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Nudging the Health Workforce to Share Experiences (Including Failures!)

What behavioral experiments can tell us

There is a critical need for the family planning and reproductive health (FP/RH) workforce to share and apply evidence and best practices to inform and improve programs and services. Sharing our experiences with program failures, in particular, gives us some of our greatest insights. Despite people’s best intentions, however, they often do not fully engage in knowledge sharing.

Sharing information requires individuals to engage in seemingly selfless behavior that is often not part of their direct responsibility. Cabrera and Cabrera (2002) identify clear costs to knowledge sharing, including a potential loss of competitive advantage. It also consumes time that people might otherwise invest in tasks with clear and direct personal benefits. When it comes to sharing failures, people are even more hesitant for many reasons, including the fear of losing the respect of their peers.

So how do we encourage the FP/RH workforce to share their knowledge with each other, particularly regarding their failures?

Before we answer this question, we first need to measure knowledge sharing.

Measuring knowledge sharing

Most research on knowledge sharing uses surveys that measure people’s self-reported information- sharing behavior and intentions to share. Fewer studies exist with empirical evidence on actual sharing behavior, and the empirical studies that do exist tend to focus on knowledge sharing through online communities for commercial profit rather than for health and development professionals.

Thumbnail image linking to Table: Overview of the Knowledge SUCCESS Information-Sharing Assessments (37 KB .pdf)

Click here to download Table: Overview of the Knowledge SUCCESS Information-Sharing Assessments (37 KB .pdf)

To fill this gap and better understand how information sharing can be improved in the FP/RH community, Knowledge SUCCESS conducted an online assessment to capture and measure actual information sharing behavior and intention to share failures among a sample of FP/RH and other global health professionals based in sub-Saharan Africa and Asia (see Table, attached). We recently finished collecting data for the assessment and are currently finalizing the analysis of our findings. The main goal of the assessment was to investigate the most effective behavioral nudges to encourage information sharing (generally) and sharing of failures (more specifically).

Social norms: A shopper chooses a t-shirt with a giraffe on it; three people outside the shop wear the same t-shirt.

Social norms are the spoken or unspoken rules that create behavioral expectations for members of a group of people. Actively providing people with clear information on what other people are doing can nudge them to do the same behavior.
Image credit: DTA Innovation flashcards, used under a Creative Commons license.

We tested the following behavioral nudges:

  1. Social norms: We investigated if individuals are more likely to share information when they know that their peers are sharing information, too. We also tested the impact of social norms on people’s willingness to share their professional failures.
  2. Recognition: We investigated if individuals are more likely to share information if they are told that the recipient would know who shared it. In other words, will individuals share more information if they receive personal recognition?
  3. Incentives: We investigated the effect of offering an incentive (a chance to enter a raffle for free registration for the International Conference on Family Planning) on people’s willingness to share professional failures.

In addition to these behavioral nudges, we explored the positive and negative associations with a body of terms that describe “failures” to identify the best way to convey the meaning while avoiding strong negative connotations.

Finally, the assessment also explored whether and how information sharing behavior differs by gender. For example, previous research suggested that people have a tendency to interact with other people of the same gender. Therefore, we investigated whether information sharing behavior differed when individuals were asked to share with someone of the same gender compared with someone of a different gender. In addition, studies have shown that women experience more hostility than men when presenting at conferences, which may discourage them from sharing publicly at a live session or gathering. In our failure-sharing assessment, we explored gender differences in participants’ intention to share failures when they were told that there would be a live Q&A session after the failure-sharing event.

How we intend to use the experimental insights

Given the amount of value that knowledge sharing can add to the FP/RH field, the outcomes from this study will aid Knowledge SUCCESS and the broader FP/RH community in the following ways:

  1. Inform the design of Knowledge SUCCESS knowledge management solutions: Solutions such as FP insight and Learning Circles hinge on members’ information-sharing behavior. For example, with Learning Circles, FP/RH professionals convene over multiple sessions to share relevant and timely information with each other, including personal experiences, tacit knowledge, and challenges related to program implementation. On FP insight, members save and curate articles, blog posts, and other resources that are important and useful for their work so they can easily come back to them, while simultaneously sharing these resources with other members who may be likewise inspired. Our experiments aim to identify which behavioral nudges (social norms or recognition) trigger knowledge-sharing behaviors; results will be incorporated into the design and implementation of these and other knowledge management solutions.
  2. Provide baseline data on whether and how information sharing behavior differs by gender among FP/RH professionals: Gender differences in willingness to share information may have subtle yet important implications for knowledge management. For example, if the experiments find that women are more likely to share information with other women when organizing Learning Circles or other learning exchange events, recommendations might include ensuring a balanced mix of men and women in groups or finding ways to facilitate greater sharing among genders. By analyzing these dynamics, we can incorporate elements into our knowledge management solutions that foster knowledge sharing equally across genders and ensure that we are not unintentionally implementing gender-related barriers to information sharing.
  3. Support FP/RH and other global health professionals in their knowledge management efforts: We plan to share our findings widely so that others working in FP/RH and global health programs can benefit from them to inform their own knowledge management interventions and practices.

We recently completed data collection for these experiments and look forward to sharing the insights with the broader FP/RH community as they become available. Stay tuned for more information!

To learn more about Knowledge SUCCESS behavioral research, register for our June 16 webinar here.

Nudging the Health Workforce to Share Experiences (Including Failures!)
Maryam Yusuf

Associate, Busara Center for Behavioral Economics

As an Associate at the Busara Center for Behavioral Economics, Maryam has supported and led the design and implementation of behavioral research and interventions for social investment programs, financial inclusion, health care (primarily family planning and reproductive health), and agricultural resilience projects. Prior to Busara, Maryam worked as an Associate Consultant at Henshaw Capital Partners focusing on private equity advocacy and capacity building for subject matter experts (SMEs). She holds a BSc in Economics and Business Finance from Brunel University.

Ruwaida Salem

Senior Program Officer, Johns Hopkins Center for Communication Programs

Ruwaida Salem, Senior Program Officer at the Johns Hopkins Center for Communication Programs, has nearly 20 years of experience in the global health field. As team lead for knowledge solutions and lead author of Building Better Programs: A Step-by-Step Guide to Using Knowledge Management in Global Health, she designs, implements, and manages knowledge management programs to improve access to and use of critical health information among health professionals around the world. She holds a Master of Public Health from the Johns Hopkins Bloomberg School of Public Health, Bachelor of Science in Dietetics from the University of Akron, and a Graduate Certificate in User Experience Design from Kent State University.

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