes at the popula-
tion level? Different places,
times and people may have
varying degrees of comfort
with government legislation.
In the past decades, we have
seen legislation on drinking
ages, seat belts, bike helmets,
smoking in public places, and
recently, smoking in cars with
kids present. But there is al-
ways the opposition voice that
says, “I want my freedom –
don’t legislate my behaviour.”
A brief moment of self-
declaration – I am, by nature,
very comfortable with up-
stream policy, being born and
bred in Canada, politically
middle of the road, a long-
time population health re-
searcher and health advocate.
But I have to realize that not
everyone agrees with my
stance in life. So how can we
use the ideas in Nudge to en-
courage population health
That’s exactly why I enjoyed
this book so much – it gives
me tools to use for those who
may be more libertarian by
nature. Richard Thaler is a
professor of behavioral sci-
ence and economics at the
University of Chicago. Cass
Sunstein is a professor of ju-
risprudence in the University
of Chicago’s Law School and
Department of Political Sci-
ence. So although the book is
written in very accessible
ways, it has a detailed and
fascinating bibliography for
those who want to delve more
into the research behind the
statements. Their definition of
nudge is (p. 6): “… any aspect
of the choice architecture that
alters people’s behavior in a
predictable way without for-
bidding any options or signifi-
cantly changing their eco-
nomic incentives.” This
hinges on the concept of
choice architecture – if choice
architects build a system cor-
rectly, they are “self-
consciously attempting to
move people in directions that
will make their lives better.”
Thaler and Sunstein use the
term, ‘libertarian paternal-
ism’, by which they mean (p.
5), “… a relatively weak, soft,
and nonintrusive type of pa-
ternalism because choices are
not blocked, fenced off, or
significantly burdened.”
Their ideal of libertarianism is
not surprising, given their
roots in the University of Chi-
cago and their strong belief in
the freedom of choice of peo-
ple. But the combination of
libertarian with paternalism
sounds like an oxymoron. In
the authors’ minds, paternal-
ism refers to the fact that
through choice architecture,
institutions (private or public)
can influence peoples’ free
choice in helpful ways that
could improve their lives. In
many ways, this is not a new
concept to population health
scientists, who have long been
involved in the built environ-
ment, and the idea of ‘making
the easy choice the right
choice’. We are familiar with
Invited Book Review
Nudge: Improving decisions about health, wealth and happiness
Page 2 IPPH POP News
Nudge: Improving
decisions about
health, wealth and
By R.H. Thaler and
C.R. Sunstein
Yale University Press:
293 pp.
Invited book review by
Dr. Patricia Martens,
Director, Manitoba
Centre for Health Pol-
icy; CIHR/PHAC Ap-
plied Public Health
Chair; Professor, De-
partment of Community
Health Sciences, Fac-
ulty of Medicine, Uni-
versity of Manitoba.
issues such as making stairs
more accessible in buildings,
or designing cities for walk-
ability, or making the health-
ier choice fun (like in the pi-
ano stairs example you can
see at These
types of examples would
qualify as a libertarian pater-
nalism approach in the minds
of Thaler and Sunstein.
The intriguing idea of setting
healthy defaults is used exten-
sively throughout Nudge, to
frame people’s choices in
such a way as to nudge them
to choose healthier options.
The book romps through a
myriad of examples, all the
way from savings and invest-
ments, to social security, mar-
riage, prescription drug plans,
saving the environment, teen
pregnancy prevention, smok-
ing cessation, and motorcycle
helmet use. All of these be-
haviours can indeed be influ-
enced by nudges. I particu-
larly like their idea of the Ci-
vility Checker on emails, to
prevent sending an angry
email without appropriate
nudging to wait awhile (p.
Nudges can be highly effec-
tive, and we need to do more
research into understanding
their effects. Although I really
enjoyed the basic premise of
the book, at times I found the
stance of libertarianism un-
comfortable. Taken to its ex-
treme, libertarian paternalism
should always take prece-
dence over legislation. But we
certainly don’t want to negate
the basic public health tool of
the power of legislation,
probably one of the most ef-
fective ways to improve
population health quickly. For
example, Thaler and Sun-
stein’s example of encourag-
ing motorcycle helmet use
through extra health insurance
requirements doesn’t translate
well to a universal health care
system that needs to balance
choice for the individual with
cost for the society. So for
that reason, I was heartened to
see the authors’ self-
declaration in the last chapter,
stating that they are suppor-
tive of some redistribution of
wealth, and that “a good soci-
ety makes trade-offs between
protecting the unfortunate and
encouraging initiative and
self-help.” (p. 242).
This book is highly entertain-
ing. It can also result in crea-
tive thinking for both deci-
sion-makers and researchers,
to look for the opportunities
that abound through choice
architecture. What should we
implement, does it work, and
what are the benefits? In
Canada and the world, we are
all striving towards better
population health and reduc-
ing socioeconomic gaps.
Maybe this will give us one
more tool.
Page 3 February 2011, Issue 24
“This book is highly
entertaining. It can also
result in creative
thinking for both
decision-makers and
researchers, to look for
the opportunities that
abound through choice
2010 CIHR-IPPH-CPHA Population and Public Health Research Milestones
CIHR-IPPH in partnership
with the Canadian Public
Health Association (CPHA)
are pleased to recognize the
winners of the inaugural
Population and Public Health
Research Milestones Initiative
The research milestones have
significantly contributed to
the public's health in Canada
and globally; they are relevant
to at least one of the 12
CPHA achievements (http:// or to another
population and public health
priority; they demonstrate
originality in addressing a
public health problem; they
have led to significant im-
provements in health and/or
health equity; and, they have
influenced research, policy
and/or practice. These mile-
stones were determined
through a competitive peer
review process.
Says Ms. Debra Lynkowski,
CEO, CPHA, “The milestones
that have been selected dem-
onstrate the extraordinary
contribution that population
and public health research has
made to public health prac-
tice. In Canada, we are truly
fortunate to have such dedi-
cated and talented researchers
working in the name of popu-
lation and public health; we
know that Canadians enjoy
the benefits of their research
every day.”
Says Dr. Nancy Edwards,
Scientific Director, IPPH,
“Canadians have demon-
strated leadership in the field
of population health research.
These milestones are impor-
tant reminders of our long-
standing contributions in this
important field and the win-
ners have been giants in this
field. The relevance of popu-
lation health principles and
approaches is more timely
than ever as we look at our
most pressing health equity
issues in Canada and glob-
These milestones in research
are published as a special
section in the Nov/Dec 2010
issue of the Canadian Journal
of Public Health.
Page 4 IPPH POP News
and rapid international travel,
globalization of food supplies,
and continued human, and
agricultural encroachment
into the world’s remaining
wilderness areas enhance the
risk, and speed of transmis-
sion, of global zoonotic dis-
ease pandemics. Given the
dual nature of infection in
animals and humans, prevent-
ing and controlling zoonotic
diseases involves collabora-
tion and integration of efforts
between the animal health and
human healthcare and public
health sectors.
Dr. Jan M. Sargeant holds the
only Applied Public Health
Chair based in a veterinary
college. The focus of Jan’s
work is on integrating re-
search methods between ani-
mal and human health and
developing collaborations
across these sectors. Although
strong research methodolo-
gies and theories for the study
of zoonotic diseases and inter-
ventions and policies to pre-
vent them are available and
continue to be developed,
research approaches vary be-
tween animal and human
health sectors. Integrating
methods across these commu-
nities will enhance our ability
to combat these diseases.
An example of the benefits of
integrating research methods,
and an early area of research
focus, is evidenced-base in-
puts to risk assessment. The
animal health and food safety
communities use quantitative
risk assessment extensively to
quantify risk, evaluate and
compare intervention strate-
gies, and provide input to
animal and animal produce
imports. Essential to the va-
Dr. Jan Sargeant is the Di-
rector of the Centre for Pub-
lic Health and Zoonoses and
a Professor in the Depart-
ment of Population Medi-
cine at the Ontario Veteri-
nary College, University of
Zoonotic diseases, those
transmitted between animals
and humans, account for
approximately 60% of infec-
tious organisms known to be
pathogenic to humans and
over 75% of emerging infec-
tious diseases. Foodborne
pathogens, the majority of
which have their reservoir in
domestic animals, are esti-
mated to cause at least 11
million human illnesses an-
nually in Canada at a cost of
over $3.7 billion. Disease
outbreaks can have devastat-
ing effects on communities,
as evidenced by the 2000
outbreak of E. coli O157 in
Walkerton, Ontario, where
there were over 2000 ill-
nesses and 6 deaths. Even
zoonotic diseases with only
very limited zoonotic poten-
tial, such as Bovine Spongi-
form Encephalopathy
(BSE), can have enormous
impacts on the health of
Canadians; the finding of
the first BSE positive animal
had economic repercussions
for rural communities that
resulted in significant public
health consequences due to
mental health disorders.
Zoonotic diseases with pan-
demic potential, such as
SARS and avian influenza,
have highlighted the poten-
tially catastrophic nature of
these diseases, and the vul-
nerability of our public
health system to respond to
a major epidemic. Increased
Dr. Janice Sargeant
Applied Public Health Chair
“Zoonotic diseases, those
“Zoonotic diseases, those
transmitted between ani-
transmitted between ani-
mals and humans, ac-
mals and humans, ac-
count for approximately
count for approximately
60% of infectious organ-
60% of infectious organ-
isms known to be patho-
isms known to be patho-
genic to humans.
genic to humans.”
lidity of these models is the
data inputs used. In human
healthcare and public health,
systematic reviews and meta-
analyses are widely used as a
scientifically defensible
method to summarize and
quantify the body of scientific
knowledge on a specific topic
or question. However, system-
atic reviews were essentially
unknown in the animal health
research community, with the
exception of some work in
companion animal medicine.
Therefore, Dr. Sargeant and
colleagues began to explore
the potential for using system-
atic reviews to summarize the
literature and produce evi-
dence-based data inputs to risk
assessment. As interventions
in livestock are almost always
applied at the group level,
some modifications to system-
atic review protocols were
necessary. Additionally, as
seen in the healthcare field
when systematic reviews be-
gan to be used, there were
substantive issues with the
quality of reporting of clinical
trials in livestock / food safety.
Although guidelines for re-
porting of clinical trials have
been developed for individual
and group trials in humans,
there are some important dif-
ferences in livestock trials.
These include 2 levels of
“participants” (livestock own-
ers who consent to participa-
tion and the animals who are
allocated to treatment groups)
and the allocation of interven-
tions to groups of animals,
rather than to individuals. This
led Jan and her colleague An-
nette O’Connor (Iowa State
University) to lead an initia-
tive to develop reporting
guidelines specifically for tri-
als in livestock populations,
Applied Public Health Chair Feature: Dr. Janice Sargeant
Page 5 February 2011, Issue 24
when prioritizing zoonotic
Currently, we are conducting
large scale conjoint surveys
of both the public and of ani-
mal and human health profes-
sionals to explore the relative
importance of these criteria in
disease prioritzation and to
develop a scoring system for
zoonoses. The results will be
used to derive a rank-ordered
list of zoonoses for prioritiza-
tion. Interestingly, although
results are preliminary, it
appears that health profes-
sionals and the public do not
rank the criteria considered in
disease prioritization in the
same order, and would there-
fore prioritize zoonoses dif-
ferently. The public survey
will be used to identify issues
of greatest concern to the
general public with implica-
tions for communication of
disease risk and public educa-
tion. The health professional
survey will provide input to
scientists and government or-
ganizations on the prioritization
of zoonoses in Canada, with the
potential for informing policy.
These are a few examples of
research undertaken via the
Applied Public Health Chair.
The work has involved numer-
ous undergraduate and graduate
students, as well as post-
doctoral fellows. The research
has also included scientists and
decision-makers from both the
human and animal public
health communities and these
collaborations and networks
will enable us to continue to
build communities and work
across sectors to control and
prevent zoonotic diseases in
including investigations of on-
farm food safety interventions.
In January 2010, the RE-
FLECT statement was co-
published in five journals, a
first in veterinary medicine
As the research conducted
through the Applied Public
Health Chair award has
evolved, our focus has shifted
from food safety as a particu-
lar model to zoonotic diseases
in general. Because of the
scope and complexity of
zoonoses, an important issue is
how to prioritize these dis-
eases for research, and poten-
tially for policy. An example
of such work is an exploration
of conjoint analysis, a quanti-
tative method developed pri-
marily in the marketing sector,
as a method of prioritization.
Focus groups involving animal
health and public health scien-
tists and individuals from the
general public identified over
50 criteria for consideration
2010 IPPH-PHAC Cafés Scientifiques
IPPH is very pleased to have
been involved in two cafés
scientifiques in 2010 in col-
laboration with the Public
Health Agency of Canada.
These cafés covered a diver-
sity of interesting and contro-
versial topics including child
poverty (http://www.cihr- and
health literacy (http://
e/42741.html). They took
place in Montreal and Van-
couver, respectively, in both
official languages.
Here is a taste of what was
discussed at the two cafés.
Child poverty café: Presently,
international poverty reduc-
tion strategies are aimed at
"integration"; not transfer
payments, not welfare, but
the act of entering the labor
market by right. Countries
that have succeeded in bring-
ing families out of poverty
have quality child care that is
accessible and available in
sufficient quantity to support
parent integration into the
labor market.
Health literacy café: Will our
increasing dependence on
information technology cre-
ate a digital divide with those
lacking health literacy skills
finding it increasingly diffi-
cult to get access to accurate
and vital health information
and possibly experiencing
lower health
What commu-
nity services
are needed?
Health literacy café, Bellaggio Cafe, Vancouver
(L-R) Ms. Belinda Boyd, Ms. Dace Starr, Dr.
Irving Rootman, Dr. Ellen Balka
Page 6 IPPH POP News
and case study research had
shown that successfully im-
plementing community-based
projects requires placing em-
powerment strategies at the
forefront of interven-
tions (Mansuri & Rao, 2004;
Ife, 2002). However, the insti-
tutional characteristics for
scaling up these successful
locally-based empowerment
programs are poorly under-
stood. This understanding is
critical, given the sheer com-
plexity inherent in bringing
these interventions to a larger
scale, especially in low-
income and cross-cultural
What I learned from THP is
that, at the local level, pro-
moting meaningful commu-
nity engagement requires not
only increasing people's
'capacity to aspire' (like the
chief I spoke to above), but
also ensuring that people have
the capacity to make effective
and purposeful choices—
which really gets at the true
meaning of empowerment. To
do so, people require (a) the
collective and personal assets
to make a choice (i.e. skills,
knowledge, resources) and (b)
an environment in which the
institutional ‘rules of the
game’ are aligned to make
that choice possible. At the
organizational level, doing so
requires a culture of continu-
ous learning and flexibility in
which praxis—the ongoing
interplay between theory and
practice—is a core organizing
The Hunger Project and a
number of organizations—
from grassroots to transna-
tional levels—have very
much begun to walk the talk
Chris Connolly, B.Sc.
(Microbiology & Immunol-
ogy and International De-
velopment Studies)
Policy Fellow, Institute for
Health and Social Policy
McGill University
The village chief, still
dressed in his work clothes
after returning from his farm
to meet me, makes occa-
sional eye-contact as he an-
swers my question in a pa-
tient and soft-spoken ca-
dence. He nods approvingly,
gazing out the door of his
clay-walled home, as my
translator repeats back:
“We learnt that we can re-
duce poverty. We learnt that
sometimes, certain deaths
may occur through poverty;
one may acquire certain
diseases through poverty.
Through the training, I con-
sider myself to be a poor
man. And I realized that
there is a way out, where we
can move from where we
It was the summer of 2009,
and I was fortunate to be in
rural Eastern Region,
Ghana, as part of a policy
fellowship with the Institute
for Health and Social Policy
(IHSP) at McGill Univer-
sity. There, I was conduct-
ing a qualitative case study
under the IHSP's 2009 re-
search theme “making equal
rights real through partici-
pation.” I was investigating
the scale-up of a commu-
nity-based strategy for meet-
ing basic needs by an inter-
national organization called
The Hunger Project (THP).
I knew that existing theory
Chris Connolly, B.Sc.
Policy Fellow, Institute for
Health and Social Policy
McGill University
when it comes to engaging
community stakeholders as
partners in development. What
is needed, though, is an under-
standing of how implementing
agencies may foster the sort of
reflexive community practice
needed to support organic
community processes; to
scale-down global efforts in
order to scale-up local empow-
There are also lessons for stu-
dents of public health who are
often acting as agents of
change internationally or in
settings involving Aboriginal
Peoples. I learned that, given
the incredibly complex and
contextual nature of empower-
ment work, we must reflect
critically on the ways in which
we as “external” practitioners
may be as supportive as possi-
ble of meaningful and empow-
ering community processes.
1. Mansuri, G., & Rao, V.
(2004). Community-Based and
-Driven Development: A Criti-
cal Review. The World Bank
Research Observer, 19(1), 1-
2. Ife, J. (2002). Community
Development: Community-
based alternatives in an age of
globalisation, 2nd edition.
Frenchs Forest, Australia:
Pearson Education Australia.
Student Corner: Chris Connoll
Page 7 February 2011, Issue 24
Ottawa Celebrates 100 Years of Public Health in Canada
Health professionals from
across the country came to-
gether in early January in
Ottawa at the 100 Years of
Public Health exhibition. The
event celebrated 100 years of
public health history in Can-
ada and the centenary of the
Canadian Public Health As-
sociation (CPHA).
Leaders in public health from
across the country spoke at
the opening ceremony about
Canada’s public health his-
tory, accomplishments and
current state. Speakers in-
cluded Ottawa Mayor Jim
Watson; Debra Lynkowski,
Chief Executive Officer, Ca-
nadian Public Health Asso-
ciation; Krista Outhwaite,
Associate Deputy Minister,
Public Health Agency of
Canada; Dr. Vera Etches,
Associate Medical Officer of
Health, Ottawa Public
Health; and Dr. Nancy Ed-
wards, Scientific Director,
Canadian Institutes of Health
Research-Institute of Popula-
tion and Public Health.
“This unique exhibition pro-
vides residents of our city
with a reminder of the impor-
tant work performed over the
past 100 years by the dedi-
cated professionals in Public
Health,” said Ottawa Mayor
Jim Watson.
The average lifespan of Ca-
nadians today is more than 30
years longer than in the early
1900s and at least 25 of those
years are attributable to ini-
tiatives taken in public health.
"Public health is something
people don't think about, but
it affects our lives in every
way. From family planning,
to healthier mothers and ba-
bies, control of infectious dis-
eases and the use of seat belts,
public health saves lives and
helps Canadians live longer,"
says Debra Lynkowski,
CPHA's Chief Executive Offi-
cer. "This exhibition features
the great achievements of pub-
lic health and how far Canada
has evolved over the past 100
The exhibition is a walking
tour of 100 years of public
health initiatives, detailing the
importance of public health
and its fundamental impact on
the well-being of Canadians.
The 100 Years of Public
Health exhibition celebrates
achievements in public health
history and profiles the people
who made them happen.
“This unique exhibition is a
true testament of the
extraordinary work done every
day by Ottawa Public Health
staff – work that cuts across
the life spans of all Ottawa
residents from pre-natal care
to seniors’ health,” says
Dr. Vera Etches. “Knowing
our public health history will
serve our community well as
we embrace the opportunities
and challenges of the future.”
The exhibition was led by the
Canadian Public Health
Association in collaboration
with Ottawa Public Health, the
Canadian Institute for Health
Information, the Canadian
Institutes of Health Research
and the Public Health Agency
of Canada.
“The average lifespan
of Canadians today is
more than 30 years
longer than in the early
Ottawa Mayor Jim Watson and Associate Medical Officer
of Health, Dr. Vera Etches at the public health exhibition
in Ottawa.
Opening Ceremony speakers (l to r): Dr. Gregory Taylor and
Krista Outhwaite (PHAC), Dr. Vera Etches (Ottawa Public
Health), Debra Lynkowski (CPHA), Dr. Nancy Edwards
Page 8
Scientific Director
Dr. Nancy Edwards
Tel: 613-592-5800 ext 8414
Associate Director
Erica Di Ruggiero
Tel: 416-524-0111
Senior Evaluation Associate
Sarah Viehbeck
Tel: 613-592-5800 ext 1925
Knowledge Translation and
Communications Officer
Emma Cohen
Tel: 613-562-5800 ext 8439
Administrative Coordinator
Ashley Page
Tel: 613-562-5800 ext 8414
Fax: 613-521-2919
Assistant Director
Julie Senécal
Tel: 613-952-4538
Associate, Strategic Initiatives
Kim Gaudreau
Tel: 613-957-6128
Fax: 613-954-1800
For general inquiries, or to be
added to our E-Bulletin News
List, please contact: ipph-
(continued from p. 8)
We found this a very help-
ful exercise. Our mock
review panel asked us in-
triguing questions and the
IAB gave us excellent
feedback. We look forward
to meeting with our official
reviewers, describing the
achievements of our Insti-
tute and the community of
public and population
health scientists in Canada.
The report and recommen-
dations of the International
Review panel are expected
towards the end of June.
I will conclude by letting
you know that we’ve had a
few more comings and go-
ings of team members. I
want to thank Ghisline
Bourque for her contribu-
tions to the Institute. Ghis-
line was Acting Assistant
Director in 2010. We are
delighted to have Julie Sené-
cal back in this position; she
is rapidly getting caught up
on the many Institute portfo-
lios that have been active
Funding Opportunities
Please visit the IPPH website for a list of current funding opportunities being
offered by the Institute
over the past 16 months. I
also want to thank Dr. Marni
Brownell who has stepped
down from our IAB. She
made important contribu-
tions to our knowledge
translation advisory sub-
group and we will miss her.
Public health professionals, researchers, policy-makers, academics and students
from across the country and around the world will meet in Montreal, Quebec for the
2011 Annual Conference of the Canadian Public Health Association (CPHA) as the
Association enters its second century of service to Canadians. CPHA and our col-
laborators invite you to its 2011 Annual Conference, to be held June 19-22, 2011.
The preliminary program and online registration are now available.
For Early Registration Savings, register online by March 4, 2011!
For further information, please contact:
CPHA Conference Department
Phone: 613-725-3769, ext. 126
Dr. Barbara Riley, Propel Centre for
Population Health Impact and University of
Waterloo, presenting a poster at the PHIR
Please check the IPPH website in the
coming weeks for the PHIR Symposium and
Workshop proceedings.
... Many authors have identified that LMS usage data can be utilized to predict student grades (Conijn et al., 2017;Elbadrawy et al., 2015;Jo et al., 2015;Lu et al., 2018;Yang et al., 2017). Fewer researchers have explored whether LA interventions can act like nudges (Thaler & Sunstein, 2009) to change student behaviour in a way that is believed to positively impact learning outcomes (Hellings & Haelermans, 2020;Lim et al., 2019). However, those who have explored this have generally found that learners can be guided to change their behaviour. ...
Full-text available
This study seeks to explore if student behaviour can be changed using social modelling, specifically to increase usage of a learning management system (LMS), and whether any such increased LMS usage leads to higher student grades. After years of research into learning analytics, exploring which indicator can best predict student performance, with hopes of using that insight to improve student outcomes, there remain very few empirical studies which are randomized controlled trials, which is necessary to identify causation, and none that take place in a blended learning environment in the Global South. As learning analytics is a subject area for improving the learning of students worldwide, it is time to include more than just the Global North. In this experiment, 309 first year undergraduate participants were randomly assigned to control and treatment groups. Each member in the treatment group was sent a weekly email containing a link to an online dashboard showing the student’s performance compared against other students in the same cohort. Students in the treatment group did increase their use of the LMS but that increased usage did not translate into higher grades implying that the most important learning behaviours are not captured by the LMS, at least not in this study. Also of interest were that female students showed higher levels of engagement with the online dashboard and that the best predictor of a student’s grade in the second half of the semester was the student’s grade in the first half, supporting existing literature.
... In particular, the use of nudges has gained popularity due to their capacity for assisting and guiding individuals towards safer privacy practices [1]. At their core, nudges are interventions that encourage a certain behaviour which, in turn, tends to maximize people's welfare [48]. Such interventions are the means for behavioural change and consist of small modifications in the context within which decisions are made [28]. ...
Online self-disclosure is perhaps one of the last decade's most studied communication processes, thanks to the introduction of Online Social Networks (OSNs) like Facebook. Self-disclosure research has contributed significantly to the design of preventative nudges seeking to support and guide users when revealing private information in OSNs. Still, assessing the effectiveness of these solutions is often challenging since changing or modifying the choice architecture of OSN platforms is practically unfeasible. In turn, the effectiveness of numerous nudging designs is supported primarily by self-reported data instead of actual behavioral information. This work presents ENAGRAM, an app for evaluating preventative nudges, and reports the first results of an empirical study conducted with it. Such a study aims to showcase how the app (and the data collected with it) can be leveraged to assess the effectiveness of a particular nudging approach. We used ENAGRAM as a vehicle to test a risk-based strategy for nudging the self-disclosure decisions of Instagram users. For this, we created two variations of the same nudge and tested it in a between-subjects experimental setting. Study participants (N=22) were recruited via Prolific and asked to use the app regularly for 7 days. An online survey was distributed at the end of the experiment to measure some privacy-related constructs. From the data collected with ENAGRAM, we observed lower (though non-significant) self-disclosure levels when applying risk-based interventions. The constructs measured with the survey were not significant either, except for participants' External Information Privacy Concerns. Our results suggest that (i) ENAGRAM is a suitable alternative for conducting longitudinal experiments in a privacy-friendly way, and (ii) it provides a flexible framework for the evaluation of a broad spectrum of nudging solutions.
... At one end are extensive management systems such as those the International Standards Organisation promulgates. The other end of the spectrum includes simple 'nudges', such as signage that encourages behavioural change without forcing it (Thaler & Sunstein, 2009). ...
This book assesses how governance has evolved in six nations – England, Australia, Canada, Germany, Italy, and the Netherlands – between 1970 and 2018. More specifically, it examines how the governance approaches and the sets of policy tools used to govern have altered with respect to four public policy sectors that represent core responsibilities of the modern OECD state: education, energy, environment and health. To structure this analytical approach, the book harnesses sociological institutionalism in the area of ‘policy sequencing’ to trace both the motivations and the consequences of policy-makers’ altering governance approaches and the resulting policy tools. Combining a comparative and international focus, this book will appeal to scholars and students of public policy and governance.
Full-text available
Background: Behavioural science and its contribution towards improving public health is receiving increased recognition. Yet, the translation of these insights into public health practice is under-researched. This study explored the factors influencing the use of behavioural science within public health at a local authority level. Methods: Fourteen local authority staff (n = 13 female) in the south of England participated in semi-structured interviews, which were analysed inductively to identify key themes. These were later mapped deductively to the COM-B model and Theoretical Domains Framework. Findings: Nine themes were identified as factors that influence the use of behavioural science in local authority public health: 1) ‘Limited past experience’, 2) ‘Narrow understanding’, 3) ‘Perceived value of behavioural science’, 4) ‘Translational gap from theory-to-practice’, 5) ‘No protected time’, 6) ‘Old ways of working’, 7) ‘Political influence and organisational culture’, 8) ‘Relationships with key stakeholders’, 9) ‘Access to behavioural science resources’. Deductive mapping of these themes revealed that five of the COM constructs (excluding Physical Capability) and eleven of the TDF domains influenced behavioural science use, with ‘Social influences’ and ‘Knowledge’ being the most prominent. Discussion: Use of behavioural science within local authority public health practice is limited and inconsistent. For it to be successfully implemented, there must be an understanding of its role and value, alongside strategies to overcome a translational gap from theory to practice. Public health teams would benefit from protected time to enable application and strategies to break old habits of using a common-sense approach. System-wide buy-in, particularly related to senior leadership and system partners is needed, which would benefit from organisational and political culture change. Training opportunities, practical resources and expert in-house support should be considered a priority across public health teams.
This paper will argue that recent developments in AI technology and its role in digital capitalism threaten the rule of law. AI (or the companies who control it) promotes and monetizes free speech, political competition, and other aspects of democracy, while our societies have been shifting towards a “rule of code,” i.e., a system in which source code is able to put meaningful restraints not only on any individuals and institutions within a society, but also on law and the State. Based on Lawrence Lessig’s “Code is Law,” this paper will draw a more elaborated picture of “regulating AI” according to which AI is not only something that is to be regulated but also something that actively regulates individual and institutional behavior. From this background, it will be argued that, given the interdependence of governments and big tech corporations, free and open societies need to regain control over source code and the critical digital infrastructure to avoid being regulated by private companies that develop, control, and promote AI.
Conference Paper
Full-text available
Many philanthropic (i.e., donation-and reward-based) crowdfunding projects fail to assemble enough funding to succeed. We consider a review focused on developing a theoretical framework an essential next step to assist practitioners and academics in implementing and understanding philanthropic crowdfunding. Which key motives are central for donating via crowdfunding? We developed a framework which is a mix of the empirical findings reported in the 237 studies researching philanthropic crowdfunding. We integrated the empirical insights with theories from social psychology and behavioral economics. We propose a theoretical framework with eight categories: (1) altruism, (2) psychological benefits, (3) material benefits, (4) relational aspects, (5) central narrative, (6) perceived quality, (7) solicitation and (8) innovation. The categorisation of motives for giving via crowdfunding adds to an emerging area of research. It allows initiators to extract best practice examples for increasing the probability of successful crowdfunding projects considering the key influencing factors of personal motives for giving.
Where is Thomas Kuhn when we need him? Today's sustainability dialogue would have you believe the sustainability “paradigm” has shifted. That products with hydrocarbons as ingredients or that require toxic processes to derive their base or recycle are better for people, planet, and our collective prosperity than glass, an endlessly recyclable product that is made from pure, natural ingredients and won't harm people or the planet. We arrived at this moment by allowing an unbalanced and uncorrected dialogue to be spread, one that has created the illusion of a paradigm shift. The solution lies in a unified glass‐advocacy voice to re‐balance the dialogue—and correct the record. That solution requires active participation by the industry from end to end.
The conveyance of technical risk information from experts to the lay public is unlikely to be successful unless the social context of such messages is addressed. This context includes social networks, economic resources, political rights and responsibilities, histories, and ideologies. Social context can be taken into account by clearly defining desired outcomes, identifying the information desired by citizens, and choosing communicators carefully. Technical and social perspectives on risk communication, incomplete in themselves, can in combination improve management of hazards.
The evaluability hypothesis posits that when two objects are evaluated separately, whether a given attribute of the objects can differentiate the evaluations of these objects depends on whether the attribute is easy or difficult to evaluate independently. The article discusses how the evaluability hypothesis explains joint-separate evaluation reversal, which is the phenomenon that the rank order of the evaluations of multiple objects changes depending on whether these objects are evaluated jointly or separately. The article presents empirical evidence for the evaluability hypothesis. The final section of the article discusses implications of the hypothesis for issues beyond reversals-in particular for inconsistencies between decisions and their consequences. Decisions are typically made in the joint evaluation mode, and outcome of a decision is usually experienced (or consumed) in the separate evaluation mode. Thus, reversals between joint and separate evaluation may manifest themselves in decision-consumption inconsistencies.
Upon many witnessing the immense destruction caused by Hurricane Katrina in August 2005, feelings of sympathy were coupled with those of puzzlement: how could so much carnage be caused by a hazard that was so predictable? In 2004 the region had the benefit of a full dress rehearsal for Katrina when Hurricane Ivan—another category 5 storm while in the Gulf—triggered full-scale evacuations of the same areas, revealing many of the same weaknesses of preparedness procedures that were observed during Katrina. In addition, just weeks before the storm planners in New Orleans engaged in a training exercise that simulated the impact of a hypothetical hurrican—Pam&mdash:that breached the levees of New Orleans, submerging 87% of the city. Finally, the warnings of impending catastrophe could not have been stronger or more accurate in the days and hours leading up to the storm's landfall. Substantial numbers of residents nevertheless failed to heed urgent warnings to leave, few organized efforts were made to assist those who lacked the means to do so, and governments failed to have sufficient resources in place to deal with the disaster when it was realized.