1. Jackson Jackson & Wagner, October 20121 Driving Behavior and The Bottom Line What Every Practitioner Needs to Know

2. Jackson Jackson & Wagner, October 20122 “Never mind what our publics are thinking -- The question is what are they doing?” Patrick Jackson, APR, Fellow PRSA1932 – 2001

3. Jackson Jackson & Wagner, October 20123 Why Seek Behaviors? Measureable Bottom line Observable Progressive Takes public relations from the realm of “nice to have” to “need to have”

4. Jackson Jackson & Wagner, October 20124 Change occurs only when the pain of not changing is greater than the pain of the status quo

5. Jackson Jackson & Wagner, October 20125 Typical Chances of Achieving Behavior Change # People = 100 Awareness.4040 Knowledge.5020 Attitude.20 4 Behavior.10.4

6. Jackson Jackson & Wagner, October 20126 Areas of Study With Behavioral Theories Useful to Public Relations Behavioral Economics Behavioral Psychology Organization Behavior Anthropology Sociology Learning Theory Political Science

7. Jackson Jackson & Wagner, October 20127 Behavioral Economics Loss Aversion Pain of loss is 2x intensity of pleasure of gain Status Quo Bias Tendency to strongly prefer to sit with what we “own” over buying more or discarding it

8. Jackson Jackson & Wagner, October 20128 Behavioral Psychology Dual Process Theory of the Brain Automatic and emotional (gut) Slower, more reasoned Joshua Greene, professor at Harvard and leader in Moral Psychology “Most of the time, when we’re deciding what is the right thing to do, what’s happening in the brain is the emotional response, not the reasoned one”

9. Jackson Jackson & Wagner, October 20129 Organization Behavior Motivation-Hygiene Theory (Herzberg)  Hygiene Factors (environment)  Policies and administration  Supervision  Working conditions  Interpersonal relations  Money, status, security  Motivators (The Job Itself)  Achievement  Recognition for accomplishment  Challenging work  Increased responsibility  Growth and development

10. Jackson Jackson & Wagner, October 201210 Anthropology Nesting – the need to make a place your own to be comfortable and focused The “officeless office” - unassigned workplaces “free address” or “non-territorial offices”

11. Jackson Jackson & Wagner, October 201211 Sociology Social Network Theory Nodes (people) and Ties (connections) Suggests that the attributes of individuals are less important than their relationships and ties with other actors within the network Example: Opinion leader networks

12. Jackson Jackson & Wagner, October 201212 Learning Theory Understand the “Habit” Loop Charles Duhigg, “The Power of Habit: Why We Do What We Do in Life and Business” Three Step Process Cue or Trigger (awake) Routine (shower) Reward (feel clean/alert)

13. Jackson Jackson & Wagner, October 201213 Public Relations Behavioral Theories Grunig’s Situational Theory PR Behavioral Model Four Steps to Behavior Change Lesly’s Paradigm Roger’s Diffusion of Innovation/Adopters Theory

14. Jackson Jackson & Wagner, October 201214 Grunig’s Situational Theory Dependent Variables Active & Passive communication behavior Independent Variables (situational) Problem Recognition Level of Involvement (Problem Personalization) Constraint Recognition

15. Jackson Jackson & Wagner, October 2012 15 Problem Recognition & Personalization Low High Constraint Recognition High Low High likelihood of behavior change Low Likelihood of behavior change

16. Jackson Jackson & Wagner, October 2012 16 Behavioral Public Relations Model www.jjwpr.com A Awareness Rarely Latent Readiness LR Usually TE Triggering Events Preparatory or Intermediate Behavior B R Relationship Building Occasionally BUltimateDesiredBehaviorsBUltimateDesiredBehaviors Usually

17. Jackson Jackson & Wagner, October 2012 17 Behavioral Public Relations Model www.jjwpr.com A Awareness Rarely Latent Readiness LR Usually TE (4 types) Triggering Events Preparatory or Intermediate Behavior B R Relationship Building Occasionally BUltimateDesiredBehaviorsBUltimateDesiredBehaviors Usually Underlying Factors

18. Jackson Jackson & Wagner, October 2012 18 Behavioral Public Relations Model www.jjwpr.com A Awareness Rarely Latent Readiness LR Usually TE (4 types) Triggering Events Preparatory or Intermediate Behavior B R Relationship Building Occasionally BUltimateDesiredBehaviorsBUltimateDesiredBehaviors Usually Addresses underlying factors

19. Jackson Jackson & Wagner, October 2012 19 Behavioral Public Relations Model www.jjwpr.com A Awareness Rarely Latent Readiness LR Usually TE Triggering Events Preparatory or Intermediate Behavior B R Relationship Building Occasionally BUltimateDesiredBehaviorsBUltimateDesiredBehaviors Usually Continuum of Behaviors

20. Jackson Jackson & Wagner, October 201220 4 Steps To Public Behavior Change Coalition Campaign Enforcement Engineering Social Reinforcement

21. Jackson Jackson & Wagner, October 201221 Focus on Stakeholders Who Can Give You Behaviors

22. Jackson Jackson & Wagner, October 201222 Zealots mind made up as soon as hear of issue Have opinion, won’t do anything about it Willing to Discuss, open minded – will drive decision Have opinion, won’t do anything about it Zealots mind made up as soon as hear of issue 100% of Stakeholders How Americans Typically Respond to Issues 1% 45% 8% 45% 1% Immediate Leaning Opinion Leaning Immediate Favorable Favorable Leaders Unfavorable Unfavorable

23. Jackson Jackson & Wagner, October 201223 Roger’s Diffusion of Innovation

25. Trinity Health Background 10 th largest health system in U.S. Formed in 2000 after merger of MHS and HCHS 56,000+ FTEs; 11,000 physicians (only 3400 employees) 47 hospitals, 432 outpatient, 32 LTC, 10 States Big!

26. Barriers Physicians resistant to learning new system Can’t mandate for non-employees Growth, change of leadership so Slow implementation (3 years) Big expense to change

27. Opportunities Healthcare field trending toward electronic databases Statistics show improved quality of care, reduced error rates Government $ to upgrade … penalities after 2015

28. Strategies Learning Theory: Think like a doctor = lots of facts, statistics Lots of training and education to solidify the “why” Participation in evaluation – “hands on” Social network theory 3 rd party endorsements Physician testimonials Early adopters leading the laggards

29. Strategies (continued) Psychology Tie to Values “we are called to be innovative in improving health delivery” Personalization of campaign vs. corporate cookie cutter 4 Steps to Behavior Change Theory Engineering Enforcement

30. Evaluation Percent of physicians in ER logging orders into system 15-20% to 70-90% in one year

31. Jackson Jackson & Wagner, October 2012 31 Temple, New Hampshire

32. Jackson Jackson & Wagner, October 2012 32 Temple, New Hampshire

33. Jackson Jackson & Wagner, October 201233 Triggering Events & Actions NH Climate Change Resolution lead up to 2008 presidential election Appointment of town energy committee Fire Department roof Energy inventory done by Committee Ice Storm

34. Jackson Jackson & Wagner, October 201234 Strategies & Theories Utilized Foot-in-door (psychology) Cheerleading (sociology) Opinion Leaders, Role Models (Social Network Theory) Habit Loop (Cue/Routine/Reward Behavioral Continuum & Triggering Events (Behavioral PR Theory)

35. Jackson Jackson & Wagner, October 201235 Questions? Discussion? Jackson & Wagner Our Passion is to help an organization achieve effective relationships with both internal and external stakeholders, so that mutually desired behaviors result. www.jjwpr.com