Hi, I'm Chelsea Clinton, and this is in fact, a podcast about why public health matters even when we're not in a pandemic. Today we're talking about what works and what doesn't when it comes to helping people have good information to make good decisions for their health, even when they may need to change their behavior or their minds. Throughout this pandemic, we've seen the impact individual decisions can have on our collective health, whether it's wearing masks, practicing social distancing, or getting vaccinated. But getting people to do those things requires effective messaging and effective trusted messengers. Today, I'm talking with two people who have spent years figuring out what it takes to spark widespread change in actions and attitudes. Later we'll hear from Polster author, political strategists and communications consultant Frank Lentz, But first I'm talking with behavioral economist Maya Shankar. Maya has spent year studying why people do what we do and how to encourage positive changes that can have huge results. She's currently Google's Global director of Behavioral Economics, which I hope to talk to about in a future episode. For today's conversation, we're focused on her time as senior advisor in the Obama administration, where she founded and served as chair of the White House's Behavioral Science Team, a group of scientists studying the intersection between human behavior and public policy and using that science to help motivate people to make choices to improve their health and their lives. Maya. I'm so thrilled to welcome to the podcast. Thank you for being with us today. And I think maybe we'll start with your story, if that's okay, because I know that you originally trained and I think thought you were going to become a classical violinist and yet now are a cognitive scientist. How did that happen and what sparked your interest in the field originally. I think if you had told me as a child, one day you'll be studying the mind, I would have been like, you're crazy. I'm a violinist. Yeah. When I was six, I started playing the violin and it became serious very quickly. So when I was nine, I started studying at Juilliard every weekend, and then when I was in my teens, it's like Pearlman asked me to be his private violence student, and that really accelerated things for me. And I for anyone who may not know who it's like Pelman is, explain why that was such a big deal. So he's like arguably the best violinist in the world. I still get tinkles saying that he was my teacher. But yeah, it was just such an amazing period of my life. And then I had a hand injury suddenly one day, and unfortunately, doctors told me at that point that I could never play the violin again. So I kind of went from like this peak interest and passion to being told you have to pivot. Oh, I'm so sorry. I can't imagine how devastating that was, especially given where you were at that point in time and in your study and your dreams for yourself, and yet you imagined a different future. Yeah, so I was pretty lost, and I didn't know what it was that I could be passionate about again. But fortunately for me, the summer before college, I stumbled upon a book on how the mind works, and it basically detailed the remarkable abilities that our minds have to process language. So this book was on language acquisition, and I remember thinking, oh, my gosh, this is amazing, Like I have taken my ability to process language speak language, comprehend it for granted my entire life, and it's actually the result of really sophisticated cognitive processing and every thinking. If this is what underlies language, like what underlies even higher level stuff like doing complex math, or thinking about deep philosophical questions, or analyzing the cost benefit of a public health policy, or falling in love. And I just in that moment, I just became so captivated by the inner workings of the mind. And so that began a decades long journey to study the mind. So I got my PhD and post doc in cognitive psychology and neuroscience and basically have been studying how and why we make decisions, as well as how we develop our attitudes and beliefs about the world. And the reason why I believe this body of research is so important is that one of the things behavioral science teaches us is that there are many surprising factors that influence our behaviors, factors we might not even be consciously aware of. Before you were in Google, you were at the White House and the Obama administration, and you helped create the White House Social and Behavioral Sciences Team, which kind of colloquially has been touched, has been touched, has been has been dubbed the nudge unit. Um. I don't know what that says about my language acquisition, but could you talk about what maybe some of the work you did while you were at the White House led to any changes at the federal level on how we might nudge to help people make better decisions for themselves. Yeah. So one project we worked on was with the Department of Veterans Affairs, and we were trying to boost enrollment in a benefits program m that veterans could take advantage of upon returning to this country. And the reason the government offered this program is that assimilating back to civilian life can be a very challenging transition, and we wanted to do everything we could to aid the transition right, to open up job opportunities, higher education, etcetera, etcetera. And so the v A was seeing, oh, man, you know, we're offering this program, but participation rates are low. What can we do about it? Especially in a resource constrained environment where we don't have a ton of dollars to throw at this, But we really want to make sure that veterans are getting the best experience they can. So they came to us and they said, we just have this one email to work with, Please do what you can to it. We ended up changing just one line in the email message. Instead of telling veterans that they were eligible for the program, we simply reminded them that they had earned it through their years of service. And that one word tweak led to a nine percent increase in participation in the program and access to the program, which is many, many thousands of people. It's a lot of veterans. What this owed us, and the principle that it was based on is a version of what's called the endowment effect, which says that we value things more when we feel we own them, or in this case, have earned them, and that we have something to lose by not taking advantage of them. Another quick example of some of the work we did at the White House had to do with going to college. Every year of college accepted high school grads who are from urban districts failed to matriculate in college in the fall because they haven't completed required tasks like filling out a course enrollment form or taking a placement test. And this is tragic, right, Chelsea, because these are kids who have already overcome all the barriers along the way when it comes to applying to college and then even getting in, and yet they don't end up matriculating in the fall. So this phenomenon is known as summer melts. And what behavioral science shows us is that we reliably underestimate the kinds of small barriers that can deter people from achieving their long term goal. What we found from our inventions while at the White House was that sending students just eight text messages over the summer that reminded them to complete these tasks boosted college enrollment by nine and so again like a really low cost intervention, but it was a game changer for these students. And like, I don't know these days, what we send eight text messages within ten minutes in our daily in our daily lives, that could make the difference between a kid going to college or not going to college. Do you know if that program continued under the Trump administration. It's a good question. Um, not sure in this case. But what I did try to do when designing the behavioral science team within the White House was to build it in a very bipartisan part of government because I just felt like what we're promoting here is not a partisan agenda. We're just trying to make government programs smarter, make sure that they actually achieve their policy objectives. And so we built the team in part of the government again that's relatively bipartisan. It's called the General Services Administration, which meant that even though I disbanded the White House component of the team when I left the agency, components of the team still persistent and we're still working on really amazing programs. I'm just incredibly curious now, having listened to your reflections on your time in government, what you think over the last fifteen months, when so much has been made partisan and political that really shouldn't have been when it comes to COVID, I think what's really important for people to understand is that there are obviously many underlying causes for why people fall prey to misinformation or labor under false beliefs, and it's really important to understand the psychology underlying each of these causes because then we can design tailored solutions. We can't use a blunt instruments to solve all of the problems. So if we can really with this like fine point, figure out, Okay, what is the psychology leading to X non ideal outcome or why non ideal outcome that we can really try and solve it. So, behavioral economics has shed light on several of these and has served up some potentially very powerful solutions. So the first one has to do with a framework called cultural cognition, and this is work done by Dan Kahan and others. He's a professor at Yale Law School. Basically, what this theory says is, look, we all know that people can disagree strongly, even on empirical matters, things that you and I are like, Okay, these are just the facts. Is climate change real? Does gun control regulation lead to fewer deaths? Right? It's like yes and yes, And so it's tempting to think that in order to persuade people of something, we just need to give them more facts. It's just an information gap problem, right. If we can just give them more information, we can solve the problem. But I think many of us see in our everyday lives that this doesn't always work. Right, Like the proverbial Thanksgiving dinner where you're sitting across from your relative and they're absolutely convinced that COVID is not real and giving them. More evidence just doesn't seem to work, and that's because we may be failing to appreciate a key piece of the puzzle, and that's that we don't just form our beliefs from facts. We form our beliefs partly based on our group identities and the values that group has. There's this really illustrative example, a classic study from the fifties about sports team loyalty that I think highlights this really well. So in this study, fans of opposing teams were shown footage of controversial referee calls from a football game. Okay, and even though these people were watching exactly the same footage, they arrived at very different conclusions about the referee calls based on their loyalty to their sports team. So they tended to think that calls were unfair towards their team, but not the opposing team. So what this study illustrates is that there are internal group allegiances are literally shaping their their views of reality. So how does this relate to COVID. What it shows us is that people's beliefs about COVID may in fact be serving as a deep reflection of their values and their group membership. Some of us think it's just if he's of cloth, wear a mask for God's sake. But for many people, wearing a mask or getting vaccinated or social distancing can carry huge symbolic significance. They feel in some way that it threatens their group membership. It's not this like thoughtful cost benefit analysis of the inconvenience of wearing a mask versus the risk of getting a virus, and it is profound meaning within their social networks. And I think, unfortunately, so much of what we've seen over the last many months now of COVID our efforts from people who think they're doing the right thing too by not only heaping more evidence, but also often shouting at people or shaming or attempting to shame people. And we know that doesn't work. It never works. How do you think we can all just be more aware of those different identities that we carry within ourselves so that we may better understand how they influence our behavior and sometimes in ways that our counter to what we think we're doing. You are one million percent right shouting, being antagonistic, undermining people's values. This stuff doesn't work. While it feels good, we're like fulfilling some sort of deep emotional need to just get it out. It's not effective. Okay, So here's the good news. Behavioral economics helps us to identify part of this problem, but then it also offers up some solutions. One of my favorite bodies of research that's emerging, it's really fresh, is called moral reframing, and it's the idea that when we ground our arguments in moral terms that affirm, rather than threaten the moral values of those we disagree with, it's far more effective at helping them change their views. So, to give you a concrete example, if you're trying to convince conservatives to care more about the environment, you might appeal to values that conservatives tend to hold, for example, patriotism. There's research showing that like a frame such as being pro environmental allows us to protect and preserve the American way of life. It is patriotic to conserve this beautiful country's natural resources, which by I also agree with, Yeah, I completely agree with exactly. So this framing, which is holding their values constant, but is saying that they can achieve progress on those values through climate change reform, is a very effective way of getting folks to change their minds. And it's really funny. So I'm I'm interviewing folks for this new podcast that I'm coming out with, which is all about change, and one of the people that I interviewed, she's a woman named Megan Phelps Roper. She grew up in this, you know, absolutely vile hate group. It was a religious cult called the Westboro Baptist Church. Oh, I'm very familiar with the Westboro Baptist Church. It's super venomous. And what was fascinating about Megan's story is that she was a true believer in her life. She was born into the church, her grandfather founded it. When she graduated from college, she became one of the church's most vocal supporters. And it was only when people engaged with her in the way that I just described, using these moral reframing techniques, that it started to make a dent. That it created a crack in her ideology that ultimately led her to realize that everything she had ever believed was wrong and that she needed to challenge her own views. But importantly, again, they didn't tell her, Megan, your views are absolutely completely insane. They said, Okay, I'm going to take your values as fixed, but I'm going to show you through these reframing techniques why you might want to think about them differently. And that was very powerful for her. And I always think, wow, if you could take someone who had such an extremist ideology and use this kind of technique, how powerful is that? And the other thing Chelsea I wanted to mention is we really need to be thoughtful about who the messenger is when communicating some of these public health messages. We know that people are far more receptive to evidence that challenges their existing views when it's coming from a member of their own community. And importantly that expert bodies, so public health officials are far more persuasive when they comprise a diverse group of people that exist somewhere across this political spectrum. I'm really curious, Maya, whether we're talking about moral reframing or nudge theory, or the broader ecosystem of everything under behavioral economics, how do people feel if they're aware of kind of the different ways that the government, from your job when you were at the White House, or private companies like Google where you are now, how do people feel like they're not being manipulated? My belief always is that everybody should know they're being nudged, because even nudges that are completely transparent are effective. Can you give an example of that. Absolutely, So this actually relates to the opiate epidemic. This is one of my favorite interventions. So it's a complicated problem, many underlying causes, but behavioral science does tell us about one of the causes, and it has the benefit of being again highly transparent, very low cost, and relatively easy to implement. Okay, let's think of about that moment in the doctor's office. When the doctor is first prescribing an opioid prescription for a patient. They're typically using some sort of software, and that software includes a default number, a preset number of pills to prescribe to the patient. What researchers found is that when they lowered this default number from thirty pills to twelve pills in the system, it decreased opioid prescriptions by across an entire health system. So in this case, like the researchers aren't pretending they're trying to fool the doctor, right, the number has changed in the system, and doctors are very mindful of the fact that this number has changed. But it is a really healthy nudge to make doctors slightly more thoughtful about just recommending the default number in there and trying to engage in some degree of critical thinking in order to make sure that they're they're giving the right amount. I always think of nudges as being the sort of thing that help people who already have this goal but are facing obstacles or barriers to get over the finish line. But it's just not powerful enough a tool or an instrument to actually convince people to do things that they don't already want to do. We'll be right back. Stay with us why I was just just going to ask, because we've now talked so much about nudges, and if you could just provide maybe a coherent definition of what a nudge is and what nudge theory is. Yeah. So, behavioral economics teaches us that there are these very surprising factors that influence our behaviors, and a nudge is a design tweak that we might see in any given policy or program that reflects this understanding of the science of human behavior. One of my favorite examples, because this is an example that motivated me to go join the government in the first place, was in the domain of school lunches. Basically, the federal government has a program that offers millions of low income kids access to free or reduced price lunches at school. What we are finding is that even though we are offering this program, millions of kids were still going hungry every single day at school. It was a tragedy because the programs being offered, but parents aren't signing up. So we try to figure out, Okay, what are the behavioral factors that are underlying this lack of participation, and then how can we design a nudge that in turn helps solve it. And what we realize when we do this behavioral analysis is that one, parents aren't signing up because the application process is extremely burdensome. There's a single mom who's working three jobs to make ends meet, and then we're asking her to fill out this application form. It's requiring that she references old tax documents and there's a huge penalty if she gets one of these pieces of information wrong, and so we're setting her up for failure. And that's one barrier. Another barrier is stigma. So I remember when I was at the White House, I spoke with principles from different schools, like, for example, this one principle in Florida, who said, these folks work really hard, and the idea of actively signing their kids up for a public benefits program it's just a really hard thing for them to swallow. They don't like the stigma associated with having their kids rely on the government. So what the government did is utilize a nudge, which is an understanding that when something is the default option, when kids are automatically enrolled in a program, and parents only need to take an active step to unenrolled their kids, it's can significantly boost participation rates. So what we did is we are What the government did is it realized, hey, we we actually already have a bunch of data around these kids eligibility criteria because they're enrolled in things like Medicaid or women's and children's programs. We can use that data to automatically enroll eligible kids. So now as a default, all these kids are now getting access to school lunch, and like I said earlier, parents only need to take an affirmative step that they actively want to unenroll their kids. And as a result of this nudge, Chelsea like twelve and a half million more kids were now eating lunch at school every day. So my we've talked a lot about where nudges have worked. Can you talk about where either you or others in your field have had a lot of hope about a nudge having a similarly powerful impact and then it just not working. One place where I really see the limitations of nudges and behavioral sciences in the domain of changing your mind. I think nudges are very effective when a person has already decided that they want to do something that maybe the long term goals and their short term costs create some sort of tension. It's like, oh, I know I want to eat healthier, I know I want to exercise, but it's just so painful right now, and I'd rather watch TV and eat the ritos. And so nudges can be really effective at helping to bridge that gap. They have an intention to do something and you can translate it into action. There are a lot less effective when it comes to changing people's fundamental beliefs about the world, their actual attitudes, the opinions that they've made up over time. So, as you mentioned, I mean think your instincts are totally right. That yelling at people telling that that they're wrong, that doesn't work. What does work is what's known as motivational interviewing. This kind of strategy of interacting with people is a highly effective tool for moving the needle when it comes to mindset change. So here are some of the tips that listeners can take with them. So the first is you want to show genuine curiosity for the person's views. It needs to feel like a conversation that you're having. And one way to make it feel like a genuine conversation is to increase the number of questions you're asking versus the statements you're making. I could be like, Chelsea, you should think X, Y, and Z, or I could say, Chelsea, why is it that you think this thing? Like how did you come to develop these beliefs in the first place. Another technique that I think can be really powerful is reminding people of their agency that you're not forcing a mindset shift on them. Instead, you are recruiting their agency. You are are giving them the tools and maybe new information that they can then noodle with to try to change their own minds. And that's a much more sustainable process. Right. If someone feels like they came up with a new opinion, they changed their mind on their own terms, it's much more likely to be durable. Just on a on a personal level, have you personally nudged any of your family or friends? Are there any personal anecdotes you can share as a final question. So, I have a family member overseas who I felt like I was not taking COVID seriously enough and was like, I read that if you eat these specific foods, you're more likely to resist COVID, or you can build immunity towards COVID, and oh gosh, you know, my initial instinct was to be like, this is so insane. How can you believe these things? Like you're by genetic relative? And then I had to remind myself, Okay, don't forget that. You need to, you know, validate what he's saying, you know, repeat some of that back in your language. And I don't think I fully change things for him, but he did get vaccinated. I think though it matters my have for people to hear that that it's even for you, who is, you know, one of the world's leading experts on nudge theory, that you still have to do the hard work to hopefully anyone listening to usk and think, oh, well, I can do it too. There are a lot of concrete steps we can take in our own lives to try to help make a positive impact. I think what behavioral science teaches us is like it doesn't always have to feel so emotionally charged and explosive. Right. We can take these small steps and over time to slowly chip away because I think we can be more thoughtful about the way that we engage with others and how we approach the problem of behavior change or mindset change. Well man, thank you so much, Thank you for your time, thank you for your work, thank you for your nudges, and hopefully I will have the chance to talk again soon. That sounds great. Thank you so much. Kelsee My's new podcast, A Slight Change of Plants is out this week, and trust me, you won't want to miss it. There's one thing we know for sure about encouraging more people to wear masks or get vaccinated. It's a lot harder because we're so politically polarized here in the US. Frank Lentz has seen and studied this phenomenon up close. He's a political communications expert, author, and pundit known for shaping Republican messaging and strategy over decades. He's also a Polster, who has run far more focus groups than just about anyone I know. As his Twitter bio says, he'll show you what Americans really think with data, facts and the occasional meme. I've been fascinated by the work Frank has done over the last several months to understand why some people are more likely to believe that COVID nineteen isn't a threat to them, and why then they're less likely to get a COVID nineteen vaccine. We caught up in between the classes he's currently teaching at Oxford University. Frank, thank you for just delving into this topic. You know, I think it makes sense to start with where do you think we are right now in term terms of people who want to get vaccinated, people who maybe think they might get vaccinated, and then people who may not want to get vaccinated. Where do you think we are? Well? I wish you'd been on my focus group last night, women eighteen to thirty nine. And the level of concern hesitation about getting the vaccine is so great, and it's not over issues of pregnancy or menstruation or any of the things that we've heard about. Yeah, and that we've heard about it as real concerns from people anecdotally, The problem with them, or the challenge for them, is that COVID is not as serious to them. Many of them have had it, it took them a day or two to get over it, and they simply don't see the need, or they think that the vaccine is actually more dangerous than COVID itself, or they want other people to do it so they won't have to, and any of these, if it continues, means we will not reach herd immunity, which I'm coming less and less competent in. It means that we will never be as safe and secure as we could be. We know that for some people that really still are access challenges, for people who have mobility challenges, for whom we do need to very much go that last proverbial mile and bring the vaccines to them. We know that for many people who live in rural areas, for whom it's just too far a track, we need to bring vaccines to them. But we also know there are groups in our country for whom vaccines are available around the corner or increasingly at their local doctor's office or kind of their pharmacy, and they're still not going Frank, how do we think about the different groups that you've now spoken to and what may work to try to help encourage them to recognize that COVID is actually really serious. There are three different segments that we need to reach out to. The first and largest are Trump voters, and they don't want to be told what to do. They don't trust the government, they don't trust the facts. They believe that the media is dishonest with them, and they're very hard to convince because they believe that Donald Trump lost the election because of COVID, and so that makes them instantly more hesitant either about the virus or the vaccine. So many of them are in rural areas which are less likely to trust the vaccine or want to get it. And so many of them are anti government, which means that they won't even accept what the c d C says or the f d A or Anthony Faucci. That's group number one. Group number two or black and brown, and there's been a very successful effort from the Biden administration to reach out to them, to do so on their terms, but that black and brown community needs to hear from others in their community. That's what's going to make a difference for them, and then the third or eighteen the thirty nine year olds in general, particularly eighteen the thirty nine year old women, and for them it's somewhat of a fear, but it's also for some it's the feeling that they're either invincible or they're healthy. We're not reaching them the way that we need to. And I want to suggest one profession which has not been used enough, that works for all three of these groups. It's your pharmacist. I had a stroke last January. And I had a stroke because I ate too much, I traveled too much, I slept too little. I lived a very unhealthy life and it has and will continue to affect me for the rest of my life. And because of that, I don't want anyone to make these decisions I made. I don't want anyone to make the mistakes I made. I want them to know that not taking care of yourself could and will have a negative consequence that you will never ever be able to shake. Getting COVID is so much worse. You don't have to be stuck with shortness of breath, you don't have to be stuck with the inability to taste, you don't have to be stuck with all of what COVID does to you if you get it, So don't make the same mistakes I did. Be proactive and listen to the people who really care about you, because it could save your life. And Frank, returning to your diagnosis, around Republicans who voted for President Trump, who are unlikely to certainly be standing in line first to get the COVID nineteen vaccines, have you found any messages or messengers that at least hopefully have the chance of working. The most amazing message would be delivered by Donald Trump and Joe Biden, together, the current president and the former president, each one delivering a sentence of thanks to the other, Donald Trump complimenting Joe Biden forgetting the vaccine out across the country incredibly fast, efficient and effective. Joe Biden giving Donald Trump credits for his administration developing the vaccine in a rigorous and detailed and scientific manner, and then the two of them saying, but don't trust us, trust our doctors, and let binds doctor and Trump's doctors safe. For the remaining fifty seconds of a sixty second ad that we know that this vaccine is safe. We know that it works. That's the most powerful message of all. But Chelsea, we're not going to do it because our politics are so divided. Now, I've been saying for months, I think, truly starting last October, I can't wait to watch President Trump get vaccinated on television. I can't wait for him to take credit for the extraordinary pace of vaccine development without sacrificing quality, without sacrificing safety. I've been asked repeatedly, do I wish the President Trump had been in the p s A with the four presidents? And I think before someone can finish asking the question, I say, yes, this should be ideally nonpartisan. But if we can't have it be nonpartisan, it at least needs to be bipartisan. So I just I couldn't agree more more enthusiastically and emphatically with my public health hat on with what you're saying. But but even better than the politicians is your doctor and your pharmacists. If you get a video from your doctor that's texted or emailed, you're gonna watch it of them will and if they tell you to get vaccinated, over those who have not been vaccinated are going to listen because it's your doctor and your pharmacists, they know you, and that would be even more powerful than the politicians. And in terms of the three messages that work best, that this vaccine is even more much more effective than the flu shot, which so many Americans take. That the vaccine that they cut bureaucracy and they cut red tape, but they didn't cut corners. One of the greatest phrases of all. And third is that over of all doctors have been vaccinated. Those are three messages and they absolutely positively work, particularly when when delivered by someone you know. And Frank, what advice would you have for people talking to their own family members who might be hesitant. And the most powerful familiar relationship is grandparents and grandchild. I joke that it's because they both have the same enemy, but it's actually true. Well, I was very close to my grandmother, like I talked to her every single day, Frank, So I love my parents a lot, but my grandmother had a super special place in my hurt. And that happens across the country. And it doesn't matter what ethnicity you are, doesn't matter what region of the country. People feel that closeness and the idea that grandparents and grandchildren can't hug. I know grandparents who have who are very sick and have somehow managed to stay alive because they want that embrace. Again. That the dream is to be able to tuck your grandchild in at night, be able to give them a kiss and say I love you, I love you, and to be able to do so with complete safety and security matters. That's the ad that I want. I think that makes a difference. So it's not the government telling you to do it. It's your grandma and your grandpa. We're taking a quick break, stay with us. One of the things that I've been really concerned about for many years is the misinformation, the disinformation around vaccines, especially which has largely been allowed to flourish unchecked online by the social media companies. And we have seen just an unprecedented explosion of misinformation around COVID and the COVID nineteen vaccines. How much of that do you see reflected in the surveys that you're conducting or the focus groups that you're you're conducting. It's not just misinformation or disinformation, it's in some case is no information at all that they give you all the reasons why they're hesitants and they've made no effort to confirm them, or they accept sources that nobody else would believe simply because it's easier for them to do so. I'm very upset with social media platforms and with the technology because in the end, their irresponsibility is causing people to die. I also know the part of it, the messaging, where the words themselves matter, where I blame the politicians. For example, call it a government mandate and you immediately agitate every right of center voter. Call it a protocol, and that's acceptable. Another example is the lockdown versus stay at home. Stay at home is you're at home. Lockdown is you're in prison. So every politician who used these phrases was actually causing a problem. And the one that's happening right now, and it's really agitating to me, is that they call it a vaccine passport. Well, to those on the left, a passport is something that will never some people never be able to own. It's expensive, it's exclusive. And on the right, a passport, a vaccine passport to them means more government involvement. You call it a vaccine verification, and the American people say, yes, you call it a vaccine passport. The public says, no, that's not misinformation, that's simply bad language. Frank, I do want to go back, though, to the eighteen to thirty nine year olds. What do you think would be sufficiently persuasive to the eighteen to thirty nine year old you've been talking to, so that they make a different risk assessment of COVID versus the COVID nineteen vaccines, and hopefully then are persuaded to get themselves vaccinated. It's not about them. It's about the people they love. It's about the people they want to protect. For an eighteen to thirty nine year old, it's about their grandparents and being able to see them in a safe and secure manner. If you try to make it about them, it will fail because they just don't fear COVID. If you try to make it about the side effects, they're much more afraid of the side effects of the vaccine than they are of the virus itself. And if you try to make a political argument, it just doesn't resonate. If I want eighteen to thirty nine year olds to get the shot, I need to tell them how easy it is, and I need to tell them that they will have a light at the end of the tunnel, and so often these interviews, I forget that if you want people get vaccinated, let them know that they can take their masks off. Let them know that they'll be able to celebrate the fourth of July like they used to. Let them know that our schools are going back and people are going back to work. If you don't tell them that, then they won't get vaccinated, and we will be under a threat from this, from this horrible virus. And I will acknowledge something to you. I don't even want to look at you when I say this. When I got the vaccine, the first shot in my arm, I started to cry because I had a pre existest in condition I was damaged from last year, and that shot to me was life itself. It was actually, I'm going to live. And I didn't know that for six or seven months. So I don't understand how people can be so cavalier. They gave me my life back, and I'm so grateful to those researchers, and I feel so blessed, and I want others to feel as blessed as I feel. Frank I cried too. I cried to when I got my first shot because it just felt it felt like hope. You know, I am curious. Has there been anyone that you've seen changed their mind who's been in that group? And if so, what changed their mind or not? Yes? Yes, and people have changed their minds and they tend to change their minds to get the vaccine, and it's usually because of interaction with their doctor and their pharmacists. But the problem of the eighteen to nine year olds is that they're not necessarily calling that they're just getting stuff off the web. That just getting superficial information. That's why we need to connect every person and the medical professional who may trust the most that will have the greatest impact and will have the fastest impact. Is there a next best alternative to your doctor? If you don't necessarily have a doctor, it's the closest person to you, maybe your child, that maybe your parents, maybe your spouse, but the person that you love most. Because in the end, if it's a message that's delivered from love and a message about returning to life itself, they'll do it. If it's a message that comes across like a mandate, like you must do it, you have to do it. You don't have a choice. It will be rejected. Even the tone, even the context of how we deliver this determines whether or not it's credible and whether or not people actually follow Frank. Thank you so much for all of your time. To learn about Frank's work and upcoming focus groups on this and other topics, follow him on Twitter at Frank Luntz. Changing people's minds isn't easy. In fact, it can be really hard, even with the best information from trusted messengers with the best intentions. But in this moment, when we're working so hard to vaccinate as many people as possible and learn from the COVID nineteen pandemic, it's really important. I hope that after listening to Maya and Frank, you might feel a little more confident about broaching and conversation with someone close to you who may not yet be convinced about getting vaccinated or making other decisions that you know are good for their health and our shared public health. Beyond the pandemic, the tools of informing and persuading that we heard about today can be effective when it comes to so many other topics in public health, including climate change, the stigma amount substance used disorders and addiction, and so much more. I, for one, I'm really glad that Maya, Frank and so many others are deeply committed to understand name what it really takes to get someone to take action or change their mind and build a healthier, more just country in the process. In Fact is brought to you by iHeart Radio. We're produced by Erica Goodmanson, Lauren Peterson, Cathy Russo, Julie Subrian, and Justin Wright, with help from the Hidden Light team of Barry Luriy, Sarah Harowitz, Nikki Huggett, Emily Young, and Hugh Abodeen, with additional support from Lindsay Hoffman. Original music is by Justin Wright. If you liked this episode of In Fact, please make sure to subscribe so you never miss an episode, and tell your family and friends to do the same. If you really want to help us out, leave us a review on Apple Podcasts. Thanks again for listening, and see you next week.

Hi, I'm Chelsea Clinton, and this is in fact, a podcast about why public health matters even when we're not in a pandemic. Today we're talking about what works and what doesn't when it comes to helping people have good information to make good decisions for their health, even when they may need to change their behavior or their minds. Throughout this pandemic, we've seen the impact individual decisions can have on our collective health, whether it's wearing masks, practicing social distancing, or getting vaccinated. But getting people to do those things requires effective messaging and effective trusted messengers. Today, I'm talking with two people who have spent years figuring out what it takes to spark widespread change in actions and attitudes. Later we'll hear from Polster author, political strategists and communications consultant Frank Lentz, But first I'm talking with behavioral economist Maya Shankar. Maya has spent year studying why people do what we do and how to encourage positive changes that can have huge results. She's currently Google's Global director of Behavioral Economics, which I hope to talk to about in a future episode. For today's conversation, we're focused on her time as senior advisor in the Obama administration, where she founded and served as chair of the White House's Behavioral Science Team, a group of scientists studying the intersection between human behavior and public policy and using that science to help motivate people to make choices to improve their health and their lives. Maya. I'm so thrilled to welcome to the podcast. Thank you for being with us today. And I think maybe we'll start with your story, if that's okay, because I know that you originally trained and I think thought you were going to become a classical violinist and yet now are a cognitive scientist. How did that happen and what sparked your interest in the field originally. I think if you had told me as a child, one day you'll be studying the mind, I would have been like, you're crazy. I'm a violinist. Yeah. When I was six, I started playing the violin and it became serious very quickly. So when I was nine, I started studying at Juilliard every weekend, and then when I was in my teens, it's like Pearlman asked me to be his private violence student, and that really accelerated things for me. And I for anyone who may not know who it's like Pelman is, explain why that was such a big deal. So he's like arguably the best violinist in the world. I still get tinkles saying that he was my teacher. But yeah, it was just such an amazing period of my life. And then I had a hand injury suddenly one day, and unfortunately, doctors told me at that point that I could never play the violin again. So I kind of went from like this peak interest and passion to being told you have to pivot. Oh, I'm so sorry. I can't imagine how devastating that was, especially given where you were at that point in time and in your study and your dreams for yourself, and yet you imagined a different future. Yeah, so I was pretty lost, and I didn't know what it was that I could be passionate about again. But fortunately for me, the summer before college, I stumbled upon a book on how the mind works, and it basically detailed the remarkable abilities that our minds have to process language. So this book was on language acquisition, and I remember thinking, oh, my gosh, this is amazing, Like I have taken my ability to process language speak language, comprehend it for granted my entire life, and it's actually the result of really sophisticated cognitive processing and every thinking. If this is what underlies language, like what underlies even higher level stuff like doing complex math, or thinking about deep philosophical questions, or analyzing the cost benefit of a public health policy, or falling in love. And I just in that moment, I just became so captivated by the inner workings of the mind. And so that began a decades long journey to study the mind. So I got my PhD and post doc in cognitive psychology and neuroscience and basically have been studying how and why we make decisions, as well as how we develop our attitudes and beliefs about the world. And the reason why I believe this body of research is so important is that one of the things behavioral science teaches us is that there are many surprising factors that influence our behaviors, factors we might not even be consciously aware of. Before you were in Google, you were at the White House and the Obama administration, and you helped create the White House Social and Behavioral Sciences Team, which kind of colloquially has been touched, has been touched, has been has been dubbed the nudge unit. Um. I don't know what that says about my language acquisition, but could you talk about what maybe some of the work you did while you were at the White House led to any changes at the federal level on how we might nudge to help people make better decisions for themselves. Yeah. So one project we worked on was with the Department of Veterans Affairs, and we were trying to boost enrollment in a benefits program m that veterans could take advantage of upon returning to this country. And the reason the government offered this program is that assimilating back to civilian life can be a very challenging transition, and we wanted to do everything we could to aid the transition right, to open up job opportunities, higher education, etcetera, etcetera. And so the v A was seeing, oh, man, you know, we're offering this program, but participation rates are low. What can we do about it? Especially in a resource constrained environment where we don't have a ton of dollars to throw at this, But we really want to make sure that veterans are getting the best experience they can. So they came to us and they said, we just have this one email to work with, Please do what you can to it. We ended up changing just one line in the email message. Instead of telling veterans that they were eligible for the program, we simply reminded them that they had earned it through their years of service. And that one word tweak led to a nine percent increase in participation in the program and access to the program, which is many, many thousands of people. It's a lot of veterans. What this owed us, and the principle that it was based on is a version of what's called the endowment effect, which says that we value things more when we feel we own them, or in this case, have earned them, and that we have something to lose by not taking advantage of them. Another quick example of some of the work we did at the White House had to do with going to college. Every year of college accepted high school grads who are from urban districts failed to matriculate in college in the fall because they haven't completed required tasks like filling out a course enrollment form or taking a placement test. And this is tragic, right, Chelsea, because these are kids who have already overcome all the barriers along the way when it comes to applying to college and then even getting in, and yet they don't end up matriculating in the fall. So this phenomenon is known as summer melts. And what behavioral science shows us is that we reliably underestimate the kinds of small barriers that can deter people from achieving their long term goal. What we found from our inventions while at the White House was that sending students just eight text messages over the summer that reminded them to complete these tasks boosted college enrollment by nine and so again like a really low cost intervention, but it was a game changer for these students. And like, I don't know these days, what we send eight text messages within ten minutes in our daily in our daily lives, that could make the difference between a kid going to college or not going to college. Do you know if that program continued under the Trump administration. It's a good question. Um, not sure in this case. But what I did try to do when designing the behavioral science team within the White House was to build it in a very bipartisan part of government because I just felt like what we're promoting here is not a partisan agenda. We're just trying to make government programs smarter, make sure that they actually achieve their policy objectives. And so we built the team in part of the government again that's relatively bipartisan. It's called the General Services Administration, which meant that even though I disbanded the White House component of the team when I left the agency, components of the team still persistent and we're still working on really amazing programs. I'm just incredibly curious now, having listened to your reflections on your time in government, what you think over the last fifteen months, when so much has been made partisan and political that really shouldn't have been when it comes to COVID, I think what's really important for people to understand is that there are obviously many underlying causes for why people fall prey to misinformation or labor under false beliefs, and it's really important to understand the psychology underlying each of these causes because then we can design tailored solutions. We can't use a blunt instruments to solve all of the problems. So if we can really with this like fine point, figure out, Okay, what is the psychology leading to X non ideal outcome or why non ideal outcome that we can really try and solve it. So, behavioral economics has shed light on several of these and has served up some potentially very powerful solutions. So the first one has to do with a framework called cultural cognition, and this is work done by Dan Kahan and others. He's a professor at Yale Law School. Basically, what this theory says is, look, we all know that people can disagree strongly, even on empirical matters, things that you and I are like, Okay, these are just the facts. Is climate change real? Does gun control regulation lead to fewer deaths? Right? It's like yes and yes, And so it's tempting to think that in order to persuade people of something, we just need to give them more facts. It's just an information gap problem, right. If we can just give them more information, we can solve the problem. But I think many of us see in our everyday lives that this doesn't always work. Right, Like the proverbial Thanksgiving dinner where you're sitting across from your relative and they're absolutely convinced that COVID is not real and giving them. More evidence just doesn't seem to work, and that's because we may be failing to appreciate a key piece of the puzzle, and that's that we don't just form our beliefs from facts. We form our beliefs partly based on our group identities and the values that group has. There's this really illustrative example, a classic study from the fifties about sports team loyalty that I think highlights this really well. So in this study, fans of opposing teams were shown footage of controversial referee calls from a football game. Okay, and even though these people were watching exactly the same footage, they arrived at very different conclusions about the referee calls based on their loyalty to their sports team. So they tended to think that calls were unfair towards their team, but not the opposing team. So what this study illustrates is that there are internal group allegiances are literally shaping their their views of reality. So how does this relate to COVID. What it shows us is that people's beliefs about COVID may in fact be serving as a deep reflection of their values and their group membership. Some of us think it's just if he's of cloth, wear a mask for God's sake. But for many people, wearing a mask or getting vaccinated or social distancing can carry huge symbolic significance. They feel in some way that it threatens their group membership. It's not this like thoughtful cost benefit analysis of the inconvenience of wearing a mask versus the risk of getting a virus, and it is profound meaning within their social networks. And I think, unfortunately, so much of what we've seen over the last many months now of COVID our efforts from people who think they're doing the right thing too by not only heaping more evidence, but also often shouting at people or shaming or attempting to shame people. And we know that doesn't work. It never works. How do you think we can all just be more aware of those different identities that we carry within ourselves so that we may better understand how they influence our behavior and sometimes in ways that our counter to what we think we're doing. You are one million percent right shouting, being antagonistic, undermining people's values. This stuff doesn't work. While it feels good, we're like fulfilling some sort of deep emotional need to just get it out. It's not effective. Okay, So here's the good news. Behavioral economics helps us to identify part of this problem, but then it also offers up some solutions. One of my favorite bodies of research that's emerging, it's really fresh, is called moral reframing, and it's the idea that when we ground our arguments in moral terms that affirm, rather than threaten the moral values of those we disagree with, it's far more effective at helping them change their views. So, to give you a concrete example, if you're trying to convince conservatives to care more about the environment, you might appeal to values that conservatives tend to hold, for example, patriotism. There's research showing that like a frame such as being pro environmental allows us to protect and preserve the American way of life. It is patriotic to conserve this beautiful country's natural resources, which by I also agree with, Yeah, I completely agree with exactly. So this framing, which is holding their values constant, but is saying that they can achieve progress on those values through climate change reform, is a very effective way of getting folks to change their minds. And it's really funny. So I'm I'm interviewing folks for this new podcast that I'm coming out with, which is all about change, and one of the people that I interviewed, she's a woman named Megan Phelps Roper. She grew up in this, you know, absolutely vile hate group. It was a religious cult called the Westboro Baptist Church. Oh, I'm very familiar with the Westboro Baptist Church. It's super venomous. And what was fascinating about Megan's story is that she was a true believer in her life. She was born into the church, her grandfather founded it. When she graduated from college, she became one of the church's most vocal supporters. And it was only when people engaged with her in the way that I just described, using these moral reframing techniques, that it started to make a dent. That it created a crack in her ideology that ultimately led her to realize that everything she had ever believed was wrong and that she needed to challenge her own views. But importantly, again, they didn't tell her, Megan, your views are absolutely completely insane. They said, Okay, I'm going to take your values as fixed, but I'm going to show you through these reframing techniques why you might want to think about them differently. And that was very powerful for her. And I always think, wow, if you could take someone who had such an extremist ideology and use this kind of technique, how powerful is that? And the other thing Chelsea I wanted to mention is we really need to be thoughtful about who the messenger is when communicating some of these public health messages. We know that people are far more receptive to evidence that challenges their existing views when it's coming from a member of their own community. And importantly that expert bodies, so public health officials are far more persuasive when they comprise a diverse group of people that exist somewhere across this political spectrum. I'm really curious, Maya, whether we're talking about moral reframing or nudge theory, or the broader ecosystem of everything under behavioral economics, how do people feel if they're aware of kind of the different ways that the government, from your job when you were at the White House, or private companies like Google where you are now, how do people feel like they're not being manipulated? My belief always is that everybody should know they're being nudged, because even nudges that are completely transparent are effective. Can you give an example of that. Absolutely, So this actually relates to the opiate epidemic. This is one of my favorite interventions. So it's a complicated problem, many underlying causes, but behavioral science does tell us about one of the causes, and it has the benefit of being again highly transparent, very low cost, and relatively easy to implement. Okay, let's think of about that moment in the doctor's office. When the doctor is first prescribing an opioid prescription for a patient. They're typically using some sort of software, and that software includes a default number, a preset number of pills to prescribe to the patient. What researchers found is that when they lowered this default number from thirty pills to twelve pills in the system, it decreased opioid prescriptions by across an entire health system. So in this case, like the researchers aren't pretending they're trying to fool the doctor, right, the number has changed in the system, and doctors are very mindful of the fact that this number has changed. But it is a really healthy nudge to make doctors slightly more thoughtful about just recommending the default number in there and trying to engage in some degree of critical thinking in order to make sure that they're they're giving the right amount. I always think of nudges as being the sort of thing that help people who already have this goal but are facing obstacles or barriers to get over the finish line. But it's just not powerful enough a tool or an instrument to actually convince people to do things that they don't already want to do. We'll be right back. Stay with us why I was just just going to ask, because we've now talked so much about nudges, and if you could just provide maybe a coherent definition of what a nudge is and what nudge theory is. Yeah. So, behavioral economics teaches us that there are these very surprising factors that influence our behaviors, and a nudge is a design tweak that we might see in any given policy or program that reflects this understanding of the science of human behavior. One of my favorite examples, because this is an example that motivated me to go join the government in the first place, was in the domain of school lunches. Basically, the federal government has a program that offers millions of low income kids access to free or reduced price lunches at school. What we are finding is that even though we are offering this program, millions of kids were still going hungry every single day at school. It was a tragedy because the programs being offered, but parents aren't signing up. So we try to figure out, Okay, what are the behavioral factors that are underlying this lack of participation, and then how can we design a nudge that in turn helps solve it. And what we realize when we do this behavioral analysis is that one, parents aren't signing up because the application process is extremely burdensome. There's a single mom who's working three jobs to make ends meet, and then we're asking her to fill out this application form. It's requiring that she references old tax documents and there's a huge penalty if she gets one of these pieces of information wrong, and so we're setting her up for failure. And that's one barrier. Another barrier is stigma. So I remember when I was at the White House, I spoke with principles from different schools, like, for example, this one principle in Florida, who said, these folks work really hard, and the idea of actively signing their kids up for a public benefits program it's just a really hard thing for them to swallow. They don't like the stigma associated with having their kids rely on the government. So what the government did is utilize a nudge, which is an understanding that when something is the default option, when kids are automatically enrolled in a program, and parents only need to take an active step to unenrolled their kids, it's can significantly boost participation rates. So what we did is we are What the government did is it realized, hey, we we actually already have a bunch of data around these kids eligibility criteria because they're enrolled in things like Medicaid or women's and children's programs. We can use that data to automatically enroll eligible kids. So now as a default, all these kids are now getting access to school lunch, and like I said earlier, parents only need to take an affirmative step that they actively want to unenroll their kids. And as a result of this nudge, Chelsea like twelve and a half million more kids were now eating lunch at school every day. So my we've talked a lot about where nudges have worked. Can you talk about where either you or others in your field have had a lot of hope about a nudge having a similarly powerful impact and then it just not working. One place where I really see the limitations of nudges and behavioral sciences in the domain of changing your mind. I think nudges are very effective when a person has already decided that they want to do something that maybe the long term goals and their short term costs create some sort of tension. It's like, oh, I know I want to eat healthier, I know I want to exercise, but it's just so painful right now, and I'd rather watch TV and eat the ritos. And so nudges can be really effective at helping to bridge that gap. They have an intention to do something and you can translate it into action. There are a lot less effective when it comes to changing people's fundamental beliefs about the world, their actual attitudes, the opinions that they've made up over time. So, as you mentioned, I mean think your instincts are totally right. That yelling at people telling that that they're wrong, that doesn't work. What does work is what's known as motivational interviewing. This kind of strategy of interacting with people is a highly effective tool for moving the needle when it comes to mindset change. So here are some of the tips that listeners can take with them. So the first is you want to show genuine curiosity for the person's views. It needs to feel like a conversation that you're having. And one way to make it feel like a genuine conversation is to increase the number of questions you're asking versus the statements you're making. I could be like, Chelsea, you should think X, Y, and Z, or I could say, Chelsea, why is it that you think this thing? Like how did you come to develop these beliefs in the first place. Another technique that I think can be really powerful is reminding people of their agency that you're not forcing a mindset shift on them. Instead, you are recruiting their agency. You are are giving them the tools and maybe new information that they can then noodle with to try to change their own minds. And that's a much more sustainable process. Right. If someone feels like they came up with a new opinion, they changed their mind on their own terms, it's much more likely to be durable. Just on a on a personal level, have you personally nudged any of your family or friends? Are there any personal anecdotes you can share as a final question. So, I have a family member overseas who I felt like I was not taking COVID seriously enough and was like, I read that if you eat these specific foods, you're more likely to resist COVID, or you can build immunity towards COVID, and oh gosh, you know, my initial instinct was to be like, this is so insane. How can you believe these things? Like you're by genetic relative? And then I had to remind myself, Okay, don't forget that. You need to, you know, validate what he's saying, you know, repeat some of that back in your language. And I don't think I fully change things for him, but he did get vaccinated. I think though it matters my have for people to hear that that it's even for you, who is, you know, one of the world's leading experts on nudge theory, that you still have to do the hard work to hopefully anyone listening to usk and think, oh, well, I can do it too. There are a lot of concrete steps we can take in our own lives to try to help make a positive impact. I think what behavioral science teaches us is like it doesn't always have to feel so emotionally charged and explosive. Right. We can take these small steps and over time to slowly chip away because I think we can be more thoughtful about the way that we engage with others and how we approach the problem of behavior change or mindset change. Well man, thank you so much, Thank you for your time, thank you for your work, thank you for your nudges, and hopefully I will have the chance to talk again soon. That sounds great. Thank you so much. Kelsee My's new podcast, A Slight Change of Plants is out this week, and trust me, you won't want to miss it. There's one thing we know for sure about encouraging more people to wear masks or get vaccinated. It's a lot harder because we're so politically polarized here in the US. Frank Lentz has seen and studied this phenomenon up close. He's a political communications expert, author, and pundit known for shaping Republican messaging and strategy over decades. He's also a Polster, who has run far more focus groups than just about anyone I know. As his Twitter bio says, he'll show you what Americans really think with data, facts and the occasional meme. I've been fascinated by the work Frank has done over the last several months to understand why some people are more likely to believe that COVID nineteen isn't a threat to them, and why then they're less likely to get a COVID nineteen vaccine. We caught up in between the classes he's currently teaching at Oxford University. Frank, thank you for just delving into this topic. You know, I think it makes sense to start with where do you think we are right now in term terms of people who want to get vaccinated, people who maybe think they might get vaccinated, and then people who may not want to get vaccinated. Where do you think we are? Well? I wish you'd been on my focus group last night, women eighteen to thirty nine. And the level of concern hesitation about getting the vaccine is so great, and it's not over issues of pregnancy or menstruation or any of the things that we've heard about. Yeah, and that we've heard about it as real concerns from people anecdotally, The problem with them, or the challenge for them, is that COVID is not as serious to them. Many of them have had it, it took them a day or two to get over it, and they simply don't see the need, or they think that the vaccine is actually more dangerous than COVID itself, or they want other people to do it so they won't have to, and any of these, if it continues, means we will not reach herd immunity, which I'm coming less and less competent in. It means that we will never be as safe and secure as we could be. We know that for some people that really still are access challenges, for people who have mobility challenges, for whom we do need to very much go that last proverbial mile and bring the vaccines to them. We know that for many people who live in rural areas, for whom it's just too far a track, we need to bring vaccines to them. But we also know there are groups in our country for whom vaccines are available around the corner or increasingly at their local doctor's office or kind of their pharmacy, and they're still not going Frank, how do we think about the different groups that you've now spoken to and what may work to try to help encourage them to recognize that COVID is actually really serious. There are three different segments that we need to reach out to. The first and largest are Trump voters, and they don't want to be told what to do. They don't trust the government, they don't trust the facts. They believe that the media is dishonest with them, and they're very hard to convince because they believe that Donald Trump lost the election because of COVID, and so that makes them instantly more hesitant either about the virus or the vaccine. So many of them are in rural areas which are less likely to trust the vaccine or want to get it. And so many of them are anti government, which means that they won't even accept what the c d C says or the f d A or Anthony Faucci. That's group number one. Group number two or black and brown, and there's been a very successful effort from the Biden administration to reach out to them, to do so on their terms, but that black and brown community needs to hear from others in their community. That's what's going to make a difference for them, and then the third or eighteen the thirty nine year olds in general, particularly eighteen the thirty nine year old women, and for them it's somewhat of a fear, but it's also for some it's the feeling that they're either invincible or they're healthy. We're not reaching them the way that we need to. And I want to suggest one profession which has not been used enough, that works for all three of these groups. It's your pharmacist. I had a stroke last January. And I had a stroke because I ate too much, I traveled too much, I slept too little. I lived a very unhealthy life and it has and will continue to affect me for the rest of my life. And because of that, I don't want anyone to make these decisions I made. I don't want anyone to make the mistakes I made. I want them to know that not taking care of yourself could and will have a negative consequence that you will never ever be able to shake. Getting COVID is so much worse. You don't have to be stuck with shortness of breath, you don't have to be stuck with the inability to taste, you don't have to be stuck with all of what COVID does to you if you get it, So don't make the same mistakes I did. Be proactive and listen to the people who really care about you, because it could save your life. And Frank, returning to your diagnosis, around Republicans who voted for President Trump, who are unlikely to certainly be standing in line first to get the COVID nineteen vaccines, have you found any messages or messengers that at least hopefully have the chance of working. The most amazing message would be delivered by Donald Trump and Joe Biden, together, the current president and the former president, each one delivering a sentence of thanks to the other, Donald Trump complimenting Joe Biden forgetting the vaccine out across the country incredibly fast, efficient and effective. Joe Biden giving Donald Trump credits for his administration developing the vaccine in a rigorous and detailed and scientific manner, and then the two of them saying, but don't trust us, trust our doctors, and let binds doctor and Trump's doctors safe. For the remaining fifty seconds of a sixty second ad that we know that this vaccine is safe. We know that it works. That's the most powerful message of all. But Chelsea, we're not going to do it because our politics are so divided. Now, I've been saying for months, I think, truly starting last October, I can't wait to watch President Trump get vaccinated on television. I can't wait for him to take credit for the extraordinary pace of vaccine development without sacrificing quality, without sacrificing safety. I've been asked repeatedly, do I wish the President Trump had been in the p s A with the four presidents? And I think before someone can finish asking the question, I say, yes, this should be ideally nonpartisan. But if we can't have it be nonpartisan, it at least needs to be bipartisan. So I just I couldn't agree more more enthusiastically and emphatically with my public health hat on with what you're saying. But but even better than the politicians is your doctor and your pharmacists. If you get a video from your doctor that's texted or emailed, you're gonna watch it of them will and if they tell you to get vaccinated, over those who have not been vaccinated are going to listen because it's your doctor and your pharmacists, they know you, and that would be even more powerful than the politicians. And in terms of the three messages that work best, that this vaccine is even more much more effective than the flu shot, which so many Americans take. That the vaccine that they cut bureaucracy and they cut red tape, but they didn't cut corners. One of the greatest phrases of all. And third is that over of all doctors have been vaccinated. Those are three messages and they absolutely positively work, particularly when when delivered by someone you know. And Frank, what advice would you have for people talking to their own family members who might be hesitant. And the most powerful familiar relationship is grandparents and grandchild. I joke that it's because they both have the same enemy, but it's actually true. Well, I was very close to my grandmother, like I talked to her every single day, Frank, So I love my parents a lot, but my grandmother had a super special place in my hurt. And that happens across the country. And it doesn't matter what ethnicity you are, doesn't matter what region of the country. People feel that closeness and the idea that grandparents and grandchildren can't hug. I know grandparents who have who are very sick and have somehow managed to stay alive because they want that embrace. Again. That the dream is to be able to tuck your grandchild in at night, be able to give them a kiss and say I love you, I love you, and to be able to do so with complete safety and security matters. That's the ad that I want. I think that makes a difference. So it's not the government telling you to do it. It's your grandma and your grandpa. We're taking a quick break, stay with us. One of the things that I've been really concerned about for many years is the misinformation, the disinformation around vaccines, especially which has largely been allowed to flourish unchecked online by the social media companies. And we have seen just an unprecedented explosion of misinformation around COVID and the COVID nineteen vaccines. How much of that do you see reflected in the surveys that you're conducting or the focus groups that you're you're conducting. It's not just misinformation or disinformation, it's in some case is no information at all that they give you all the reasons why they're hesitants and they've made no effort to confirm them, or they accept sources that nobody else would believe simply because it's easier for them to do so. I'm very upset with social media platforms and with the technology because in the end, their irresponsibility is causing people to die. I also know the part of it, the messaging, where the words themselves matter, where I blame the politicians. For example, call it a government mandate and you immediately agitate every right of center voter. Call it a protocol, and that's acceptable. Another example is the lockdown versus stay at home. Stay at home is you're at home. Lockdown is you're in prison. So every politician who used these phrases was actually causing a problem. And the one that's happening right now, and it's really agitating to me, is that they call it a vaccine passport. Well, to those on the left, a passport is something that will never some people never be able to own. It's expensive, it's exclusive. And on the right, a passport, a vaccine passport to them means more government involvement. You call it a vaccine verification, and the American people say, yes, you call it a vaccine passport. The public says, no, that's not misinformation, that's simply bad language. Frank, I do want to go back, though, to the eighteen to thirty nine year olds. What do you think would be sufficiently persuasive to the eighteen to thirty nine year old you've been talking to, so that they make a different risk assessment of COVID versus the COVID nineteen vaccines, and hopefully then are persuaded to get themselves vaccinated. It's not about them. It's about the people they love. It's about the people they want to protect. For an eighteen to thirty nine year old, it's about their grandparents and being able to see them in a safe and secure manner. If you try to make it about them, it will fail because they just don't fear COVID. If you try to make it about the side effects, they're much more afraid of the side effects of the vaccine than they are of the virus itself. And if you try to make a political argument, it just doesn't resonate. If I want eighteen to thirty nine year olds to get the shot, I need to tell them how easy it is, and I need to tell them that they will have a light at the end of the tunnel, and so often these interviews, I forget that if you want people get vaccinated, let them know that they can take their masks off. Let them know that they'll be able to celebrate the fourth of July like they used to. Let them know that our schools are going back and people are going back to work. If you don't tell them that, then they won't get vaccinated, and we will be under a threat from this, from this horrible virus. And I will acknowledge something to you. I don't even want to look at you when I say this. When I got the vaccine, the first shot in my arm, I started to cry because I had a pre existest in condition I was damaged from last year, and that shot to me was life itself. It was actually, I'm going to live. And I didn't know that for six or seven months. So I don't understand how people can be so cavalier. They gave me my life back, and I'm so grateful to those researchers, and I feel so blessed, and I want others to feel as blessed as I feel. Frank I cried too. I cried to when I got my first shot because it just felt it felt like hope. You know, I am curious. Has there been anyone that you've seen changed their mind who's been in that group? And if so, what changed their mind or not? Yes? Yes, and people have changed their minds and they tend to change their minds to get the vaccine, and it's usually because of interaction with their doctor and their pharmacists. But the problem of the eighteen to nine year olds is that they're not necessarily calling that they're just getting stuff off the web. That just getting superficial information. That's why we need to connect every person and the medical professional who may trust the most that will have the greatest impact and will have the fastest impact. Is there a next best alternative to your doctor? If you don't necessarily have a doctor, it's the closest person to you, maybe your child, that maybe your parents, maybe your spouse, but the person that you love most. Because in the end, if it's a message that's delivered from love and a message about returning to life itself, they'll do it. If it's a message that comes across like a mandate, like you must do it, you have to do it. You don't have a choice. It will be rejected. Even the tone, even the context of how we deliver this determines whether or not it's credible and whether or not people actually follow Frank. Thank you so much for all of your time. To learn about Frank's work and upcoming focus groups on this and other topics, follow him on Twitter at Frank Luntz. Changing people's minds isn't easy. In fact, it can be really hard, even with the best information from trusted messengers with the best intentions. But in this moment, when we're working so hard to vaccinate as many people as possible and learn from the COVID nineteen pandemic, it's really important. I hope that after listening to Maya and Frank, you might feel a little more confident about broaching and conversation with someone close to you who may not yet be convinced about getting vaccinated or making other decisions that you know are good for their health and our shared public health. Beyond the pandemic, the tools of informing and persuading that we heard about today can be effective when it comes to so many other topics in public health, including climate change, the stigma amount substance used disorders and addiction, and so much more. I, for one, I'm really glad that Maya, Frank and so many others are deeply committed to understand name what it really takes to get someone to take action or change their mind and build a healthier, more just country in the process. In Fact is brought to you by iHeart Radio. We're produced by Erica Goodmanson, Lauren Peterson, Cathy Russo, Julie Subrian, and Justin Wright, with help from the Hidden Light team of Barry Luriy, Sarah Harowitz, Nikki Huggett, Emily Young, and Hugh Abodeen, with additional support from Lindsay Hoffman. Original music is by Justin Wright. If you liked this episode of In Fact, please make sure to subscribe so you never miss an episode, and tell your family and friends to do the same. 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