26 SCIENCE NEWS | February 26, 2022
M.J. HUSSEINFEATURE | LOOK TO THE OUTLIERS
like half-moons into landscapes to retain water,
the researchers reported online December 28 in
Development Engineering.
To find out what propelled the villagers to adopt
those successful practices, the team sent a local
consultant, Mohamed Jama Hussein, to sleuth
around. Hussein compared 10 of the potential
positive deviant villages with two villages show-
ing average levels of vegetation density and eight
hard-hit, low-vegetation villages — the negative
deviants. He discovered that the leaders of posi-
tive deviant villages had aggressively blocked
private citizens from enclosing communal lands
for personal use. By contrast, “squatting ” on pub-
lic lands remained common in the other villages.
Hussein also observed that farmers in the suc-
cessful villages were diversifying their sources of
income. Some had started growing their own live-
stock feed. And many women had started keeping
bees, which offered an unexpected perk, Albanna
says. The bees’ presence deterred people from cut-
ting down rangeland shrubs and trees for fuel.Targeted interventions
Besides giving researchers and policy makers
the information they need to design new inter-
ventions, the positive deviance approach can
also strengthen existing efforts, says behavioral
science and public policy expert Kai Ruggeri of
Columbia University.
“It’s such an easy adaptation that could
potentially have major impact,” says Ruggeri,
who wrote a commentary with computer scien-
tist Tomas Folk of Rutgers University in Newark,
N.J., encouraging researchers to consider using thepositive deviance approach in the November
Perspectives on Psychological Science.
A focus on outliers could increase the power of
nudges, the two wrote. Nudges, which discretely
guide people toward making better decisions,
were defined and popularized by behavioral
economists Richard Thaler and Cass Sunstein
(SN Online: 10/9/17). Researchers have tested
whether nudging people with reminders to
attend doctor appointments can reduce no-
shows. For instance, a 2011 report in the Journal
of Tele medicine and Telecare showed that, across
29 studies, automated phone or text reminders
increased attendance by almost 30 percent.
But when another research team, which
included Ruggeri, zoomed in on a low-income
population, a group that can miss up to 45 percent
of appointments, the researchers could not rep-
licate those results. They scoured the electronic
medical records of almost 64,000 low-income
urban patients at a health care center for disad-
vantaged populations and found that a robocall
followed by a text message failed to increase atten-
dance. Those results were published in 2020 in
BMC Health Services Research.
Nudge interventions often target the average
participant, Ruggeri says. “If you look at the way
nudging is largely done, it speaks to a middle-
class-and-above population.” But researchers
attempting to shrink societal inequalities could
use a positive deviance approach to help the need-
iest individuals, Ruggeri says.
That would mean identifying low-income par-
ticipants who attended all their scheduled doctor
appointments. Mapping those individuals’ paths
could potentially lead to nudges and other behav-
ioral interventions targeting potential no-shows
in similar groups. That way, Ruggeri says, policy
makers could more effectively reach the cohort
that would benefit greatly from preventive care.
Back in Somalia, Hussein wrapped up his field-
work in late 2021. The team is now investigating
how to do just what Ruggeri suggests: use its new-
found knowledge of successful outliers to develop
behavioral and policy interventions.
Such interventions have an added benefit: They
empower communities to harness the wisdom of
their own people, Sternin says. The solutions exist
within the community and implementing those
solutions, she notes, “is transformational.” sExplore more
s Data Powered Positive Deviance initiative:
bit.ly/DPPDInitiativeResidents of a village in northern Somalia share ideas on
how they contend with the region’s frequent droughts.