In a field study, we collected data in a restaurant and manipulated bite size by providing diners with small or large forks. We found that diners consumed more from smaller rather than larger forks. Utilizing motivation literature, which ties into the unique factors present in a restaurant consumption setting (e.g., diners have a well-defined goal of hunger satiation because they invest effort by visiting a specific restaurant, choose from a menu, and pay money for the meal), we present our rationale for the pattern of results.

Sounds pretty obvious, right. Small forks cue Big eating since each bite is Small. Big forks cue Small eating since each bite is Big. Easy-peesey. Here’s a graph to illustrate.

And, this is not a trivial effect.

We assessed the influence of fork size on the weight of the food left on the plate (less food on the plate indicated more consumption) while controlling for the weight of the initial food served, food price, meal occasion (lunch vs. dinner), appetizer (yes vs. no) and alcohol consumption (yes vs. no). This ANCOVA showed that the use of the larger fork resulted in more food left on the plate (i.e., less quantity consumed) than the smaller fork (Mlarge = 7.91 ounces vs. Msmall = 4.43 ounces; F(1, 98) = 7.80, p < .01, partial η2 = .07).

That η2 (eta squared) of .07 translates into a Small+ Windowpane, about 40/60 which would probably be obvious to an observant observer who was looking for an effect. Thus, if you were a dishwasher for this restaurant, you could probably see the difference on the amount of food left on plates between the Small and Big fork conditions. Hey, 4 ounces versus 8 ounces is a lot of spagetti and meatballs.

So the Small fork causes people to eat more because each bite is too small and so they take more bites and more food. The Big fork actually has the effect of reducing caloric consumption. Cue up the Food Police! If we can put calorie counts on menus why not fork size specifications!

Except.

Moreover, in a controlled lab study we demonstrate that when these factors are absent, the pattern of results is reversed.

What? Reversed? Yes. And practical, too.

Using ANCOVA, we assessed the influence of fork size on the weight of pasta left on the plate while controlling for the initial weight of the pasta served. The results showed that those assigned to the large fork condition left less pasta in the bowl (i.e., consumed more pasta) than those in the smaller fork condition (Mlarge = 4.09 ounces vs. Msmall = 5.19 ounces; F(1, 78) = 4.73, p < .03, partial η2 = .05).

This eta squared is another Small+ Windowpane, about a 40/60 difference. And again, someone who was really looking could probably see the practical difference here as in our sweaty dishwasher cleaning up the plates.

Small forks cue Small eating? Didn’t the first study report Big forks cue Small eating? What the hell is going on here? Which is it? A fork is a fork, right? The Food Police are not happy. Cancel that march on the White House.

This is a cross over interaction where a relationship is positive under one condition then negative under another condition.  Stated another way, it depends.  Stated under persuasion labels, the play depends upon the box or what’s the Local?

The trick here is the motivational set of the eater. In the first study with Small Fork, Big Eats:

In our consumption context, we observe that diners visit the restaurant with a well-defined goal of satiating their hunger, and, because of this well-defined goal, they are willing to invest effort and resources to satiate their hunger. Since research has shown that free choice captures realistic behavior more accurately than forced choice situations (Dhar and Simonson 2003), a restaurant offers diners several methods to exercise free choice in satiating their hunger. For instance, diners select a restaurant of their choice, choose an entrée (or entrées) from the menu of offerings, pay for their food, and have the option to take home leftovers. Therefore, people invest effort in order to satiate their hunger.

When the Other Guy has the goal of Satisfying Hunger, then we get Small Forks, Big Eats. But, in the second study with Small Fork, Small Eats:

Eighty-one participants took part in this study for partial course credit. They were told that this was a food consumption study, and each participant was taken to a separate table. They were then offered a preweighted bowl of pasta salad with either a small or a large fork and a bottle of water. The same forks from the restaurant study were used. A pasta salad was served, since several bites are required for consumption rather than a single forkful. Participants were left alone and allowed to consume as much as they wanted.

When the Other Guy has the goal of fulfilling the requirements of a study, we get Small Forks, Small Eats. The effect of fork size depends upon why the Other Guy is using the fork. For Hungry Other Guys fork size means something different than for UnHungry Other Guys doing a marketing study.

Mavens, understand persuasion by the function of a variable, not its structure, content, or appearance. How, not What. You can always spot the amateur on this play. Understand the function or how the thing does what it does, not what it is. See the difference between Doing and Being.

Wow. Philosophical Persuasion Theory!

More entertaining is the Cool Table media comment on this article. You can read the NYT, WSJ, Huffington Post, and Time for their details, but here’s the main point: They missed the main point! Each media comment on this study catches only the first study with Small Forks and Big Eats and completely misses the functional truth of the cross over interaction.  Those Cool Table players drop their maven masks to reveal muggle mugs underneath.  They each and all think Small Forks, Big Eats, so buy a Bigger Fork to lose weight!

Want to join the Cool Table? Carry a Big Fork and Eat Softly.

Want to Change the Other Guys eating? Determine Their goal, then fork them appropriately.

It Depends!

All Persuasion Is Local.

Arul Mishra, Himanshu Mishra and Tamara M. Masters. (2012). The Influence of Bite Size on Quantity of Food Consumed: A Field Study. Journal of Consumer Research , Vol. 38, No. 5, pp. 791-795

DOI: 10.1086/660838

Feedback!

Consider this method.

The study was conducted in an 17-bed intensive care unit from June 2008 through June 2010.  We placed cameras with views of every sink and hand sanitizer dispenser to record hand hygiene of HCWs. Sensors in doorways identified when an individual(s) entered/exited.  When video auditors observed a HCW performing hand hygiene upon entering/exiting, they assigned a pass; if not, a fail was assigned.  Hand hygiene was measured during a 16-week period of remote video auditing without feedback and a 91-week period with feedback of data.  Performance feedback was continuously displayed on electronic boards mounted within the hallways, and summary reports were delivered to supervisors by electronic mail.

Okay.  Big deal.  A video camera observes people as they enter rooms and a human coder merely notes a pass or a fail for hand washing.  That pass/fail information is collected first as a baseline, then as Feedback to everyone in two forms – that electronic boards in hallways and in summary email reports to supervisors.  Big deal.

During the 16 prefeedback weeks, there were 60,542 hand hygiene events observed and 3,933 events were categorized as passing, for an overall hand hygiene compliance rate of 6.5%, ranging from a weekly low of 3.5% to a high of 9.8%. For the 16 postfeedback weeks, there were 73,080 observations, with 59,627 categorized as passing, for an overall compliance rate of 81.6%, with rates ranging from 30.8% to 91.2%. During the 75-week maintenance period, 298,860 observations were made, with 262,826 in compliance (87.9%). Weekly rates ranged from 83.5% to 91.6%.

Here’s the graphic.

The Interested Reader does the Windowpane math for us.  I quote.

By my calculations, the  comparison between the postfeedback results and the prefeedback results gives an odds ratio of 63.8 (63.79), a log odds ratio of 4.2 (4.16), an r of .75 .(749), and a BESD of 87/13. The comparison between the follow-up results and the prefeedback results gives an odds ratio of 105.0 (104.98), a log odds ratio of 4.7 (4.65), an r of .70 (.697), and a BESD of 63/37.

What IR labels as BESD we call the Windowpane, but that still means 13/87 smells just as sweet and clean as . . . newly washed hands!  Considering that a 25/75 outcome is Large, we’re into Huge, Stupendous, Awesome, perhaps even and either Groovy or Gear!

And, just from Feedback.  Now, quickly note the feedback is not provided to each person, but rather is given as a running rate to everyone on those public electronic boards.  That’s a great persuasion wrinkle in this Feedback Play.  It adds the power of Norms whether as a Comparison Cue (If Everyone Else Is Doing It, You Should, Too) or as a Argument (I’m a serious health care worker dedicated to safe and healthy behaviors).  Thus, this study is truly Feedback Plus with that Plus being a healthy dose of social norms and comparison.  And just look at that compliance curve.  Man, it looks like a guided missile launched in Week 16.  You know you’ve hit a winner when you get a behavior curve like that with that effect size.

I’d encourage you to get this paper and read it.  This crew worked like dogs for what most people would think of as a little study.  Just count pass/fail and aggregate.  Big deal.  I’m only showing the tip of a research iceberg.  My compliments to these researchers.  This is hard damn work, smartly done.  To those who would shrug at it:  If you can’t praise it, beat it!

Donna Armellino, Erfan Hussain, Mary Ellen Schilling, William Senicola, Ann Eichorn, Yosef Dlugacz, and Bruce F. Farber. Using High-Technology to Enforce Low-Technology Safety Measures: The Use of Third-party Remote Video Auditing and Real-time Feedback in Healthcare. Clin Infect Dis. (2012) 54(1): 1-7 first published online November 21, 2011

doi:10.1093/cid/cir773

P.S. Bonus! Palmore and Henderson provide a tough and fair review of this research and note privacy concerns and several important methods and measurement issues. This is just great peer review science in action. Great research, great criticism – that’s how you advance.

P.P.S.  Thanks, too, to Interested Reader.  You can tell that IR is a better gearhead bean counter than I with those two and three decimals of accuracy.  And, what IR calls BESD is what we label the Windowpane also again demonstrating the performance superiority of IR to yours truly.  Yes.  The Windowpane is actually the BESD or Binomial Effect Size Display.  If you are speaking Research Geek, you should use BESD.  If you’re just a plain old geek like me, Windowpane!

P.P.P.S.  Binomial Effect Size Display.  Really.  Is that the best Rosenthal could come up with?  No wonder smoothies like Gladwell and those Cool Table elites sell all the books and get all the boys and girls.  The Igon and the Ecstasy!

Although lowering dietary salt resulted in a small dip in blood pressure, the researchers found no strong evidence that it reduced rates of death in people with high or normal blood pressure. One study suggested that restricting salt in patients with congestive heart failure could even potentially increase risk of death.

Okay, so a well done review and meta-analysis concludes reducing population consumption of salt has no impact on mortality.  Take your Falling Apples with a sprinkle of sea salt!

But.  In the same article, the Time writer notes:

Still, there is plenty of data — and consensus among experts — that excess dietary salt does affect blood pressure and cardiovascular health.

So.  The best scientific evidence we’ve got from the Cochran review claims no effect, yet there’s plenty of consensus among experts to claim there is an effect.

What journalism might call Point Versus CounterPoint is only what a persuasion theorist would call Biased Versus Objective Processing.  You can certainly find experts who will point to cases that prove salt kills and then try to generalize that reductions in salt consumption at the population level would save lives.  Anyone, without or without those little letters following their name, who reasons like this is not a scientist, but rather merely mortal and in the throes of common sense, human nature, and most particularly, Biased Processing.

What’s the difference between Falling Apples and Change We Cannot Believe In?

Persuasion.

Oh.  And, don’t forget the Bubble!

You may already know about this and if you do, have you shared it with other people? Do so. Now.

The National Cancer Institute has an online tobacco cessation program for teens. It includes text to cell phone quit coaching and other helpful and private services.

These automatic communication programs have limited success rates whether using telephone, email, web, or now text and coming soon apps for smartphones. But, they do produce change in a few people and cost almost nothing to operate. Low effectiveness, sure, but incredible efficiency.

If you have a kid who smokes, point her to the website. If you know someone who knows a kid who smokes, point him to the website. WATtapping here can make a very small, but important change.

P.S. I found this at this JAMA article.

Bridget M. Kuehn. Texting Teens to Quit. JAMA. 2012;307(4):351.

doi: 10.1001/jama.2012.4

JAMA. 2012;307(4):351. doi: 10.1001/jama.2012.4

There’s something happenin’ here.
What it is, ain’t exactly clear.

Let’s turn Buffalo Springfield inside out and follow their classic, For What It’s Worth (YouTube), into climate change. The Wall Street Journal has published a signed editorial with sixteen scientists who affirm that Global Warming does not exist and that CO2 poses no threat to the environment.

A candidate for public office in any contemporary democracy may have to consider what, if anything, to do about “global warming.” Candidates should understand that the oft-repeated claim that nearly all scientists demand that something dramatic be done to stop global warming is not true. In fact, a large and growing number of distinguished scientists and engineers do not agree that drastic actions on global warming are needed.

The sixteen signers then note the risks for public disagreement with Global Warming advocates. They cite one outstanding case.

In 2003, Dr. Chris de Freitas, the editor of the journal Climate Research, dared to publish a peer-reviewed article with the politically incorrect (but factually correct) conclusion that the recent warming is not unusual in the context of climate changes over the past thousand years. The international warming establishment quickly mounted a determined campaign to have Dr. de Freitas removed from his editorial job and fired from his university position. Fortunately, Dr. de Freitas was able to keep his university job.

Of course, Buffalo Springfield anticipated this outcome when they sang.

Paranoia strikes deep,
Into your heart it will creep.
It starts when you’re always afraid,
Step out of line and the man comes and takes you away.

This may be the largest public retort to the scientific consensus claim from Global Warming advocates. While there have always been scientists who disputed those advocate claims, they tended to do science rather than persuasion and felt no need to sign silly petitions as if they were voting on gravity. Now, at least 16 are willing to make a high profile persuasion play in public.

Even still, the Buffalo Springfield lyric hits it.

There’s something happenin’ here.
What it is, ain’t exactly clear.

Something is happening both in the science and persuasion of climate change, but it ain’t exactly clear. This editorial is a terrible challenge to the Scientific Consensus Cue so beloved of advocates. They now must devolve into a credentials swamp, shouting My Experts Are Experts and Your Experts Aren’t! an argument no citizen wishes to hear. When advocates are fighting over CVs, they have lost whether they realize it or not.

The safest persuasion play for advocates is Silence. Don’t even acknowledge the signed editorial exists. Just keep flowing on the great wave of Truth. Ignore that Other Guy Behind the Curtain. Persist with the Al Gore PowerPoint Show and all those confident claims of Scientific Consensus. This editorial and each contrary voice changes nothing.

That’s the persuasion play. And, best of all, it requires no science!

Stop, children, what’s that sound,
Everybody look what’s going down.