Healthy Influence Blog

communication for a change

Archive for January, 2008

Misunderstanding Persuasion Theory

24th January 2008

In my neverending quest to improve the persuasion IQ of the world, I scour the Internet looking for examples of accurate and inaccurate presentations of theory and research. Today my search turned up an inaccurate example concerning New Year’s Eve Resolutions.

The BBC ran this story about using self persuasion to help their readers with those perennial plans to lose 10 pounds, exercise more, stop lingering by adult book stores and so on . . . (that was a joke). What’s nice about the story is that they actually mention an outstanding example of persuasion theory and research, the work of Robert Cialdini and the six cues of influence.

As the story states,

Scientists have been studying the influence process for over half a century and have found six principles that not only help organisations to get us to say “yes” to their requests, but could also help us to achieve the goals we set ourselves.

So far, so good. Except for one thing. There is no way that these persuasion and influence cues would produce significant, lasting behavior change. As Cialdini and other persuasion researchers have noted, these kind of persuasion tactics are aimed at people who are “low WATT” thinkers, with limited Willingness and Ability To Think (Cialdini calls this “click,whir” in his great book, “Influence.”) Cues are useful to such people precisely because they require limited cognitive processing. Thus, we typically find that likable people are more persuasive when receivers really aren’t thinking closely about the topic or issue. When the persuasive situation is really important to us and we are giving it our full attention, sure, it’s nice that the source is friendly or attractive, but, to quote an old Wendy’s commercial, “Where’s the beef?”

Applying persuasion cues as they are properly described in the BBC report would be highly ineffective self persuasion tactics regarding New Year’s Eve Resolutions precisely because those Resolution typically involve significant, serious, and negative behaviors. With these “high WATT” processors, the last thing you want to do is hit them with a cue, but rather with strong arguments, compelling information about the central merits of the behavior in question. A very different animal.

Quick summary. Kudos, to the Beeb for getting the theory right. Raspberries, for getting the application wrong.

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0 for 5 on Persuasion Quiz

24th January 2008

Okay, kids, today you can take a Persuasion Quiz!

Yay!

I hope you did better than I. 0 for 5 for me. Imagine that. Here I am a self styled Internet expert on all things Persuasion and Influence. And I scored 0 for 5. Hey, for those of you with a probability background you know that guessing on 5 multiple choice items each with 5 options should produce 1 correct guess. Do you know how hard it is to deliberately pick 5 consecutive incorrect answers?

That’s not a rhetorical question. What is the a priori probability of 0 for 5? I can’t immediately recall the formula.

I just took the quiz again and got 2 of 5. And again to get 3 of 5. And, now, finally after 4 attempts, I get 5 for 5. Oddly enough, the start up of the quiz advises that you can take it as many times as you’d like, but the questions will change. For my several attempts, each quiz was the same (how do you think I got better?).

I also disagree with some of the “correct” answers.

Juries rate as more believable expert witnesses who speak in incomprehensible language compared to experts who use easy to comprehend language or who appear honest? I need to see the research on that.

People are more likely to support you on some issue if you give: 1, 3, 5 or as many reasons as you can think of. The correct response is: give 1 reason. What? Argument quantity can function as an argument or a cue (or a moderator, but that’s something else), but regardless the research tends to show that more arguments produce more change. Not just one.

What is so surprising to me about this quiz is that it is written by people with serious academic backgrounds, most particularly Robert Cialdini. His great book, “Influence,” would directly refute the quiz.

The quiz is an excellent teaching tool and marketing device and I don’t have any problem with it as a tactic here. I just strongly question the content of this quiz. What else scares me is that I could be reading the same research literature and can’t pass a quiz written by other folks reading the same stuff.

Gotta love social science.

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Persuasion and Attacks on Pharmas

24th January 2008

More bad news for Pharmas from the Wall Street Journal (you’ll still need a subscription to read this article, but that might change soon).

“We see puffing, advertising based on untrue facts or facts that can’t be substantiated, medically, ethically or legally,” says Michigan Democratic Rep. Bart Stupak, chairman of the Energy and Commerce investigations subcommittee.

The efforts are fueled by a growing genre of investigative research by physicians focused on industry influence and the reliability of medical literature. Catherine DeAngelis, editor in chief of JAMA, the Journal of the American Medical Association, says she has more articles on the drug industry’s role in research coming soon. “I want to show how they manipulate the data and why we have to be so cynical about them,” she says.

In the case of the recent antidepressant analysis, the New England Journal said in a statement that “it is critically important that physicians have all the available data,” and patients who participated in unpublished studies “should not be left on the cutting room floor to make a drug look better than it really is.”

You don’t need to read the entire article to see that some big players have Big Pharma in the crosshairs and are upset at the advertising claims. Let me highlight a couple of key quotes in this tangle. Rep. Bart Stupak sees “untrue facts.” The JAMA editor wants to “to show how they manipulate the data.” And the New England Journal wants physicians to “have all available data.”

Okay. Now, let’s add this story from the WSJ (again, you need a subscription).

Health plans are drawing scrutiny for offering financial incentives to entice doctors to prescribe cheaper generic medicines, including paying doctors $100 each time they switch a patient from a brand-name drug.

Pharmaceutical companies have long gone to great lengths to try to get doctors to prescribe their brand-name pills. They spend billions of dollars, plying physicians with samples, educational lunches and speaker fees. But as the patents for a growing number of blockbuster medicines expire, some health insurers are trying to trump those perks with bonuses or higher reimbursements for writing more generic prescriptions.

The idea, health plans say, is to save everyone — patients, employers and insurers — money. And many doctors argue that it’s only right to reimburse them for spending time evaluating whether a cheaper generic alternative is better or as good for a patient.

What’s going on here? You’ve got Congressional Members, journal editors, and health researchers closing in on the Evil Pharma guys, yet everyone seems to think that physicians need to get extra pay for prescribing drugs. Isn’t that a fundamental part of the job description already? Haven’t they been trained and hired to do this? And the idea that even if they need to do extra work, why should they earn extra money every time their prescribe a new pill? Why not just one lump payment for the “extra” learning?

For me, the persuasion lesson here comes from attribution theory. When money is flowing to physicians, journal editors, and researchers, it is “good” money. When money is flowing to Evil Pharmas, it is “bad” money. “Good” money buys expert service and life-saving pills, while “bad” money lines the pockets of greedhead businessmen (while also, it must be admitted, providing that life-saving pill).

In the last quoted WSJ story, there is also a graphic that details potential savings if physicians prescribed generic drugs rather than branded drugs. In the category of chloesterol lowering drugs, the WSJ claims that currently only 7% of physician prescriptions are for generics. Only 7%! If instead, 70% of the prescriptons were for generics, it would save over $7 billion annually. For the majority of cases, generic drugs for lowering chloesterol as just as effective as branded drugs. How much training and financial incentive does any physician need to know this?

I simply cannot fathom the mindset of the health and safety community in this fight with the Pharmas. From a persuasion perspective they are exposing themselves to incredibly dangerous lines of attack with their own biased attacks on Evil Pharmas. Please realize here that as I’ve explained in prior posts, my own past here is on all sides of every fence in this exchange. I’ve worked “for” virtually all of the players here (except for insurance companies, I think). I’m trying to focus on the persuasion elements of this case while also trying to see my own blinders (always a difficult task).

Consider the editor of JAMA and her advance statement of wanting to expose the bias. She’s making it sound like she’s on a hunting expedition while she’s supposed to be an unbiased arbiter of science. Please scan JAMA for the studies that show how her readership, physicians, clearly avoid prescribing generic drugs because they receive incentives from Pharmas for using branded drugs. That research you won’t find very often especially compared to the mob science she’s proposed to wield against the Evil Pharmas. Her position lacks proportionality. If people are biased by profit, then there should be research addressing all of those people, not just the one’s outside of your circulation base. Yet, because of attributional biases, the health and safety community cannot see the risks they run with their laserlike focus against for profit operations.

We are headed for a bad train wreck in our society with the collision of science, profit, government, and pride.

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