Choice Posture, Architecture, and Infrastructure: Systemic Behavioral Design for Public Health Policy

The demands of many public health contexts and challenges call for conditions that foster effective decision making. Policy designers must make appropriate choices appear viable, accessible, and beneficial. They can do this by harnessing transdisciplinary knowledge about behavioral tendencies, simultaneously integrating insights into end users and non-human agents, and employing design methods for system-level solutions. We propose a “choice triad” model to help practitioners frame transdisciplinary approaches to complex public health challenges and design effective conditions for choice. It has three lenses: choice posture, to reveal human and non-human agents’ predispositions and inclinations; choice architecture, to improve immediate choice environments and encourage preferred actions; and choice infrastructure, to reveal the underlying system structures, processes, and policies that shape how potential public health solutions are accessed and supported. This approach promises to augment traditional design tools and expand current conceptions of available “economies of choice” when crafting behavioral public policy solutions. In combination, these lenses can provide a new conceptual syntax and working model to diagnose and develop solutions within complex public health settings. We introduce two examples to illustrate this model: the water crisis in Flint, Michigan, and Covid-19 vaccination efforts in the United States.