Dear Director-General Tedros:
The Mercury Project research consortium congratulates the World Health Organization on the passage of ‘Behavioural sciences for better health’ (EB152/CONF./6) at the 76th World Health Assembly. As the Secretariat implements this resolution, the Mercury Project consortium recommends the use of a science-based framework of health decision-making and behavior to effectively operationalize WHO’s commitment to using behavioral science to achieve better health outcomes. Specifically, we offer our framework as a tool to (1) structure the evidence proposed repository, (2) support the proposed synthesis of studies into actionable policy recommendations, and (3) prioritize studies that measure effects on observable health behaviors.
The Mercury Project, an initiative of the Social Science Research Council, is a multidisciplinary consortium of 90+ social and behavioral scientists and practitioners committed to identifying cost-effective and scalable interventions to increase vaccination demand and science-based health decision-making more generally. Our consortium is grounded in a common framework of health decision-making and behavior based on a large body of findings in the behavioral and social sciences (Mercury Project Consortium 2021).
In our framework, we identify four intervention designs that practitioners can incorporate in developing programs and policies that increase vaccination and other protective health behaviors. Interventions may:
- Lower the search costs of finding accurate information about vaccines and other effective health technologies,
- Lower the decision costs of assessing multiple sources of information about vaccines and other effective health technologies,
- Lower the logistical costs of acquiring vaccinations and other effective health technologies,
- Raise the social benefits of being vaccinated and adopting other effective health technologies.
In addition, in our framework, we emphasize the importance of measuring the impacts of interventions on a common set of observable health behaviors.
A science-based framework of health decision-making and behavior could guide the Secretariat in efficiently putting the resolution into action in three specific ways:
(1) A science-based framework of health decision-making and behavior could structure the proposed repository of behavioral science findings into distinct categories of intervention design components and outcomes.
The resolution calls on the Secretariat to “establish a global repository of behavioral science evidence from empirical studies that can be accessed and used in strengthening health-promotion activities.” We applaud this recommendation. We suggest the repository be organized by reference to a science-based framework of health decision-making and behavior, including tagging included studies by intervention design components and measured outcomes. This scaffolding will allow researchers and policymakers to quickly sift through the evidence and to pinpoint solutions potentially useful in their settings. We suggest that our framework’s four intervention design components and eight measured outcomes provide a clear way of tagging studies included in the repository.
(2) A science-based framework of health decision-making and behavior could support the synthesis of studies across time and place into coherent policy guidance.
The resolution calls on the DG to, “develop guidance, including through the application of behavioral science, that addresses public health priorities, including vaccine hesitancy as well as [inaccurate health information] that conflicts with public health-based evidence.” The use of a science-based framework of health decision-making and behavior, such as the one we propose, can support the development of programming and policy guidance by synthesizing well-powered studies across time and place into common intervention design components and common measured outcomes. This structure will support the translation of research into coherent policy recommendations (Vivalt 2020).
(3) A science-based framework of health decision-making and behavior could support a focus on a common set of observed behavioral outcomes that go beyond survey responses.
There are documented gaps between health knowledge and intention, and between intention and behavior (e.g., Dai et al. 2021). These gaps exist across a broad range of health decision-making contexts. Our framework indicates the importance of prioritizing the inclusion of studies—in the repository and in policy guidance—measuring effects of interventions on behavioral outcomes, while also providing policy-relevant evidence on mechanisms, context, and costs (e.g., Egami & Hartman 2022).
We applaud the WHO for recognizing the importance of behavioral science to achieving better health.
The Mercury Project Consortium applauds the WHO for recognizing the importance of behavioral science to achieving the goal of healthier societies. We look forward to contributing research to the repository and to supporting the solution-focused use of the behavioral sciences at the Secretariat and in Member States. We hope the Secretariat will adopt a science-based framework of health decision-making and behavior to effectively and efficiently implement the promises in the adopted resolution, “Behavioural sciences for better health.”
The Mercury Project Consortium
Our thirteen research teams, comprising over 95 researchers and practitioners, span over ten disciplines, twenty countries, and seventy institutions. The disciplines include data science, economics, information science, political science, psychology, and public health. Consistent with the Social Science Research Council’s one hundred years of supporting solutions-oriented social and behavioral science, the Mercury Project is founded on the premise that social and behavioral science R&D can provide governments, NGOs, and private firms with workable solutions to pressing health challenges.
Dai, H. et al. 2021. Behavioural Nudges Increase COVID-19 Vaccinations. Nature, 597(7876): 404–9.
Egami, N., & Hartman, E. 2022. Elements of External Validity: Framework, Design, and Analysis. American Political Science Review, 1-19.
The Mercury Project Consortium. 2022. The Mercury Project Research Framework. Brooklyn, NY: SSRC.
Vivalt, E. 2020. How Much Can We Generalize From Impact Evaluations? Journal of the European Economic Association, 18(6):3045–3089.