Missed hospital appointments (Do Not Attend [DNAs]) undermine healthcare efficiency and access. A high-profile study found that adding descriptive social norms (DSNs) or specific institutional cost (SIC) messages to SMS reminders could substantially reduce DNAs. This prompts optimism that integrating behavioural insights, besides reminders themselves, offers a cost-effective approach to mitigate DNAs. However, subsequent similar interventions have reported heterogeneous findings, echoing broader debates on recent meta-analyses about how to evaluate such findings. We address this issue by framing Behavioural Insights as Applied Science, which structures validation in three phases inspired by clinical research. We treat the aforementioned study as a Phase 1 proof of concept and conduct a Phase 2 replication under comparable operational conditions in a quasi-experimental, time-blocked field trial at South-western Jutland Hospital (20,867 appointments) across Cardiology, Endocrinology and Pulmonology. Patients received SMS reminders rotating every 2 months between a standard message, DSN framing or SIC framing. Neither DSN nor SIC reduced DNAs overall. SIC increased cancellations (OR = 1.41, p < 0.001) but not DNAs; DSN reduced DNAs in Cardiology (OR = 0.76, p = 0.027), while SIC increased DNAs in Endocrinology (OR = 1.31, p = 0.021). Our findings underscore the importance of applying a systematic approach in the evaluation of Behavioural Insights.

Over the past twenty years, behavioural insights and nudges have gained prominence in public policy design. Public opinion research on this subject has largely considered two questions: (1) who supports nudges? and (2) where is support for nudges strongest? Using data from two nationally representative surveys fielded in 2023 and 2024 (N = 2020 and N = 1991), we take up these questions in Canada—a ‘principled pro-nudge’ country. We measure opinion toward 30 nudge policies across three policy domains—15 that provide a benchmark to other country studies, coupled with 15 that reflect policies that were implemented by Canadian nudge units. We also analyze open-ended responses to a question that asks what individuals think of nudging (if they think of them at all). We find that approval for nudges is high, with 71% of respondents supporting nudges that have been implemented in Canada. Second, we identify similar gender, ideological and identity-based patterns for support as observed in countries with different social and market structures. Third, analyzing open-ended responses that gauge respondents’ thoughts on BI, our findings highlight the complicated nature of public opinion toward BI, which includes optimism alongside uncertainty and skepticism.

Much of political science rests on assumptions about how policy makers and citizens behave. However, questions remain about how public policy can improve the government–citizen relationship. In this research note, we present behavioural insights (BI) as one way to address this gap. First, we argue that BI can be strategically used both to alleviate administrative burdens and to enhance citizen experience. Second, we argue that BI interventions can assist in several stages of the policy process, strengthening causal inferences about policy efficacy. Third, we present original data from Canada's ongoing experimentation with BI across multiple jurisdictions and areas of public policy. We conclude by acknowledging the myriad pathways through which BI research can engage with public policy to support the enhancement of citizen-oriented service delivery.

Behavioural science has made significant contributions to public policy over the last decade from tax compliance to pensions and energy use. However, behavioural insights (BI) have not yet been able to claim significant policy shifts in the area of crime, despite increasing interest and experimentation. This paper offers a critical reflection on the state of BI and crime from the perspective of those who have been at the forefront of this work since the inception of the world's first behavioural science team in government. We outline how existing theories of crime have already laid foundations for the successful application of BI but identify opportunities to build on these with tools from behavioural science. We conclude by examining how continued cross-pollination of ideas between BI and disciplines such as applied criminology points to promising directions for future research.