Applying Segmentation

The application of behavioral insights is often limited to the design of messaging and communications. But psycho-behavioral segmentation can enable a much broader actionability.

Communication Design

Customized interpersonal communications - typing tool and custom messaging
Targeted mass communications - framing that elicits self-selected attention

Service Delivery Design

Customized experiences, spaces and incentives

Policy Decisions

Identifying and addressing vulnerabilities
Identifying and addressing gaps in intervention landscape
Identifying short-term and long-term opportunities

Monitoring & Evaluation

Adding a psycho- behavioral layer to programmatic data by capturing segment profiles of users

Typing Tool

The Typing tool is a ‘mini survey’ that contain 3-4 simple questions that can enable the identification of an individual’s segment profile based on their responses. Artificial intelligence/machine learning tools are used to create segment typing tools.

This tool can be used at point of service delivery to tailor communications and protocols based on an individual’s segment profile. The typing tool can also be used for monitoring the engagement of different segments and to conduct mini-surveys to assess segment distribution at hyperlocal level.

Targeting using Typing Tool

Short, simple questionare and response-based classification tree to identify the segment profile of individuals.

Customized Communication at Point of Service Delivery

Segment: Anxious

Typing Tool Script

“Hello, I’d like to take a few minutes of your time to learn more about you so that I can provide you with some information about the COVID-19 vaccine that could be relevant for you.

To begin, could you share how many times you have visited a doctor or clinic within the last five years?

The past few years have been difficult for a lot of us with COVID. Could you tell me a little bit about your experience over the last two years? Did you have any difficulty paying for your basic needs?

Thank you for sharing. We have received a lot of information about COVID from many sources. Now if you could think about the government and doctors as sources of information for COVID, do you trust them a little, a lot, or not at all?

Thank you. Finally, could you let me know which of the following statements about COVID you agree with? [read through the four statements]”

Customized Communication

“Thank you again for your time and for answering my questions. I’d like to talk to you about the COVID vaccine. Can you tell me a little bit about your thoughts about the COVID vaccine?

A lot of people have concerns about the safety of the COVID vaccine, and that is natural. It is a new vaccine, and it has been difficult living in a pandemic. Can you let me know what concerns you have about the vaccine?

[Address any of these concerns, explaining in terms easy to understand. Be certain to listen for and address any misinformation about the vaccine., especially side effects, that they may share]

Thank you for letting me share a bit about the COVID vaccine. Do you have any questions for me?”

Intro to differentiated designs

Within larger campaigns, when specific messages are appropriately aligned to a segments underlying, often inexplicit drivers of latent demand, then the person is intrinsically driven to engage with the product, without any external pushes or influences.

People are driven to pay attention and engage with the messages that are relevant to them. This outcome is referred to as ‘self-selected attention’ and is the key to by-passing the heavy-touch demand-generation process.

Self-Selected Attention

The Hopeful

The Relieved

The Anxious

The Doubtful

The Indifferent

Where and how to deliver services and incentives

When thinking about service delivery, we want to design experiences that meet segments where they are at and address the concerns they have. This should include understanding where to find them (ie where they spend their time), what emotions they have at the point of service delivery and common barriers such as lack of trust in health system and concerns with maintaining confidentiality.

At health facilities

Integrate with routine health services
Leverage provider interactions

In public spaces

Travel-related touchpoints
Educational and professional spaces
Community spaces
Recreational spaces
Champions and advocates

Mandates and incentives

Travel mandates
Workplace mandates
Economic incentives

Policy Decision-Making

Segmentation framework can inform evidence-based policy decisions

Samples are nationally representative
Vulnerable populations can be mapped and targeted
Opportunities and gaps in intervention portfolio can be identified

Mapping Vulnerabilities And Portfolio Mapping Help Make Policy Decisions

Kenya Workshop

Designing Segment-Targeted Interventions for Improving COVID 19 Vaccine Uptake
Nakuru Kenya January 30 - February 3

In collaboration with Kenya’s Ministry of Health, Final Mile organized a co-design workshop. Through a combination of theory, group discussions, activities and practical application, participants:

Learned a new way of understanding and decoding vaccine uptake through psycho-behavioral segmentation:

Built capacity with Human Centered Design (HCD) as a problem solving approach, both as a process and mindset, with a grounding in behavioral science
Applied HCD to develop segment targeted interventions for vaccine demand and uptake
Identified ways to apply segmentation and HCD to additional health system priority efforts beyond the COVID-19 pandemic

At the end of the five day workshop participants developed:

Segment-based, contextualized interventions to address COVID-19 vaccine uptake
A roadmap of activities for implementing the intervention and applying HCD
A plan for leveraging segmentation and HCD in health priorities beyond COVID-19

This workshop was possible through early investment and relationship building with government and agencies not only before the workshop but after as well. This collaboration led to active participation throughout the workshop with participants sharing experiences and making connections between their work and the concepts shared. Participants appreciated the rigour of the shared research findings as well as the workshop format that included discussions and activities to apply the content. While COVID-19 vaccination uptake is still a priority for those attending, it may not be much longer. Understanding this, we also discussed ways to leverage workshop learnings beyond COVID into areas such as addressing misinformation, rebuilding trust and routine immunization.

Participant quotes:

“This is a practical and effective approach to health care interventions”

“I found the group discussions to be the most valuable part of the workshop, as they gave us the opportunity to exchange ideas and perspectives on the topics covered.”

“The design for learning / training was very engaging and is easy and relevant for replication in any training”

“Training approach, handouts, relevance of the content and its great value add to our work. Data provided and evidence based research.”

Applying beyond COVID-19

Even as the COVID-19 outbreak risk is reduced, second-order risks are still unfolding. The health system and other programs have not recovered from disruption and shocks. The COVID-19 pandemic has had significant indirect effects as well - The broader economic and societal impacts of such control measures are as yet unknown. Indirect effects can be broadly considered as the negative impact of the social measures implemented to reduce COVID-19 infection, along with the necessary prioritization of healthcare services directed towards its care. Together these have inevitably led to substantial disruption of routine medical services.

This segmentation study while aimed at COVID-19 vaccine hesitancy, the actual segments are broad-based to aspects such as trust, access and engagement in the health system. Therefore we can look at these psycho-behavioral segments to understand the larger impacts of the pandemic including the impact on routine immunization, and potential the impact on new vaccines introduced in the future.

The COVID-19 vaccine framework can be used for any NEW vaccine:

Broad based Segments & impact beyond COVID

Impact on uptake of Childhood Routine Immunization

Risk of COVID vs. Risk of Vaccine Preventable Diseases:

During the pandemic, the risk of exposing child to COVID at a health facility was highly salient, while the risk salience of vaccine preventable diseases has diminished in the communities due to success of vaccination campaigns.

Need to reinforce risk salience for child killer diseases and vaccination as the best way to protect children in a pandemic.

Mixed Communications from the Government and the Health System:

Communication on routine immunisation was minimal to non-existent, resulting in a widely-held perception that routine immunisation wasn’t urgent nor a government priority. Further shortages in the clinics, reinforced this belief.

Need for govt to focus on communication to reinforce the importance/urgency of the vaccine in Pandemics.

‘Active’ Decision-Making vs. Norms and Defaults:

A shift to more ‘active’ decision-making around routine immunisation led to inaction, as caregivers questioned what had previously been a fairly automatic and normative behaviour.

In an ‘active’ decision making, need to reinforce the salience for vaccines given big gaps in RI knowledge, and help return to defaults.

A New ‘Bad Vaccine’ Mental Model:

Although there’s historically been high level of trust in vaccines in most communities, the rampant myths and misinformation regarding COVID vaccine has created a ‘bad vaccine’ mental model. There’s a risk that other vaccines may fall within the distrusted ‘bad vaccine’ mental model in the future.

Need to anticipate and address spread of misinformation and distrust in relation to vaccines, especially newly developed ones.

Latent Demand for Alternative Health Info Sources and Counternarratives

Most interventions addressing the infodemic focus on the sources and supply of misinformation. The demand-side of the infodemic is neglected and poorly understood. Sustainable strategies for managing infodemics must focus on the demand side, because as long as demand for alternative info sources and counternarratives exists, new sources will arise to meet the demand even if we curtail existing sources of misinformation. Latent demand is targeted by back faith actors and anti-vaxxers. The same latent demand can be channeled towards credible information sources.

User needs for online health information:

Balance and diversity

Freedom to choose (decision autonomy)

Trust

Transparency

Certainty about value of time spent