Sarah Watters

Meet Sarah

Sarah graduated from the London School of Economics with an MSc and PhD in Social Policy where her research focused on behavioral principles in health contexts. She has successfully led multinational research projects, focusing on, for example, the use of telecare to enhance the quality of seniors' lives. At Wellth, she continues this research through her work developing behavioral strategies and frameworks to help patients with chronic conditions live healthier lives. Today, Sarah leads 50 West, a behavioral science consultancy, focused on decision making and behavior change at both the individual and organizational level. There, she partners with organizations of all sizes and missions, with a particular focus on digital health companies.

1. How does your work help others or contribute to the world and what motivated you to pursue this path?

My work contributes to the world, society, and communities by getting people to actually follow through on the behaviors that they want to be doing, that will make them healthier and that will enable them to get out in the community and contribute and be healthy not only from a physical standpoint but also socially and emotionally and mentally and all those good things as well.

So that's really how my work is helping people on a really high level. On a more specific level at Wellth, my work helps patients who have multi morbidity, so multiple chronic diseases typically, and these patients fall under either one of two brackets.

The first one, they have multiple chronic diseases and they're getting older. The second bracket, they have multiple chronic diseases and they happen to be quite under-resourced when it comes to finances and otherwise.

How I tackle the problem at Wellth is with the common understanding that a lot of these people have probably not had a great interaction with their health care system or with a doctor, or if they don't personally have a doctor, they may have had poor encounters in the past.

And something that I believe quite strongly about is that we need to be in a really good mental space in order to be able to accomplish goals, particularly physical goals.

So I focus on getting these patients into a good mental state where they feel like they can trust the information that's being given to them, that it will be beneficial to them, and that they also feel like they can affect change in their own lives.

So we give these patients tiny little actions to take that show themselves that they do in fact have competence, and over time through these small actions they derive confidence as well to take on even more and more improved health behaviors, or the same behavior to a much greater extent.

2. What was the pivotal moment or influence that steered you towards this career path?

I've been thinking about this one a lot lately actually. I was one of those people who I thought I was destined to go, or not destined, but planned to and to go to medical school.

I quickly realized my college experience was not how I thought it would be, and also rather quickly traded off short term excitement through more interesting courses for potentially longer term benefit, which would have been sticking with the less interesting courses, although potentially seeing medical school through all the way to the end, but here we are!

Regardless, I set out for medical school, but I quickly transitioned into psychology and business and then I headed over to the LSE, still quite keen on pursuing health, just from a different angle, and I came across a course called Valuing Health, which is all about how we assign values to health. The course investigated a lot of the different kinds of tools that we use in these measurements and how these tools to estimate a value of health might be biased due to cognitive affects.

So, this course tipped me off to a subject, which is behavioral science, in which I became glued to pretty much right away.

I ended up doing my master's dissertation with the professor of that course, and then he eventually became my Ph.D. supervisor as well the following year. So it was a pivotal moment in my life, but in reality was more like filling in an online form.

3. Could you describe a typical day or week in your job to give us a sense of what it's really like?

So my days and weeks are looking a little bit different right now as I am no longer a full-time employee at a company.

I am now a full-time freelance behavioral science consultant. So the first tasks that I tackle each day are sometimes the ones that require the most focus. But I would say I'm not always the one who eats the frog, who goes out for the most difficult task right away, but most of the time I start with whatever is most interesting to me at that given time. I think where the trade-off is, and the benefit of going after what is interesting to you at that particular moment, is that it will give you inertia for the rest of the day, which I think is something that we kind of miss a lot of the time when we talk about getting the hard things over with. If you're struggling to get through the hard things, and that whole morning turns into a struggle, it's going to be really hard to turn that entire day around.

So, there might be better ways to tackle the hard things, I think is what I'm trying to say.

4. Are there any unique routines or rituals which you follow?

Um, not necessarily. When I go to learn a new area, I tend to go very, very broad and wide.

I want to wrap my arms around the problem before I hone in on any one particular part. I don't know if that's the nature of being a PhD or a researcher. I don’t feel uncomfortable if I only know a small part of a slice and I'm completely blind to everything else since, especially as a behavioral scientist, you know that there could be peripheral factors in that smaller slice that are affecting what's going on, which you might completely miss if you're not fully paying attention to the entire picture.

5. Which part of your job gives you the most satisfaction and why?

The part of the part of my job that gives me the most satisfaction is being able to explain to people why things aren't working for either their users or for them themselves which is actually much more powerful.

You can see and I hate to use this term but you can see this aha moment in their eyes and they can see what they've been struggling with from a slightly different angle and almost refresh their energy to keep going at the problem now that they have this whole new perspective and a tangible approach to kind of guide them.

My work at Wellth is particularly rewarding given the kind of socio-demographic nature or socio-demographic characteristics of the populations that we work with, knowing that we are able to provide them with a positive health experience and really change their lives or change their day by giving them positive feedback and by encouraging them and believing in them. I think it is probably one of the biggest things.

Additionally, at Wellth, we use incentives and we use loss-based framing to drive initial behavior. Ultimately that money, which is quite a small amount, does end up helping these people quite a bit given how financially strapped they are. It helps buy groceries or, or fill up gas. So, it’s really, really great to see and it's really nice to see that level of impact coming directly from member testimonials and things like that. It's really rewarding.

6. What skills or traits make you good at what you do?

The key skills that I rely on most in my work I think is patience, which is an unusual answer to this question, but I think that today we are all really excited about things that are quick or instant, to put it broadly.

We want to read headlines and parrot different headlines to convey that we're intelligent. We want to get to the discovery first or figure out what the insight is and then even if that insight sounds good and may not be robust in any sense, we want to get to that insight first.

So I think patience, being able to to sit back and walk through what the potential factors and confounding influences might be, and not necessarily, or trying not to anchor on one particular solution for whatever reason, is the best. I think that's what we've found in behavioral sciences. We're so keen to publish a cool insight that what we've found in behavioral science that sometimes were stuck on showcasing ourselves versus our original lines of thought.

7. What skills, if any, did you have to develop on the job and how did you approach this?

I think that when you bring behavioral science into an organization you need to kind of fit it to the cookie-to-the-cutter sort of thing.

Which means you need to figure out how behavioral science plugs into that organization and who needs insights and what type of insights do they need.

Because if you're anything like me everything is wildly cool and exciting. But when you go into industry you need to figure out what the additional value add of behavioral science is - meaning, dollars, really - and provide that or certainly provide that first.

8. How do you balance professional and personal life?

I think that when you like what you do, it can actually, that balance can be quite hard and the word balance is tricky in and of itself. I think there are always going to be some imbalances in those two things. That's just how life goes but I think it's more the awareness of indexing relatively high on one of those for a long period of time versus the other is crucial.

But how I balance my professional and personal life is to make sure that I feed my interests and see friends and family where I don't talk about this stuff at all.

I might be thinking about it because I think about behavior all the time, but stepping away from the problems that you're chewing on in the day-to-day is really important. It's really to give yourself that brain space. We need to think about stepping away as part of the process.

It's kind of step four out of five sort of thing, in having a productive day. Stepping away from work is a critical part that's easily overlooked because we think it's unimportant or less urgent than it really is.

I know myself, I tend to want to work longer hours even though I know I'm going to burn out or I already am burnt out. I think it's a really hard thing to do. I also don't love to put rules around things. I used to have a rule around never working on Saturdays, and now I think, as I mentioned, I have that conscientiousness around how you're feeling your brain and your body. So, if I feel compelled to do work, then I do work, but also recognize that I do need to step back soon. Certainly accountability partners can be helpful in reminding you of that, if you're able to have friends or partners, or someone, or a dog who needs you to walk around the block five times a day…

9. If money were no object, what project would you dedicate yourself to?

If money were no object at the moment, I'm really interested in social isolation.

Everyone's read headlines or heard stats around it.

I'm particularly interested in mental health and social isolation as a precursor to it, being able to adequately manage our physical health. I'm in the process of doing a review of different companies that are focused on social isolation and loneliness for older people. I find it actually staggering how few companies are entering this space and we talk a lot about the stats in this case, but there isn't a lot of market power going towards addressing this problem, and I think that's going to be a really big deal in the coming 5, 10, 15 years as the baby boomers age. If the social health piece isn't in place, I think we're going to see far more rapidly declining health outcomes, if people are depressed or they're anxious or lonely, or just down more generally, it's going to be incredibly difficult for them to take medication and exercise and want to eat things that are good for them, that they might not like, and all of these things that require a little bit extra energy, you need to be in the right headspace in order to execute them.

So, I think if money were no object and I could dedicate unlimited time to figuring out something, it might be something in that realm.

We haven't figured out how to crack it - loneliness and isolation - really in a scalable way that, that works across different groups of people, different user groups, I mean, ranging from older people to disabled people, or rather people with disabilities, to younger people and digital natives who obviously are, are hyper fluent in technology and probably necessitate a different, different type of solution.

10. From your perspective, what are some of the best ways to make a difference within or using behavioral science?

One of the areas that I'm really interested in in behavioral science, related to the previous question, is how do we leverage social?

So how do we leverage, not so much social media, but people like me? In this way, we have less expert education and more peer-to-peer education. Particularly in health, which is largely where I play.

People are looking elsewhere for second opinions, or they're doing their own research on the internet. People aren't just going to one location for their health care information today, and part of that has to do with access issues to health care, having to wait, or having to pay.

But a lot of it also has to do with the ability to get information from someone who might look like you, or has the same experience as you, which you'll find if you've ever kind of Google the symptom and landed on some sort of message board, or if you've landed on Reddit.

There's almost an inherent comfort knowing that someone else who is not part of an organization or is not profiting has just gone onto this website and posted about their own individual experience, and how that can help affect change in other people is something that I'm very, very interested in. I think it might yield some of the best ways to use behavioral science to make a difference.

11. What underexplored areas in behavioural science could aspiring behavioural scientists focus on?

My main thing would be to focus on something that you believe in and that is of real interest to you.

What I see in behavioral science a lot today is people are recycling a lot of the same ideas over and over again. Or they're just repeating content and not necessarily going out there and figuring out a really interesting question.

I love when you hear about independent researchers using online tools or going to sit in the park and asking 10 different people about something they’re interested in. Ultimately, you’ll be more excited to talk about it and you'll also be more likely to uncover novel insights. We all come to the behavioral science party with a mix of different experiences and our backgrounds and these all affect the areas that we're interested in and how we kind of see the world which is really cool. So focus on what you're interested in and that is your strength.

12. If a student or someone early in their career wants to end up working in your position, what next step would most accelerate them?

This is hard because I think we never know what's going to change the trajectory of our careers or our lives.

As I was saying in my introduction to behavioral science blindsided me in an elective course I ended up taking during my master's degree.

If I have any advice for my younger self, or to anyone who's interested in getting into behavioral science, I would talk to people. It's so important to just talk to people, ask them about what they're working on, and what areas that they're struggling with, and not with any agenda other than to just learn about them and the problems that they're working on. I think too many times our conversations have angles and hidden agendas or not-so-hidden agendas, and I think the younger that you can start to pollinate different potential directions in your mind, the better off you are going to be kind of as you go year through year. You're gonna have more deciding moments about whether or not I should go do this, or do that, or this person might be able to help me with this project I've been thinking about.

You'll hit more of these kinds of, as I was saying, deciding moments where things connect in hindsight. The more people you can talk to, also the more different jobs you can get exposed to, and what those jobs actually entail.

I think we all think we might want to be a product manager, or we want to be a founder of a company, or a researcher, and I think as behavioral scientists, we need to recognize that we only want to be something that we know exists.

We actually have this entire universe of unknown unknowns when it comes to our career, or things we could do that we just don't even know exist, or we don't even know those are actual paying jobs.

So, again, just to summarize my ramblings a little bit would be, to just talk to people, open as many doors as possible, with no agenda necessarily.

Especially if you're young, learn about the world and the people working in it. And something that I don't think we do enough of is just curiosity in one another.

13. Is there a common misconception in the field that you would like to address for newcomers?

I think that people outside of behavioral science and economics sometimes have particular views of the field which they don't necessarily feel compelled to hold back.

So I think if you're going to go into behavioral science, understand the area that you know really well and understand what behavioral science is really more broadly and why those criticisms are made and how you feel about them.

There are misconceptions and there are views of every field, especially given whatever is the zeitgeist, but I think the people who are, the people who are dismissive of behavioral science are the ones who actually know the least about it.

Thank you so much, Sarah, for sharing your insights and advice with us today!