Shireen: Holly Howe is a fourth year PhD candidate in marketing at Duke University. She holds a master's in kinesiology from the University of Toronto. her PhD work has focused on understanding how people think about and enact their goals. Recently, she has launched an open science online grocery store to help researchers and policymakers learn about how people make choices when shopping for groceries.

Holly: Welcome, Holly. Oh, thank you so much for having me. I'm so excited to be here. 

Shireen: This is amazing. So I want to go into some of the research work. But before that, tell me a little bit about your background. And what led you to this interest in marketing, and specifically looking at grocery stores and shopping habits?

Holly: Sure. Um, so I've always been interested in health behavior. But I became interested in marketing, specifically when I was studying for my masters in kinesiology, a lot of my work and my master's focused on what makes some people sustain exercise while others don't. So kind of expanding out from that I wanted to gain a better understanding of motivation more broadly, what makes some people really motivated towards their goals, what makes achieving goals harder for some folks? And I like to think about that holistically. So not just motivation within the person, but how might their environment things like their body image, their gender, some of the social determinants of health, how might those affect their motivation. And I know when we think of marketing, we usually just think of it as a way to sell things. But I also see marketing as a way to understand motivation. So we're looking at what is the deeper motivation between maybe why people buy but why people do a variety of other things. So we can learn in marketing, about motivation, and then transfer that knowledge to encourage certain actions. And I'm really interested in encouraging health behaviors and people. So making a healthy food choice, exercising things like that. So one of the things that I do in grad school is I study how people set goals, how they move towards their goals, and what features of the environment might help them actually achieve that goal in the long term.

Shireen: And in your studies, what have you learned about motivation and goals that might help individuals, especially those with chronic illnesses, and really increase positive health behaviors?

Holly: Yeah, as I was thinking about this, I really thought of one overarching message that's kind of driven what I study, and that's that willpower is a limited resource. Every day, each of us wakes up with a set amount of willpower, and we spend it on all sorts of decisions in our life. You can imagine you have a really busy day, you know, in the morning, you set your alarm early, you try not to hit snooze, that's a willpower decision. And then you decide to work out because you know, you're not gonna have time later in the day, that's a workout. That's a sorry, that's, that's a willpower decision. And then when you get to work, someone sends you a passive aggressive email, and you decide that you're going to, you know, turn the other cheek and respond nicely. That's another willpower decision. And so you're depleting it throughout the day. And it's not surprising that at the end of the day, if there's doughnuts in the break room you eat, you know, like all of these decisions, they'll happen together. And if you've worn down your willpower throughout the day, it's understandable that you would do that. And so I want to acknowledge that like, eating the doughnut is normal, there are decades of research showing that everyone is going to run out of willpower at some point during the day and they might make a choice that's not in line with their long term goals. So one thing that it's important to do is have compassion for yourself when it happens. And there's some research that actually shows that if you beat yourself up about it, or if you deprive yourself later, that just means you have fewer willpower resources for tomorrow. So knowing that people have a limited amount of willpower, I like to think about, well, how can we arrange our lives and arrange the environment such that every time we make a healthy choice, it doesn't have to be a willpower decision. We're not depleting that resource as much as we might be if we're forcing ourselves to do something. And in my reading, there's sort of three tips and tricks that kind of help you conserve your willpower resources so that you can make healthy choices without it feeling really exhausting. The first is find healthy things to do that you enjoy. I think we overlook this one a lot. But it's so important. From my research in kinesiology, one of the most important predictors of if people will actually sustain a behavior like exercising is if they can find an exercise that they enjoy. And I think the same is true for eating behavior. I think we have these foods that people tell us we should eat, we hate them. So as a personal example, like I hate cottage cheese, and there were years when I forced myself to eat it and every time I ate it, I was depleting that really special willpower resource that I needed for other areas of my life. And I needed for maybe health decisions that came later in the day. So if you can find a healthy food that you enjoy for me, it might be yogurt. That's less of a willpower decision, I'm not forcing myself to eat something that I don't enjoy. The second way to kind of conserve your resources is to try to make healthy behaviors a habit. Some really cool research coming out recently that shows that if something is a habit, it requires way less willpower like substantially less than if we make a decision that we have to think deeply about. And the way to make something a habit is really simple, always doing it at the same time of day, or in the same place or in response to the same queue. So for example, if I am in the kitchen, then I will do calf raises or something like that, you can make something a habit. And if you integrate it into your routine, it's not going to take as much willpower as it usually would. You can also chain behaviors that you're trying to develop into routines that you already have. So for example, I've been trying to drink a lot more water recently. And I know that I always take my dog for a walk in the morning. So I started bringing my water bottle with me. And I'm just adding that habit into something I'm already doing. And so that makes it less of a big decision every morning, like when am I going to fit my water and when am I going to do this thing. I just know, I don't have to think about it easy. And the last thing really ties into the grocery store that I hope we'll get to talk about is to avoid temptation when you can. So in the example I gave earlier, where you walk into the workroom and you discover there's doughnuts, you probably wouldn't have eaten a doughnut if you didn't walk into that break room. Or if there weren't doughnuts in that break room. If you know that there are situations that tempt you to act in a way that's not consistent with your goals, try to avoid them. For me, I love candy bars, I love them so much. And if I go into a gas station to pay, I will buy a candy bar. So started paying at the pump. Two things that you can do to kind of avoid those situations where you will be tempted to make choices inconsistent with your goals can also be really powerful, and not end up depleting that resource of willpower. Interesting.

Shireen: So I would like to talk about the Open Science Online Grocery Store. Can you tell us more about that?

Holly: Yeah, this is a project that I really love. The grocery store is a tool that my supervisor Peter Ubel and I have developed mainly a tool for researchers and policymakers where they can test something that we call choice architecture. So choice architecture is changing the way that we present options to people in order to help them make decisions that are more in line with their long term goals. In other words, how can we change our environments so that we don't have to exert as much willpower to make a healthy choice. So for example, in a grocery store, we can do something like actually that they've already done putting fruits and vegetables as the first thing that you see, when you walk into the store, it makes it easy for you to choose from them, you don't have to go and seek them out. Another thing that we know that some convenience stores have been experimenting with is putting fruits right up by the counter, you know, when you're in the grocery store, and you're going to check out you're usually tempted by you know, the the candy, the chocolate, all of these kind of vise items that might not be in line with our goals. If we change it so that you're actually being, you know, quote, unquote, tempted by healthy rodents like apples and bananas, maybe you'll be more likely to pick that up. That's an example of choice architecture. So in the store, if you were a participant in one of our experiments, the grocery store just looks like a normal online grocery store, like Amazon Fresh instacart, the options that a lot of us have gotten familiar with during the pandemic. But if you're a researcher who's using our store, you can make small tweaks to what the store looks like to the choice architecture of the store, and then see how people respond through a variety of changes that people can make. And researchers are currently using the store to explore a lot of those things. But I'll briefly talk about two changes that we've tested that seems to be really effective. First is on the ordering of a page. So let's say you come into the grocery store, the first thing you see is a page of a bunch of items, we have explored putting the healthiest items on the top of the page. So the first thing that you see and if you want to purchase an unhealthy item, you have to do a bit of scrolling to get to the bottom of the page. And we find that that has been extremely effective at improving the helpfulness of the items that people are checking out with. So that's really positive. We tend to think that's about that, avoiding temptation piece again, it's like if you could go through the grocery store and never even walked past attempting items before you checked out makes it easier to, to make those choices. The second thing that we have tried that seems effective is to create like a healthy section of the store. So we curate a selection of items. And if you go to this section, similar to walking down an aisle in a regular grocery store, you know that everything in that section is going to be good for you. You don't have to think heavily. You can just say I knew pasta. I know all the pastas in this section are relatively healthy for me. Let me choose that. And if we can kind of make it easier for people to make those decisions. Then they are also checking out with healthier carts.

Shireen: And so, Holly, the experiences such that if a researcher goes on, it's just like shopping like on Amazon Fresh, for instance is exactly like this. It's all online, what you're doing from what I'm understanding here is that you're experimenting with making it, essentially putting more effort in finding something that's a little bit unhealthy. So people have to scroll, they have to go, you know, further down on the page, but it is all virtual. So it is all online. And you're making it very easy then to pick that healthier choice.

Holly: That's exactly right, we're making it easier to pick the healthier choice. One thing that I really appreciate about choice architecture changes is that the unhealthy choice is still available. Like there are times in my life where I needed Ben and Jerry's ice cream, you know, maybe I've had super emotional day, and maybe it is the most healthy choice for me in that moment. And in that moment, it should be available in our store, it still would be, might be a little bit more difficult for me to find it. So I'm not making it based on you know, having low willpower, walking by it and feeling tempted. I'm not making that choice, because I see something new. And I'm like, Oh, I have an obsession with new flavors of Oreos, always tempted to buy them because I'm like, Oh, I wonder what that's like. But if I was going for online store, I might never see that Oreo put out a new flavor. And so I'm not making unhealthy choices or goals and consistent choices just on impulse. Basically, I can still make them if I've considered them. And I decided that it's the right choice for me. But we're making it harder for you to make that as an impulse for us.

Shireen: So how do you think practitioners can utilize this tool?

Holly: Yeah, so if your protection or listening to the podcast, I would love to talk to you more directly. And I think we'll put my contact information in here. And we can talk about it. And there's a lot that we can do directly working with each other. But also talk about some uses of the tool that really excite me. First, as a researcher, if I want to do an experiment with a major retailer, it can be really difficult retailers have their own concerns when it comes to doing experiments. No, they want to anger their customers, by rearranging the store, they don't want to put all that work on her employees to rearrange the store, it's just, it's difficult for them, they don't want to do it unless we can kind of show them some proof that this will probably work. And this will probably make their customers healthier, and not annoy everyone in the process. So the online store is a really neat tool for doing that. It's easy to make those kind of changes in our store and see how it affects what people might hypothetically buy, and then bring that data to a retailer as a way to kind of convince them to buy into your, your bigger project. Second thing that really excites me is this is also a way to provide proof to policymakers about the benefits of certain changes. So you can imagine that there are changes that might actually be good for folks making healthier choices. But that might be bad for the retailer's bottom line. I'm Canadian and in Canada, we put these very graphic warning labels on cigarettes. Obviously, that's not something that if I was selling cigarettes, I would be, you know, super eager to do because it's probably going to reduce the sales of those items. But as a policymaker, if I'm trying to increase the overall health of the population, it is something that I want to know, No, does it work? Is it effective? If we do this, will it help people. And so that's something that we can also test in the store because we don't need the buy in of the folks who make these products to maybe put a warning label on them or whatever, actually is some, some cool research on graphic warning labels on sodas showing that they are quite effective. And the store would be a way to continue to test that maybe on other products and another. The last thing that I know that people are doing with the store that gets me really excited is practitioners like dieticians, are using it as a tool to train people on new eating patterns. There are some researchers at the Children's Hospital of Philadelphia who have a project using our store to train parents on how to buy groceries for their teams who are coming out of an eating disorder recovery program. And it's a big change in the way that they have to buy groceries, they might be used to buying groceries based on, you know, lower calorie diets or trying to, try to get as many nutrients in with as few calories as you can, because that's what most people want to do. But that's not what's effective for their, their team's health at that time. So they have to learn to shift their patterns from maybe buying 1% milk to buying like full fat milk from instead of having like apples as a dessert to having pudding because they just need to get calories into their case. We're using our tool as a way to train parents to do that we can put labels on foods that we think would be especially good for their kids and say, when you're in the store, like look out for this, look out for that. avoid this, avoid that. And we can also prompt people to try to pair things so you know, we see that you're buying carrot sticks would you also like to buy full fat ranch dressing with that because that'll help the calories in the meal so we can sort of use it as a way when Folks are in dieticians offices to talk about the foods that are available and what foods are going to be most in line with whatever their long term goals are.

Shireen: I love that. With that, Holly, we're toward the end of the episode. At this point, I'd love for our listeners to connect with you and learn more about your work. Tell us more about the links, tell us how people can connect with you.

Holly: Sure. And thank you so much for having me and letting me share this work. This is something that I'm super passionate about and really excited about. But anyone wants to email me because they have questions or because they want to use the story in any way. My email is Holly dot Howe @ duke dot EDU. Howe is h o w e, my personal website also has my email on it and a link right to the grocery store. And that's holy dash howe dot com. The link to the grocery store itself, if you just want to look at it, check it out is open science all one word, dash online grocery all one word.com.

Shireen: Love it. Alright, so we'll have all these links linked up in the show notes for folks to click and move right over to your website and even check out the online grocery store. So with that, Holly, thank you so very much for being on the episode for walking us through this incredible work that you're doing that I believe will have such a large impact really on the way we shop. I mean, shopping to me is so like it just is so mindless. Because you walk in the store, you sort of have these habits. And after being more conscious of these habits, they just walk in and you just grab whatever is convenient because certain things that I level on purpose with the in store shopping experience, but even online, it seems like you know there are things that can be done the work that you're doing specifically in your research, the things that can be done that can make it easy for people to make these healthier decisions. And I'm hoping that you, you find these major retailer partners that aren't so much motivated by the economic side of things but also are focused on the health side and are looking to impact outcomes for folks there. So this is incredible work. Please keep going. This is much needed. Thank you so much for your time.

Holly: Thank you so much for having me. This was, this was a delight.

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Email: holly.howe@duke.edu

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