Posted on behalf of Amy Wang

The sixth and final principle of contagiousness that Jonah Berger discusses in the book Contagious: Why Things Catch On is “Stories.” According to Berger, creating word of mouth is critical in making products, ideas, and behaviors spread. Stories, as opposed to advertisements and facts, provide an engaging and easily transmittable medium through which people can unintentionally share information that promotes a service, idea, organization, etc.

First, stories are often entertaining, more engrossing than basic facts, and thus get passed along, reaching a large number of individuals. Second, stories often teach an important lesson or convey information and facts (that “come along for the ride” and may not necessarily be the focal point of the narrative itself). Third, stories are often believed more wholeheartedly than other methods of relaying knowledge as they come from personal accounts and experiences. People are less likely to argue against stories than against advertising claims, and in the end, are more likely to be persuaded. In these ways, stories capture people’s attentions, create conversation, and along the way, pass around information that ultimately promotes products, ideas, or messages that are embedded within the narrative.

From product recommendations to viral videos, people create narratives (intentionally or not) that carry a lesson, moral, or take-home message. Instead of listing the features of a jacket, for example, a review that describes how the jacket had the perfect warmth and comfort level when climbing through the highest peaks of Colorado is certainly creating a narrative that is more likely to be taken into consideration and talked about. Another example relates to a video campaign sponsored by Dove that shows the behind-the-scenes processes into making images of supermodels that have helped create today’s beauty standards. The video-story sparked discussion and conversation about an important issue, but it also directed peoples’ attentions to Dove and their products, which helped the company gain millions of dollars in exposure. So, instead of presenting information in a straightforward, fact-based manner, presenting or creating content that includes the product or idea that is meant to be promoted through narratives can increase contagiousness.

This principle can be used in community health interventions by depicting the personal narratives and experiences of individuals who have been using such services successfully. Also, by creating content that shows how individuals from all backgrounds can actively participate in the community health program through a narrative-like manner, the idea of the program may catch peoples’ attentions more successfully and catch on to new audiences.

Practical Value

In the age of cat videos and vine compilations, it seems a little peculiar that a video about shucking corn would be a viral YouTube hit. It’s also a little weird that of all things, a group of hikers would be talking about vacuum cleaners while exploring the Blue Ridge Mountains. But useful things are important. People like to pass on information that is useful to others.

Of all the principles described in Contagious, “practical value” is arguably the easiest to apply. If a friend likes to cook, then sending her a new recipe would benefit her and strengthen the social bond. Unlike the principle of social currency, which is mainly about making the information sender look good, practical value is about the information receiver and what is useful to him/her. Nevertheless, things with practical value are contagious because people not only want useful information, they share it. Giving helpful advice does generate a bit of social currency but at the end of the day, practical value is about altruism, helping others save time, money, etc.

When people think of practical value, Berger says saving money is what most often comes to mind. He then dives into the psychology of deals and elaborates on prospect theory, a core tenet of behavioral economics: People don’t evaluate things on absolute terms; they compare things to a “reference point,” established by their own expectations. 50 cents for coffee may seem like a great deal in New York City, but may seem ridiculously expensive in rural India.

How promotions are framed can significantly affect sales. Deals and promotions are more successful when they are restricted or for a limited time. If a product is on sale all the time, then the sale price becomes the expected price. Furthermore, Berger details the “Rule of 100:” If a product’s price is less than $100, then percentage discounts will seem larger; If the price is over $100, then dollar discounts will seem larger.

In the final pages of the chapter, Berger makes a keen observation that information that applies to a broad audience is not necessarily shared more. Narrowly focused content often reminds people of a specific friend or relative, and they feel more compelled to pass it along. But if the information could be useful to literally anyone, then people may not necessarily share.

We all love things that help us make our lives more efficient, so it’s no surprise that practical value is held in such high regard. Whether it’s tips on how to save money at the car dealership or lists of home remedies to try when you have the flu, useful information is inherently contagious and does not need much marketing to be successful. This is especially nice for global health efforts that require community response. If an intervention is designed to improve the health of a community at large, then it may not matter if it generates a lot of social currency. However, it is important to note that the community would have to feel that there is practical value and community members’ perspectives need not always agree with those of healthcare providers or researchers.


Jonah Berger’s fourth principle of contagious ideas is “public,” making our products and ideas observable. Berger explains that human herd mentality pushes us to adopt the behaviors that we can see. So if you want something to spread, make it visible. Monkey see, monkey do.

And of course, any book on contagious social behavior must include Apple—so here we are! In this chapter, we learn that the logo on Apple computers was once flipped such that nearby observers would see an upside-down version of the company logo when laptops were open an in use. Applying principles of observability, Apple designers decided to flip the logo orientation such that onlookers would see the Apple trademark right-side up. The beauty of Apple’s decision was that the product design itself served as a marketing tool. (Apple’s decision to sell white headphones instead of following the industry standard of black headphones follows similar principles. When you see someone with white headphones, you know that person is an Apple customer (and you are more inclined to mimic their behavior.)

Apple’s clever design decisions created what Berger would call behavioral residue—the physical traces that most activities will leave in their wake. Lululemon understood the power of this concept when they decided to bag customer purchases in reusable shopping bags instead of flimsy plastic or paper bags. The company knew that the customer would feel compelled to save the bag for grocery shopping and running errands, advertising the Lululemon brand while they were out in public. My favorite (non-consumerist) example of behavioral residue are “I Voted” stickers.

In the public health world, we can leverage this concept by making private thoughts and behavior publicly visible and vice versa. Take binge drinking among college students as an example. Most people know binge drinking is terrible for your health, yet 44% of students binge-drink. What’s the underlying psychology here? Students think everyone around them is binge-drinking because they see kegs at the frat house etc., so they partake in the behavior. (Monkey see, monkey do.) There’s social proof that compels students to drink. What students cannot see are their peers who are not at the frat party (instead sleeping and spending time in their rooms), and the fact that everyone around them hates binge-drinking as much as they do because behavior is public, and thoughts are private. Instead of designing public health education initiatives that tell people what they know (binge-drinking is bad), we may be better off trying to tell college students that in fact, their peers share similar mindsets! The stunning reality that in fact, no one likes binge-drinking.

However, if we’re not careful, the concept of publicity can easily backfire. One public-health centric example is Nancy Reagan’s “Just Say No” anti-drug use advertisements. Reagan’s public service announcements showed footage of teenagers smoking and their peers telling them “no.” However, researchers found the PSAs increased marijuana use among young adults. The theory driving this behavior goes back to public vs private behavior. All of a sudden, a once private behavior (marijuana smokers trying to avoid being seen) became wildly public (broadcasted on TV).

Understanding the private/public dichotomy in behavior can help us design products and processes that help to destigmatize certain health-related social behaviors. There are many relevant lessons here for the Help Desk, a GANDHI third year initiative to help connect patients to community-based organizations and support their social determinants of health needs. Think about the WIC debit-style cards which replaced paper food stamps. By turning a former public behavior (paying at a grocery store with pieces of paper) into something more private (swiping a debit card, just as any other customer might), low-income people could feel less stigmatized for partaking in this welfare program.

The Help Desk should consider the observability of its own physical presence with community partners. Increasing our visibility at the health clinic (I hope) would make seeking help on social determinants less stigmatized and allow patients to feel more comfortable in proactively looking for assistance from the Help Desk. Further, having a presence in the local community may remind patients to follow-up with referrals. How should we consider building our initial presence? Marketing visuals (e.g. logo, permanent signage)? Notes on patient take-home files?

As Berger notes in his chapter, if something is made to show, it’s made to grow.

Emotion: “Activating emotion is key to transmission”

Posted on behalf of Alexandria Hurley

Emotion is emphasized in both Made to Stick and Contagious.  The difference is on the emphasis.  In Made to Stick the ability for emotion to increase investment is emphasized.  For Contagious the transmission of ideas is more important.  The reasons behind transmission did not matter as much as the act of transmission itself.  Therefore, while concepts like empathy were emphasized in Made to Stick, in Contagious the more relevant emotions were anger and awe.

The first example of content that went unexpectedly viral was an article written in the New York Times about how a cough can be imaged.  Berger’s explanation for its rapid and extreme transmission was the articles ability to inspire awe.  “When we care, we share.”

The Wall Street Journal publishes a daily list of the most read and emailed articles which “enthralled” Berger.  After changing to an electronic form of data collection he used this information to look for trends of what emotions caused people to share.  Using previously discussed ideas about virality the researchers had the articles ranked by usefulness then analyzed to see if that coordinated with being shared.  “More interesting articles were 25 percent more likely to make the Most E-Mailed list.  More useful articles were 30 percent more likely to make the list.”  This didn’t explain why science articles were shared though.  These articles though often invoke awe, as does a lot of other viral content.

Awe is not the only emotion to inspire transmission though.  “Sadder articles were actually 16 percent less likely to make the Most E-Mailed list.”  Positive articles were 13 percent more likely to be shared than negative articles, but articles that evoked anger or anxiety were more likely to make the Most E-Mailed list.  From this data the researchers concluded that it was arousal that prompted sharing.  The more an article increased arousal the more likely it was to be shared.


Posted on behalf of Gloria Hong

Jonah Berger opens his second chapter with an interesting question: which gets brought up in conversations more often, Cheerios or Disney World? Surprisingly enough, we are told that Cheerios is the winner, showing that trigger may be more important than interest for a topic to get more word of mouth. A trigger is anything that stimulates a thought or an idea, and having more frequent thoughts can lead to action, whether it be talking about it or purchasing the thought-associated product.

In fact, he continues to build upon the significance of trigger by claiming that the timing of the trigger is what determines how soon and for how long the topic of interest will get more word of mouth. A product can get popularized immediately because of coincidental events that occur and remind them of the product being sold. For example, customers bought more Mars candy bars in 1996, when NASA launched the Pathfinder to Mars. With the space mission buzzing constantly in the media, people were reminded about the candy bar more often and sales rose  accordingly. Fast forward to 2011, On YouTube Rebecca Black’s viral song “Friday” received the most attention every Friday.

What helps an idea stick for a longer time is coupling it to things that are constantly on our minds. This was the marketing strategy for Kit Kat, when they launched their “Kit Kat and Coffee” campaign and advertised the chocolate bar as a complement to coffee. With the pick-me-up beverage frequently on our minds throughout the day, we are led to think of Kit Kat more often, and eventually, led to the action of purchasing it.

Employing this concept of trigger, anti-smoking and health-conscious campaigns have also succeeded in selling their message. Most of us can recognize the cowboy depicted as the Marlboro Man, and the anti-smoking organizations have taken advantage of this by advertising an image of the Marlboro man telling another, “Bob, I’ve got emphysema.” By tacking on this dialogue to the familiar advertisement, the anti-smoking campaign has effectively triggered us into thinking of emphysema whenever we see the original poster.

Along these lines then, it makes sense that Cheerios gets more word of mouth than Disney World because the thought of cereal is more likely to be triggered during breakfast time, as shown by data released from Twitter.

Contagious – By Jonah Berger CHAPTER 1: Social Currency – 3 Imperatives to get people talking about your big (or not so big) idea

I should have known that somewhere, at some point in time, while talking about how to make ideas catch on, the McDonald’s brand would enter the conversation…but the McRib though??! Seriously?

Mr.Berger argues that in order for any idea to spread, you have to somehow get people talking about it. You have to make it relevant and interesting to people. So much so, that they want to talk about it with others. When an idea gains this type of traction, it has social currency. People will talk about it not just because the idea itself is cool or intriguing, but because simply sharing the idea with others confers a certain amount of coolness and intrigue on the person doing the sharing. This in turn increases their social status – which is a great way to motivate people to the spread the word.There are three ways to ignite this process:

1. Inner remarkability: glass vs. rubber

The point is made that when people get together, they choose what to talk about with others. Will they choose the mundane details of their everyday lives to chat about with friends or will they pick topics that are unique and interesting? Most likely, if they have something unique to talk about, they will be eager to share that first. The first rule in increasing chatter, therefore is to find what is remarkable or interesting about your idea and market that – the inner remarkability. The example given is when the drink company Snapple decided to replace corny jokes on their beverage lids with interesting and unbelievable, but true facts that would be conversation starters for their customers. For instance, did you know that a glass ball bounces higher than rubber?

My question was, well what if your idea really isn’t all that remarkable? The answer is find something about your idea, even if it is not very exciting inherently and frame or creatively look at it in a new way that makes it notable. The 100$ Philly cheesesteak was a great example. Knowing how difficult it is for restaurants to succeed, one owner took a very common idea, in this case the cheesesteak, and made it into a novelty by charging $100 for a gourmet version of the old classic. Not only did it get people talking and clamoring to try this $100 sandwich, it drove business to his restaurant through word of mouth, helping to secure its success.

2. Leverage game mechanics through competition – The mayor of Foursquare

According to the author, what also gets people talking is when they can compare themselves to others or to a benchmark and gauge how well they are doing. The better they do, or the more they feel challenged yet at the same time capable, the more likely they are to engage with the activity or idea. Intrapersonal drive makes us work harder when an idea is set up in the form of a game that allows us to track our own progress, and slowly but surely reach higher levels. Interpersonal comparisons make people want to compete and win against others, and maybe even show off a little bit what we have achieved. People will respond to games that allow them to do this even if what they get in return is very little; like being given the title Mayor of Foursquare when you post more reviews than others. I’m not totally convinced that most people and communities are driven by the perk of comparisons and competitions with others though, maybe Mr.Berger’s perspective is a little BIASED? Thoughts?

3. Make people feel like insiders – The “McRib”

To guide people towards accepting an idea, running with it and telling others, you need to make them feel that by having that information they have been inducted into and club. With that little bit of knowledge, they now are part of the in crowd…and who doesn’t want to be part of the “in” crowd? When accessing the idea seems like a little bit of a challenge because it is either for an exclusive group of people or is scarce and difficult to find, it becomes even more appealing. Take the case of the McRIB. when it was first introduced it did not do well. To increase sales, the company made it scarce – in a limited edition offering only certain times of year at certain locations. Eventually, it gained a following and immense popularity as people posted and tweeted in search of the next offering of the sandwich.

Reflecting on this idea, I can see it’s applicability to less privileged community settings where people often feel left out of the conversations and the last to know about really good, important information. Framing the information in a way that shows that people who have been on the outside are now being invited into the club of information may be a way to get people talking about new ideas. Another hopeful point of this chapter is that social currency can trump monetary incentives to get people to buy into a new idea. This is great news when focusing on communities or populations that may have few resources.



In their novel, Made to Stick, brothers Chip and Dan Heath dedicate the final letter of the SUCCESs acronym to “Stories”. Although stories are typically associated with entertainment (movies, books, bedtime stories, etc.), Chip and Dan make the argument that being in the “audience” isn’t as passive of a role as what one might think.

While a credible idea makes people believe and an emotional idea makes people care, the emphasis of this chapter is the power of stories to make people act. That power comes from simulation (knowledge about how to act) and inspiration (motivation to act).

A teaching clinic held by Indiana University demonstrates the effectiveness of mental simulation. Many professors aren’t sure how to handle distracting students in their class. The first example given to the teachers had bulleted points such as “remain calm”, “don’t become defensive”, and other common-sense tips that weren’t very helpful. The second resource detailed a professor’s experience with a disagreeable student. By simulating the process of dealing with the problem student, the other teachers could follow along and work their way through the problem as well. This kind of mental simulation is much more useful and effective at teaching than a list of bullet points, and even has problem-solving benefits to everyday challenges. Imagining a potential argument with one’s boss may lead us to have the right words available when the time comes. Mental practice alone, the act of picturing yourself performing a task successfully from start to finish, was proven to have enhanced performance in physical tasks such as throwing darts and playing the trombone.

Stories also serve as an inspiration to others, motivating them to act. A college student named Jared had a serious weight problem, weighing 425 pounds. By creating his own “Subway diet”, he managed to drop 100 pounds in three months by eating the new line of healthy sandwiches.  Subway ran Jared’s story and quickly became headline news, increasing their quarterly sales and beating out their competition. This is an example of a “Challenge Plot”, which are inspiring by appealing to perseverance over a seemingly daunting challenge. Other types of stories include the “Connection Plot”, such as romance novels and tales about good Samaritans, focus on relationships with other people. These stories inspire us in social ways to help and be more tolerant of others. The last is the “Creativity Plot”, which promotes us to experiment with new approaches and to innovate. It is important to know your audience when deciding which type of story to tell. For example, the challenge plot is best during a kickoff party for a new project, whereas connection plots are better at a company Christmas party.

It is fitting that this is the last letter of the SUCCESs acronym because stories naturally embody most of the SUCCESs framework. Stories have the dual power to inform and to inspire. However, it is not enough to tell a great story, it must reflect the point you are trying to get across. I can see Stories as an effective way to disseminate the gravity of our project’s findings to our surrounding Duke and Durham community. In the words of Chip and Dan, “Stories can almost single-handedly defeat the Curse of Knowledge”. We’ve seen the recurring theme throughout the novel of how raw numbers and statistics fail to incite emotion and action from people. What do you think? Is it more important that we share unbiased, factual information in a presentation? Leave your thoughts below!


In Made to Stick, by Chip and Dan Heath, the steps to create sticky ideas are detailed, given in the acronym SUCCESs. The E in the acronym stands for emotional. The Heath brothers emphasize that if people are going to act, they first have to care about the message. The core question of this section is: “how do we make people care about our messages?”

The chapter begins with an example of a study conducted at Carnegie Mellon to see how people respond to different types of charitable donation requests. The researchers found that people tend to give more generous donations when they are for a specific individual rather than for an abstract cause. Presenting the donors with specific individuals in need evoked empathy. Additionally, priming the donors to think analytically led to a lesser donation.

Another strategy for creating emotional messages is to appeal to something that matters to the individual. One form of this is to appeal to self-interest, described through a Cable TV case study that measured methods of persuasion in Tempe, Arizona. The participants in the study were either given information about a cable TV or asked to imagine themselves enjoying the benefits of a cable TV. The study found that those who imagined themselves subscribing to cable TV were more likely to actually do so later. Emphasizing benefits that are realistic and easy for people to imagine themselves doing is an effective manner of persuasion.

A final strategy given is to appeal to the identities of the intended audience. The authors give the example of the Don’t Mess with Texas campaign intended to encourage people to stop littering. An identity appeal was used by enforcing the idea that “real Texans don’t litter”; the campaign was extremely effective.

The emotional component of messages is vital to evoking action. People have to care in order to be inspired to act. The same concept applies in health behavior change. A message must be emotionally relevant to its audience in order for change to occur and the Heath brothers offer multiple strategies to create these messages effectively.


The 4th letter in Made to Stick’s SUCCESs checklist stands for credibility- what makes people believe ideas? The Heath brothers point out the “powerful forces” that those who have to convince encounter with those they want to convince: family, faith, experience, and a lifetime’s worth of personal learning. Throughout the chapter, they outline three primary sources of credibility that people tap into to persuade a skeptical audience:

External credibility consists of authority figures (experts, celebrities, or other aspirational figures) and antiauthorities (like antismoking campaign star Pam Laffin) that vouch for messages. While authority figures use their status to do this, antiauthorities establish their validity through the honesty and trustworthiness that accompanies their personal experience.

Internal credibility is rooted in the idea that messages have to vouch for themselves. Vivid details boost credibility through their ability to incite visuals and tangibility, while meaningful details through concrete examples reinforce, symbolize, and support a core idea. Statistics are most effectively used when they illustrate a relationship (maybe by adding a sensory dimension), are contextualized through familiar schemas of the human experience (human-scale principle), and are used as input to a core idea rather than output. An example passes the Sinatra test when one example is enough to prove credibility: “if you can make it there, you can make it anywhere.”

The final, and arguably most powerful, source of credibility is the audience itself! By allowing an audience to test a claim for themselves, they outsource their credibility and provide a testable credential that people can experience firsthand. On his search for credibility for his discovery of bacteria in ulcers, Barry Marshall cycled through many sources of external (endorsements and institutions) and internal credibility (data and detail), and they weren’t enough- he ultimately gulped a glass of bacteria to challenge his audience to “see for themselves”.

Whenever we make decisions on what or who to believe, we look for credibility in the ideas or the people behind them. Why did we choose to study at Duke? Looking back on it, the administration had to dip into many of these sources throughout the recruitment process to make the institution “credible”; it had to showcase the experts that are at the edge of innovation in their fields, highlight its successful celebrity alumni and current model students, provide vivid details about on-campus life/dorming/clubs/dining to help us visualize a day in the life of a Duke student, illustrate statistics that emphasize its “8:1 student-to-faculty ratio” and its status as the “5th largest research university”, and finally challenge us to see for ourselves by applying!

In our own search for credibility in the manuscripts, poster boards, and conferences that accompany our research projects, we also have to battle the skepticism of bias and error that the words “qualitative research” tend to carry for people. The researchers behind qualitative research are integral parts of the process and final product, so separation between a researcher’s values and opinions is not entirely possible. One way we can establish credibility in our projects would be to critically self-reflect and be transparent about our analytic focus and preconceptions in the processes that the data is collected, analyzed, and presented. We can use these external, internal, and outsourced references for credibility to support that our qualitatively derived data has a place in a system that determines impact through evidence-based decision making.

Feel free to share your thoughts below!

Made to Stick: Chapter 3- Implementing ideas that are concrete

Not all ideas are created equal and not all equal ideas “stick” the same way.  In order to understand how ideas last, it is important to understand how they are implemented.  Implementation is important because often times it is not a matter of what is most useful but what idea makes most sense to the consumer. Concrete ideas make sense to people because they are easy to understand and imagine; often described in a way that is visual (have a lasting image) and easy to dissect (less abstract).


A concrete idea is not one mystified with weird facts and figures. Let’s take for instance the following example, “Movie popcorn has 20 g of fat”. How does one interpret that statement? What is 20 grams equal to? Is 20 grams a small amount? Compared to what? On the other hand, a concrete example would be “Movie popcorn contains more fat than a bacon-and eggs dinner, a big Mac, and fries for lunch and steak dinner with all the trimmings combined”


Now that is something that resonates with the average American!  I love popcorn, and the latter statement immediately made me reconsider my future popcorn consumption.


Implementing concrete ideas are important because they are direct and therefore have more impact on future behavior. This simple concept can be applied in a myriad of ways.

From ensuring people have better information and access to community resources to better quality of services; using concrete ideas and messages can help achieve that.

Sometimes it is as easy as having customers call one direct line to refer them to a needed service, rather than figure out for themselves where the Emergency Food pantry is located. A concrete way of implanting this message can be something along the lines of “All community services, just a phone call away” or “5 minutes: the time it takes you to connect to community resources” The easier we make the delivery and implementation of health and social services, the better outcomes we will see.