A multiple case study on the use of communication strategies by Dutch municipalities: How did the municipalities use communication strategies to achieve the goals of the Wet Maatschappelijke Ondersteuning for the elderly?

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A multiple case study on the use of

communication strategies by Dutch

municipalities: How did the municipalities use

communication strategies to achieve the goals of

the Wet Maatschappelijke Ondersteuning for

the elderly?

Master thesis

Faculty of Governance and Global Affairs

Public Administration

Economics and Governance track Supervisor: Dr. C.J.A. van Eijk

Second reader: Dr. G. E. Breeman Date of completion: February 8th 2018 Student: Jelmer van Teutem

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Abstract

Despite the fact that framing and nudging are both communication strategies whereby the goal is to change behavior, there is still little research done whereby both communication strategies are under investigation. Current literature mostly focuses on the effects of framing and on the concept of nudging. In this thesis, both communication strategies are investigated within a multiple case study. The case that is investigated is a part of the decentralization of the Dutch long term health care, namely: The Wet Maatschappelijke Ondersteuning (Wmo). The goal is to identify whether Dutch municipalities use framing and/or nudging and to identify how the municipalities used these strategies to achieve the goals of the Wmo for the elderly in the Netherlands. With the introduction of the Wmo, municipalities expect from the elderly that they become more self-sufficient and independent. This means that the municipalities ask a certain behavior change from the elderly. Furthermore, the municipalities try to increase the amount of volunteers and informal caregivers to support the elderly. The municipalities that are researched in this thesis are The Hague, Rijswijk and Amsterdam. The municipalities were selected based on differences in their size, their environment and composition of citizens, their administrative and technical capacity and their location since a most different design is used. Empirical data are collected through individual interviews at the municipalities and partially by document analysis. The results show that all three municipalities make use of framing and nudging. This means that the results for the used strategies are very similar. The execution of the strategies among the municipalities differs to some extent because all the municipalities shape their policies in a way that they fit their own environment. The execution of the strategies does correspond with existing theories on the use of framing and nudging. Furthermore, this study found an additional factor that explains differences in the execution of a communication strategy, namely: the composition of citizens within a municipality. The thesis concludes with suggestions for further research and practical implications.

Keywords: strategic communication, framing, nudging, behavior change, municipalities, the elderly, Wet maatschappelijke ondersteuning (Wmo), most different design

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1. Introduction

Back in 1997, Frank Luntz who was a Republican pollster produced a memo called “Language of the 21st_{century” and sent it to members of the U.S Congress. Since that}

moment, the memo spread among other members of the Congress but also to journalists. The message of the memo was clear and simple: “It’s not what you say, it’s how you say it”. Frank Luntz used existing communication techniques and knowledge and researched Republic campaign messages. He filtered out terms and phrases that resonated with specific interpretative schemas among audiences and therefore helped to change the attitudes of the audience. The effect of his messages was not realized by content differences but was realized by the way he presented and communicated the messages to the audience. The idea of this strategic communication was not new, but it was the first time it was used by governments to change the attitudes of citizens towards certain issues and policies (Scheufele and Tewksbury, 2007:9).

Strategic communication can take many forms and can be used in lots of ways. Riley and Hollihan (2012:60) define strategic communication as: “the study of deliberate programs

of messages or arguments that are designed by organizations, institutions or other entities in order to achieve particular goals”. This thesis will focus on two types of strategic

communication, namely: framing and nudging. Framing is based on the idea that the way a message is presented is of great importance. How an issue is presented in a news report or statement influences the way it is understood by its audience (Scheufele and Tewksbury, 2007:9-10). There is one major premise of framing theory: it is possible to look at an issue from a variety of perspectives and an issue can be construed as having implications for multiple values or considerations. Framing refers to the process by which an individual develops his own conceptualization of an issue or changes their current thoughts about an issue (Chong and Druckman, 2007b:104).

Nudging is a motivation technique whereby citizens are stimulated in a positive manner to act in a certain way. The government tries to alter citizen behavior in ‘government preferred behavior' (Thaler & Sunstein, 2008). A good example of this is the Dutch organ donor register. Political party D66 introduced a new bill for the Dutch organ donor register. The current register is based on a ‘no, unless’-system which means that citizens automatically say no to donor registration. D66 tries to introduce an organ donor register that is based on a ‘yes, unless’-system. This system automatically enrolls citizens in donor registers while the

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option to opt out remains (De Voogt, 2017). Setting it up this way, the government tries to accomplish a greater take-up of organ donors than if citizens were required to opt in since this will cost them time and effort (Nieuwsuur, 2016). Nudging can be described as a soft form of paternalism, since citizen behavior is steered in a certain direction. Although this is the case, nudges are designed in such a way that citizens keep their full freedom of choice. The instrument of nudging can be seen as a GPS. GPS devices steer people in a certain direction, but people have full freedom of choice to choose their own direction. This means citizens are guided to change their behavior without limiting their full freedom of choice (Sunstein, 2014:2).

This thesis examines how these two types of strategic communication are used by municipalities. The case that is used to research this, is a part of the decentralization of the Dutch long term healthcare, namely the “Wet Maatschappelijke Ondersteuning” (in short: Wmo). The government introduced the Wmo to reduce long term health care spending. The implications of the Wmo were that municipalities would take over the responsibility for activities regarding the support, guidance and care for citizens. In this thesis, the focus will lie on the Wmo for the elderly and the change in the role of the elderly. This case is interesting because the government asks a certain behavior change from the elderly. To be more specific, the elderly have more responsibility with the introduction of the Wmo. The government stimulates needy citizens to be more independent and self-sufficient. Citizens have to take the initiative and municipalities facilitate (Overheid, 2016).

In addition to this, municipalities ask citizens to participate as volunteer to support the needy elderly. Volunteers can support older people in two ways, namely: by volunteering as an informal caregiver (in Dutch: mantelzorger), but then on voluntary basis and for a limited time per day or by organizing activities for the older people. In this way, the government wants to enhance the participation of the elderly in society (Overheid, 2016). Since volunteers and informal caregivers can help the elderly to be more independent and self-sufficient, increasing the number of volunteers and informal caregivers is also considered to be one of the goals of the Wmo for the elderly in the Netherlands.

This research focuses on whether the municipalities use communication strategies and on how they use the communication strategies to achieve the goals of the Wmo for the

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The following research question tries to find an answer for this: “How do municipalities use

communication strategies to achieve the goals of the Wmo for the elderly in the Netherlands?”. The expectation is that municipalities all use a form of strategic

communication, but in their own preferred way. This is the expectation because all municipalities can decide how they want to organize the Wmo, and thus also the

communication to citizens about the Wmo (Overheid, 2016). The research does not look into the actual effects of the communication strategies. This means that the results of the used communication strategies lie outside the scope of this research, instead the focus lies on the process of how the communication strategies are used.

Answering this research question is both of scientific and practical relevance. Starting with the latter, this research hints upon a broader issue of how citizens can be stimulated and encouraged to pick up responsibilities in society. In a context of budget cuts, both among politicians and societal actors, the idea becomes dominant that citizens have a role in service delivery and their own wellbeing. Yet, for this a change in mindset is necessary and strategic communication is an effective way to change citizen behavior. It is able to inform, influence and/or persuade audiences in support for national objectives (Paul, 2011:17); such as the objectives of the Dutch Wmo. However, it is important that strategic communication is clear for both parties, the party that delivers the message and the party that receives the message. The message has to be clear and understandable for the recipients in order for the message to be effective. This research offers insight in the use and execution of communication

strategies. These new insights can serve as a basis for further research that tries to identify whether Dutch municipalities use and execute strategic communication effective while keeping it understandable for the elderly in the Netherlands.

In addition to this, Dutch municipalities that lie outside the scope of this research can learn from the results of this thesis. In this thesis, the communication strategies of four municipalities are investigated; the results can encourage other municipalities to learn from the experiences and insights of the four municipalities studied.

From a scientific point of view, communication strategies and nudging in particular, are topical issues. Richard Thaler won the Nobel Prize in Economics in 2017. Richard Thaler is one of the founders of the concept of ‘nudging’. He is praised for his ability to connect the field of Psychology with the field of Economics, for instance with his theory on nudging. This indicates that nudging is a scientifically relevant theory that is widely discussed (Armstrong

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III, 2017). The underlying study can contribute to this academic debate. Governments and government agencies have been guiding citizens and implementing policies since year and day. The communication strategy ‘framing’ has been used a lot in cases where governments or government agencies were involved (Chong & Druckman, 2007b). This is why there is quite some theory on the effects and implementation of framing. However, this information is lacking for the other communication strategy: ‘nudging’. Few attention is paid to how

governments or government agencies might use nudging strategies. This is strange, since both communication strategies have the same function, namely: steering or guiding citizen

behavior. This research can fill this gap in literature and lead to new insights in the use of nudging on government level.

Furthermore, this study adds to the literature as it investigates both communication strategies at the same time; something that is rare in the current literature. Yet, combining both strategies in one single study has some advantages. For instance, this research can indicate whether there are differences in the choice for both strategies. Do municipalities choose these strategies based on the same incentives and motives or do these differ? In addition to this, the research identifies whether there are differences in the implementation and use of the two communication strategies and whether there are differences in the implementation and use of the strategies between different municipalities. This also contributes to the scientific relevance of the research.

To collect all the necessary data to formulate an answer on the research question, interviews and document analysis are used. The interviews and document analysis are used to find out to what extent communication strategies are implemented and to find out whether there are differences in the use of communication strategies between municipalities in the Netherlands. Interviews will be held at four municipalities. The municipalities and people that are selected for this research are described in the methodology chapter. Document analysis is used to analyze policy plans, brochures and flyers/leaflets from the municipalities in which they communicate about the Wmo. But before the municipalities and the methodology are discussed, the theory will be described.

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2. Theory

2.1 Strategic communication

All organizations communicate in various ways and for different purposes. Part of the communication is management, marketing, advertising and public relations. Hallahan et al (2010:5) identified that these four communication disciplines share common goals. In addition to this, the objectives and strategies to achieve the goals are also similar. Although the various communication disciplines can be conceptualized in different ways, all of these disciplines require the organization to communicate purposefully to achieve their mission (Hallahan et al, 2010:4-5).

Last century, most of these communication disciplines were separated from each other and were also executed solely. Later, the boundaries between the communication disciplines were blurred and a new concept emerged, namely strategic communication. So instead of planning each type of communication (management, marketing, advertising and public relations) independently, by installing a department for each communication discipline, the idea is to develop a carefully planned communications process (Duffy & Omwenga, 2002:146). Paul (2011:17) claims that strategic communication for governments or

government agencies consist of: “coordinated actions, messages, images and other forms of

signaling or engagement intended to inform, influence or persuade selected audiences in support for national objectives”.

Advocates of strategic communication argued that the communication disciplines that were fragmented should be coordinated in a strategic way that is not only focused on the needs of the organization and the managers, but also on the needs and interests of the

audience (Hallahan et al, 2010:6-7). In this way, organizations are able to deliver a (strategic) message that is more clear and which can help the organization to achieve their goals or mission. The municipalities we focus on in this thesis also seem to use this type of

communication. The municipalities communicate the shift in responsibility to the elderly in the society and try to convince the elderly that they are the ones who have to change their behavior. The elderly have to be more independent and self-sufficient and the municipalities facilitate the elderly when they are needy and ask for health care. Also, the municipalities try to make the citizens aware of the fact that everyone has to help, for instance as volunteer or informal caregiver, to stimulate the elderly to be independent and self-sufficient.

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The following two sections describe two communication strategies, namely: framing and nudging. These sections are followed by a section on different municipality theories that influence how the communication strategies are used. The choice for the two communication strategies lies within the fact that both strategies are used to change/steer citizen behavior. In addition to this, both of the strategies are used frequently by governments or government agencies to achieve a certain behavior change (Thaler & Sunstein, 2008 and Chong & Druckman, 2007b). Since the goal of this research is to identify how municipalities use

strategic communication to achieve the goals of the Wmo for the elderly, the choice was made to focus on framing and nudging because both strategies are strategies that governments and government agencies use frequently. This led to the expectation that both strategies are also used by municipalities in the case of the Wmo. The following section looks into framing and the section after that describes nudging.

2.2 Framing

Before a single social problem turns into a political issue, it can be defined and characterized in various ways. Governments and politicians create a political issue out of a social problem. However, the way in which a government or politicians define the political issue is important. The terms that are used to define the problem have a strong effect on the support for the issue. Because the problem definition is important to maximize support, governments and politicians will try to define or ‘frame’ problems in such a way that the support for their own position or opinion is maximized (Jacoby, 2000:750). This statement is confirmed by Chong & Druckman (2007b:109): according to them, a frame in communication can change the attitude of an individual towards an issue or change the opinion of the

individual on the issue. Governments, interest groups or other elites try to influence citizens by using frames in communication. The process of governments influencing citizens’ attitudes and behavior with frames is called a ‘framing effect’ (Chong & Druckman, 2007b:109). Furthermore, Chong & Druckman (2007b:104) claim that there is one major premise of framing theory. It is possible to look at an issue from a variety of perspectives and an issue can be construed as having implications for multiple values or considerations. This is a major premise since framing is about the process of developing a particular conceptualization of an issue or reorienting a current thinking of an individual about an issue.

The ability of governments and politicians to frame issues or policies is one of their most important ways to gain support for their public policy positions. The choice of the

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audience to support a certain issue frame rather than another does not require any (tangible) resources from them while it does influence the distribution of public responses to an issue. This means that governments and politicians are able to use issue frames at low cost with the potential to gain substantial benefits (Jacoby, 2000:751).

2.2.1 Types of framing

Jacoby (2000:751) describes two types of issue framing, namely general issue frames and specific issue frames. At first a ‘general issue frame’. This is an interpretation that focuses on the activity from the government. Little attention is paid to the benefits and costs or causes and consequences that occur because of the governmental activity. An example of a general issue frame is a statement like: “The [Dutch government] should take steps to protect the environment” (Jacoby, 2000:751).

The second type of issue framing is a ‘specific issue frame’. This type of frame explicitly links the described governmental activity with targets in society. Instead of only naming the governmental activity, actors also elaborate on reasons why this governmental activity takes place and what the consequences of this governmental activity are. An example of a specific issue frame is a statement like: “The [Dutch government] should take steps to protect the environment, in order to reduce pollution of air and water and to protect people that are a victim of air and water pollution” (Jacoby, 2000:751).

Applied to the research question of this thesis, the expectation is that municipalities use specific issue frames where they elaborate on the shift in responsibility that emerges from the new Wmo. Municipalities already emphasize that citizens have to take more responsibility and that citizens have to be more independent and self-sufficient. Municipalities

communicated these changes mostly through brochures, flyers/leaflets, information on the website and in their policy plans. This already hints at the fact that they use specific issue frames. The same goes for the need for volunteers. Municipalities elaborated on the advantages of being a volunteer or an informal caregiver in their policy plans to stimulate citizens to spend time as a volunteer and help the elderly to be more self-sufficient and independent (Gemeente Rijswijk, 2016a and Gemeente Den Haag, 2015 and Amsterdam, 2015).

Chong and Druckman (2007a:100) make another distinction in frames. There are two ways to use the term frame. A frame is defined as a ‘frame in communication’ or as a ‘frame

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in thought’. A frame in communication refers to the words, images, phrases and presentation styles that a speaker uses when he or she spreads information about an issue or event to an audience (Gamson & Modigliani, 1989:4-6). The chosen frame that is presented by the speaker, reveals what the speaker sees as relevant to the topic that is discussed. This type of frame is also known as a ‘media frame’ (Chong & Druckman, 2007:100).

The second way of defining a frame is a frame in thought. A frame in thought refers to the cognitive understanding which an individual has of a given situation. This frame does not reflect the preferences and thoughts of the speaker, but refers to what an audience member thinks is the most relevant part of an issue (Goffman, 1974). A frame in thought is also known as an ‘individual frame’ (Chong & Druckman, 2007:100).

Based on this, I expect that the municipalities use a ‘frame in communication’ to influence the ‘frame in thought’ of the elderly, to inform the elderly on the shift in

responsibility and emphasize the fact that the elderly have to be more independent and self-sufficient. The ‘frame in communication’ in this case would be that the elderly have to change their behavior into a more self-sufficient and independent type of behavior and that this new type of behavior is a positive change for the elderly. In this way, the municipalities try to gain support from the elderly for the new policy. This results in a situation in which the ‘frame in thought’ will correspond with the ‘frame in communication’ since the elderly are being framed by the municipalities to support the position or policy of the municipalities.

2.2.2 Effects of framing

In some situations, individuals are presented to contrasting frames. Earlier researches find several effects in these situations. Most of the time, one of the two frames will become dominant amongst the individuals it is trying to persuade. A frame can become dominant when the side that produces the frame can establish the relevant terms of debate over an issue. Another study from Sniderman and Theriault (2004:133-165) also tried to identify how individuals react when they receive multiple frames with varying messages or thoughts. The authors found that an individual is more likely to choose the frame which corresponds with their own values and opinion when they receive a dual message (a frame that corresponds with own values and a frame that contradicts own values) than when they receive a one-sided message that contradicts their own values. Also, more knowledgeable individuals tend to express a preference on the issue that is in line with their own values. However, the results were different for political frames. The authors concluded that framing might be less

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influential in political environments because competing frames cancel each other. Because the competing frames cancel each other’s effects, the frames will fail to move the public opinion (Sniderman & Theriault, 2004:133-165).

Sniderman and Theriault (2004) claim that competing frames can reduce the effect of the frames, but it does not have to be the case that the competing frames are equal combatants or that audiences will receive equal exposure from both frames. Actors with more resources are better able to identify the frames that are most appealing to the public because there are more resources available to conduct a public opinion research. Also, actors with more resources are better able to advertise more frequently and to hire representatives who can deliver messages to the public with high credibility (Chong & Druckman, 2007a:102). In the case of the Wmo, the expectation is that the audience receives a dual message since the municipalities are communicating to their citizens that they have to be more self-sufficient and independent while it is also expected that there are citizens that might define the

introduction of the Wmo as a pure budget cut. Based on this information, another expectation is that there are contrasting frames from other actors. These actors or individuals might argue that the introduction of the Wmo is a pure budget cut or they might argue against the fact that the elderly have to be more self-sufficient and independent. However, the government is the stronger actor in this case since they have more available resources and are able to deliver their message with higher credibility according to Chong and Druckman (2007a:102). Because the government is stronger, they can make sure that the audience does not receive equal exposure from different actors. The exposure from frames that come from

municipalities is expected to be larger. Therefore, municipalities are still able to present a dominant message.

In the earlier described situations, individuals already had their preferences on an issue. When an issue is new to an audience, and individuals have not yet developed their own preferences on the issue, they are uncertain of how the competing frames relate to their own values. In these situations, opposite sides try to convince the audience that their considerations are in line with the core values and priorities of the audience (Chong & Druckman,

2007b:113). Also, the early stages of exposure to an issue, is a period in which an individual is susceptible to frames. An individual does not have many knowledge about the issue yet. Because of this Chong & Druckman (2007b:118) argue that individuals do not have their own preferences yet and individuals are open to new arguments and information.

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Chong and Druckman (2007b:113) suggest that the strength of the opposition is one of the major determinants for an individual to support an alternative that does not correspond with his or her existing values in the situation where the individual has not formed an opinion yet. Even in situations where a frame is presented that is congruent with an individuals’ values. As long as the frame from the opposite side is stronger, it can pull individuals away. This means that by creative use of frames, it is possible to draw individuals away from its opponents. Some individuals cannot be moved. They resist information that does not correspond with their own opinion and values. In situations where two competing frames cancel each other’s effect, individuals will support the frame that represents their own values (Chong & Druckman, 2007:b113-114).

Furthermore, Chong and Druckman (2007b:111-112) emphasize that there are also moderators that influence the effect of a frame. Earlier studies found out that there are several moderator variables that reduce framing effects. One of the clearest factors that limit framing effects are individual predispositions, values for instance. The reason why predispositions limit the framing effects is that individuals are more resistant towards disconfirming information. Especially individuals that are strongly attached to certain values are hard to frame. However, even if an individual has firm values, this does not mean that they are not susceptible to framing on new issues (Chong & Druckman, 2007b:111-112).

Another moderator variable is knowledge. However, the results of studies that delved into the influence of knowledge on framing effects are contradicting. Some studies found that individuals with less knowledge were easier to frame, while other studies claimed the

opposite (Chong & Druckman, 2007b:112). Druckman and Nelson (2003:731-734) argue that the difference in results emerge from failure to control for prior attitudes. Generally,

knowledgeable individuals possess certain priors that make them less susceptible to framing. When we do control for prior attitudes, results show that knowledge does enhance framing effects. The reason for this is that knowledgeable individuals are more likely to be available for the considerations that are emphasized in a frame (Druckman & Nelson, 2003:733-743).

Two other moderator variables are the availability of other information and the source of a frame. When a frame is presented to an audience, while there is lots of other

(contradicting) information available, this can mute the effect of the frame. Furthermore, the source of a frame is an important factor. Credible sources tend to shift opinions more easily than sources with less credibility (Chong & Druckman, 2007b:112).

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A final moderator variable is activity. Chong and Druckman (2007b:118-119) emphasize that individuals become less susceptible to frames when they have an active engagement with issues. Individuals get to know all the alternative arguments. This increases the ability of an individual to evaluate the applicability of the presented frames.

2.2.3 Summary

Thus, framing is a strategy whereby governments and/or politicians will try to define or ‘frame’ problems in such a way that the support for their own position or opinion is maximized. Different types of framing can be used to maximize support. For instance a general issue frame. This is an interpretation that focuses on the activity from the government. Little attention is paid to the benefits and costs or causes and consequences that occur because of the governmental activity. The government can also choose to use a specific issue frame. This type of frame explicitly links the described governmental activity with targets in society.

Furthermore, there are several factors that determine the effectiveness of a framing strategy. A frame is considered effective when it stimulates audiences to form a different opinion that corresponds with the opinion that is presented in the frame. The effectiveness of a framing strategy depends on its design, its implementation, its competitive environment and on the resources that are available for the framing strategy. Finally, the effectiveness of a frame depends on temporal factors. Frames are less effective on established issues and among individuals who are aware of the central considerations on the issue (Chong & Druckman, 2007a:102-107).

Frames can also be counter-effective. Generally, competing frames are unlikely to push an individuals’ opinion in the same direction since both of the frames try to deliver a different message. However, it is possible that a frame has the unintended consequence of causing a recipient to counter-argue with the presented frame. Instead of being convinced by the presented frame, an individual forms a position that goes against the opinion that is

presented by the frame, which means that the frame is counter-effective (Chong & Druckman, 2007a:105). The effectiveness of framing will not be taken into account in this research but the effectiveness is described in the theoretical framework to get a better understanding of how framing works and how framing can be influenced by other factors.

Now framing is described and discussed, I will look into the other communication strategy: nudging. After nudging, the theories on municipalities are described.

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2.3 Nudging

Thaler and Sunstein (2008:6) define the term nudging as the following: “Any aspect of

the choice architecture that alters people’s behavior in a predictable way without forbidding any options or significantly changing their economic incentives.” Nudging consists of three

aspects, namely: choice architecture, a libertarian aspect and a paternalistic aspect. First the choice architecture. A choice architect is responsible for organizing the context in which individuals make their decisions. In other words, the choice architect can influence the way in which alternatives are presented to individuals (Hausman and Welch, 2009:123-125). Many people are choice architects without even realizing it. A choice architect can vary from a doctor that has to describe alternative treatments that are available to a patient, to a parent who describes possible educational options for their children. The way in which the doctor or parent describes the alternatives can influence the choice of the individual that has to choose one of the alternatives. This means that a choice architect does not only decide the context in which individuals will make their decisions, a choice architect also influences the choice of the individual with the context he or she develops (Thaler & Sunstein, 2008:3-4).

The second and third aspect are close-related. Both aspects fall under the classification of libertarian paternalism. The term seems contradictory since it combines two, at first sight, contradictory concepts. Nonetheless, when these two concepts are understood properly it is possible to put them together. First the libertarian aspect. This aspect is pretty straightforward. Individuals should be free to do as they please and to choose undesirable options if they want to. In other words, individuals should have full freedom of choice. This means that the word libertarian in ‘libertarian paternalism’ refers to the preservation of liberty and freedom of choice. The paternalistic aspect refers to the claim that it is legitimate for choice architects to try and influence individual behavior in order for the individual to make better choices for themselves and for society. This means that this aspect of nudging supports institutions or governments or any other choice architect to steer people’s choices that will improve their lives (Thaler & Sunstein, 2008:4-5).

A nuance has to be made in terms of the paternalistic aspect since it is not a strong form of paternalism where choices are made for others. It is rather a relatively weak and nonintrusive type of paternalism. Options are not forbidden or blocked off. If a choice

architect tries to reduce smoking, this does not mean that it will be impossible for individuals to still smoke. If an individual wants to smoke a cigarette, he or she can smoke one. Choice

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architects are just trying to move individuals towards more optimal decisions which will make their lives better or in this case healthier (Thaler & Sunstein, 2008:5-6).

John et al. (2011a:22-23) also argue that there is no such thing as an infringement on individual freedom in the case of nudging. Governments are elected and put in place to do the best job of administering public services on behalf of the citizen in a way that is as efficient and cost-effective as possible. Using nudge strategies is a way for governments to address problems in a cost-effective way while maintaining full freedom of choice. Also, citizens help and take part in addressing the problems. This indicates that nudging can be a good alternative for other intervention tools for governments. The perception of citizens when it comes to nudging is still problematic. Standard types of intervention (regulation or taxation) are open and explicit about their intentions. Nudges, on the contrary, can be perceived as ‘we the government know better what is good for you than you do and we have found a sneaky way of getting you to make the right choice’. To avoid a situation where citizens experience nudges as misleading or as a form of manipulation, policymakers have to make sure that they are transparent and responsive when they design and implement nudges. Based on this, it is interesting to see how the Dutch municipalities developed and implemented their

communication strategies. If policymakers are transparent, chances are higher that citizens accept nudges and do not perceive them as form of manipulation or trickery. In the case of the Wmo, citizens might perceive the prescribed change in their behavior as a pure budget cut and a way of the government to withdraw from its responsibilities. When transparency is absent, interventions have the risk of being seen as illegitimate. As a result of this, the interventions will be ineffective. This means that nudging strategies have to be as public as possible (John et al, 2011a:22-23).

Based on this, I expect that the municipalities try to be as transparent as possible when they are using nudges to avoid a situation in which citizens perceive the nudge as a form of trickery or manipulation since this comes at the expense of the effectiveness of a nudge.

Condagnone et al. (2014:909-911) agree on the statement that government

intervention has to be transparent. According to the authors, every form of policy intervention will impose a criterion against someone’s will and democracy requires two things. First, policy makers have to be transparent in the terms of the values they selected in deciding and designing an intervention. Second, they also have to elaborate on why they choose those values. The policy makers have to justify their decision in terms of selecting values (Condagnone et al, 2014:909-911). Thaler and Sunstein (2008:11) also argue that it is

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important that choices remain unrestricted. Or in other words, the intervention from the government should not lead to a situation where certain options are blocked off for an

individual. This lowers the chances of an individual to perceive a nudge as misleading or as a form of trickery.

Thaler and Sunstein (2008:10-11) add that nudging should not be seen as a limitation to someone’s freedom of choice. They argue that individuals perceive nudging as paternalistic based on two misconceptions. The first misconception is that people think it is possible to avoid influencing people’s choices. However, there are many situations where some sort of organization or agent must make a decision that will influence or affect the behavior of some other individuals. It is inevitable in these situations to avoid nudging in some direction, and whether these nudges are intended or not, these nudges will affect the behavior and choices of an individual. A small example to illustrate this may be a lunch in a cafeteria. The owner of the cafeteria can decide in which way he or she wants to present the food he or she offers. The way he or she arranges the products influences the choices customers will make in terms of ordering food. In this example, the owner of the cafeteria is the choice architect. The people’s choices are pervasively influenced by the design elements selected by choice architects (Thaler & Sunstein, 2011:10). This example shows that a small occasion like buying lunch is already a situation in which behavior is being steered.

The second misconception that Thaler and Sunstein (2008:11) describe is that many individuals think that paternalism always involves coercion. In the cafeteria example, the owner can choose in which way he or she wants to order the different food products. The owner may choose to put all the healthy food in the front. This may higher the chances that people will order healthy food more often, but it does not force a particular diet on anyone. This means that paternalism does not always involve coercion. Since no coercion is involved, Thaler and Sunstein (2008:11) argue that some types of paternalism should be acceptable, even to those individuals who most value the freedom of choice.

2.3.1 Nudging as intervention tool

John et al (2011a:20-21) argue that governments experience more difficulty in

addressing common challenges and other problems in society nowadays than before. Since we live in a period of fiscal austerity, the spending option is no longer easily available for

governments. This means that governments have to address problems in other ways and that the government is more reliant on citizens helping themselves and others. Another ‘problem’

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that is relevant nowadays is the fact that citizens do not simply comply with everything the government tells them to do. Citizens question governments’ action more often and

sometimes they simply ignore government action. Based on these facts, it is obvious that the government has to come up with a different strategy to address domestic problems. In this more challenging age, it is important for governments to look past financial instruments and regulation and expand their set of intervention tools according to John et al (2011a:21). This is why they argue that nudging can fill the gap in the ability of the government to address domestic problems.

Governments mostly used regulatory and economic instruments to change civic behavior in the past. While these more traditional tools can result in the preferred outcome, they can also be problematic in several ways. First, punishment and rewards can be very costly or difficult to enforce. Punishment and rewards requires the government to closely monitor the citizens to determine whether citizens should be punished or rewarded. Also the punishments and rewards themselves can be costly. Second, incentives are often crude instruments. Incentives can bring the right consequences but can also bring (unpopular) unintended consequences with them. Third, rules and incentives mostly need clarification in terms of norms, values and benefits for citizens to understand the implementation of it. Finally, the government is limited in the use of regulatory and fiscal incentives to shape civic behavior since the public will not accept too many rules and legislation which restricts their behavior. (John et al, 2011b:361-363).

A good alternative for governments to connect with citizens and change civic behavior in a gentle way is nudging (John et al, 2011b:361-363).Since societies have changed through time and civic behavior has to be changed in different ways, the government tries to find intelligent ways to encourage, support and enable people to make better choices for

themselves. Too many rules and legislation can lead to resistance from the public. While both rules and legislation are still useful for governments, it is necessary for governments to use a larger variety of tools to prevent that citizens feel like their options are being limited. A way to still change civic behavior without limiting the options of the citizens can be achieved at relatively low costs, namely through nudging (White, 2011:1). Because these type of policies cost little or nothing, they impose no burden on tax payers. (Thaler & Sunstein, 2008:13).

Nudging is based on the bounded rationality assumption. According to this

assumption, rationality is bounded because the brain has cognitive limitations and the world is a complex place to understand (John et al, 2011a:11-12). When it comes to decision making,

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this results in a situation where an individual does not consider every available option nor always makes the optimal choice for their own utility or for the utility of society. Decisions are often driven by inner thoughts, habits or feelings and emotions. Because decisions are driven by these factors, the brain helps the individuals to focus on some things but ignores other (relevant) factors. Rationality is bounded by this framing of the human mind. John et al (2011a:12) argue that: “People will search selectively, basing that search on incomplete

information and partial ignorance, but terminate it before an optimal option emerges, and will choose instead something that is good enough”. This type of decision making cannot be

defined as purely irrational. Individuals do base their decision on goals and they are able to explain why they made a certain choice. The outcome of the decision making process is just not always optimal, which results in situations where individuals make decisions of poor quality (John et al, 2011a:12).

Thaler and Sunstein (2008:23-43) argue that there are many factors that can mislead or result in mistakes in human judgement. Human judgement and decision making can be

affected by heuristics such as anchoring, availability and representativeness but it can also be affected by factors such as optimism and overconfidence, loss aversion, a status quo bias, framing, inertia and akrasia, and myopia. Finally, human judgement and decision making can be affected by inattention and error (Thaler & Sunstein, 2008:87).

Based on these facts, Thaler and Sunstein (2008:74) developed the golden rule of libertarian paternalism: “offer nudges that are most likely to help and least likely to inflict

harm”. They add to this that: “people will need nudges for decisions that are difficult and rare, for which they do not get prompt feedback, and when they have problems translating aspects of the situation into terms that they can easily understand”.

Nudging has several benefits in comparison to other intervention tools. While other intervention tools are mostly very costly, nudges can be implemented at relatively low costs. The use of nudges as intervention tool instead of other intervention tools like laws, rules or bans can save a lot of money for the state. This money can be spent to solve other social problems or to achieve other social goals (White, 2011:1). Apart from the implementation of a nudge, costs do not differ too much from other intervention tools since there is still much research needed to identify what the best way is to develop and design the nudge. When it comes to designing and developing nudges, it is important to think about how the individual will experience and perceive the nudge. Also, it is important to present the nudge in a way that it works most effective (John et al, 2011a:14-15).

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In the context of this study, the expectation is that municipalities also use nudges to change the behavior of the elderly since nudges can be implemented at relatively low cost. Because the costs are relatively low, it can be an efficient tool for municipalities to convince the elderly that they should take more responsibility and have to be more self-sufficient and to stimulate citizens to participate as a volunteer. Since all municipalities have to spend their money in a more efficient way since the decentralization of the Wmo from the government, it is likely that they also try to use strategies, like nudging, that are cost-efficient.

Another benefit of nudging are the results of a nudge. When a nudge is successfully implemented and functions in an effective way, civic behavior is steered towards choices which are better for themselves as well as for society. This in turn would constitute improvements for their own well-being as for society as a whole. The main idea is that citizens can be offered a choice architecture that encourages them to act in a way that

achieves benefits for themselves and for their other fellow citizens. While laws and rules can also accomplish this, nudging accomplishes it while full freedom of choice remains. Laws and rules mostly take the full freedom of choice away by limiting options (John et al, 2011a:9-10). Furthermore, Thaler and Sunstein (2008:78) emphasize the fact that nudging can also be an eye-opener to some citizens. While nudging is steering people towards a certain choice, it can also offer new alternatives which an individual could not think of themselves.

2.3.2 Effects of nudging

While nudging is widely used (Berreby, 2016), there is still little information on the effects of nudging and on which factors determine the effectiveness of a nudge. Despite the fact that there is little information on nudging effects, I would still like to formulate an expectation based on what I have read on nudging. The expectation is that the effects of nudging are influenced in a similar way as the effects of framing. In this thesis, nudging is considered to be a communication strategy, just as framing. Nudging is considered to be a communication strategy because the municipalities present a certain choice architecture to the citizens. This is a form of communication, since a certain choice architecture is presented to the citizens. This is similar to the process of framing whereby the municipalities communicate with their citizens by presenting a frame instead of a certain choice architecture. Furthermore, nudging is also considered to be a strategy since the choice architecture is developed

strategically. Designers of nudges and the choice architecture develop and implement nudges based on existing theories and thorough research to make sure that the frame is effective (Sunstein, 2014:3). Since nudging and framing are both considered to be communication

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strategies, they are both also communication strategies whereby the perception of the

audience is important. The way in which an individual perceives the communication strategy can determine the choice an individual eventually makes. Therefore, it is expected that the effectiveness of a nudging strategy also depends on its design, its implementation, its

competitive environment and on the resources that are available for the nudging strategy as is the case for framing. Since this study does not look at the effectiveness of a strategy, this expectation will not be discussed in the discussion.

Since there is little information on these effects, I will also look into the design and implementation of nudging and into some of the criticisms of nudging. Because nudging is still fairly new, literature on the design and implementation is limited and there is still a lot of skepsis and criticism on the communication strategy. Authors also point out certain challenges that nudging is facing. This research may offer solutions for some of the challenges and criticisms.

2.3.3 Design and implementation of a nudge

Goepel et al. (2015) conducted a study on the design of nudges towards a sustainable society. In their research, they developed a set of phases and steps that are important for the design of a nudge. The first phase is called ‘Target behavior’. Within this phase designers should define the desired behavior, define success metrics and analyze behavior based on behavioral science. The second phase is ‘Current reality’. It is important to collect and analyze data in this phase to understand the current behavior of the target group and to understand what consequences the new behavior might bring. Furthermore, designers of the nudge try to obtain a solid understanding of the relevant context in which the behavior is displayed and designers of the nudge set a benchmark to measure success against in a later phase of the process. The third phase is ‘Design intervention’. Designers brainstorm and come up with several interventions and eventually one of these interventions is selected. The fourth phase is the ‘Project phase’. This is where the selected intervention is implemented as a pilot and is being monitored. This phase is followed up by an evaluation where success is measured and feedback is being used to improve the designed nudge. In this phase, learned lessons from the previous phases are applied. The final phase is called ‘Scale up/out’. In this phase, the intervention is repeated on a larger scale when the intervention is effective (Goepel et al., 2015:34-40).

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Sunstein (2014:1-3) wrote an article on nudging in which he presented a short guide of nudging. In this article, he states that nudges should be based on evidence and thorough research to develop a relevant choice architecture. Before a nudge can be implemented, this evidence has to be present and thorough research has to be conducted. Also, when a nudge is implemented, it should not limit the choice set of an individual or make alternatives more costly for an individual. In addition to this, transparency is important when a nudge is implemented. When the public is able to review a nudge in the same way as other type of interventions from the government, it is less likely that the public perceives a nudge as a form of manipulation or trickery.

John et al. (2011a:22-23) also claim that transparency is important by stating that policymakers have to make sure that they are transparent and responsive when they design and implement nudges.

2.3.4 Criticisms of nudging

First, once we enter into the practical implementation of a nudge, the boundary between choice architecture and social engineering becomes fuzzy. It is hard to tell whether citizens have full free choice or whether the choice is limited and it is more a soft form of paternalism. Second, nudging can be experienced as potential deception. Ethical problems with nudging may occur because of this. Chriss (2015:89) argues that the paternalistic character of nudging may lead to public backlash. Most of this public backlash consists of complaints that individual liberties are jeopardized because the government is making choices for the individuals. Third, it is unclear how nudges should be designed and implemented in a way that complete autonomy is preserved and manipulation is prevented. This is one of the main criticisms (Condagnone et al, 2014:909-911).

Nagel (2011) adds that designers of nudges should also be aware of potential biases that influence an individuals’ behavior. Also, they should know which biases should be worked with and which biases should be challenged. According to Nagel, a bias that can be nudged does not mean it should be nudged. Sometimes other policy tools are able to achieve better results. The point Nagel eventually tries to make is that designers of nudges and choice architects should understand biases, develop and include procedures to determine which biases should be nudged, maintained, prohibited, challenged or abandoned (Nagel, 2011).

This research looks at how municipalities use nudging to achieve the goals of the Wmo. It can offer new insights on whether the nudges that are implemented are more

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paternalistic or mostly focused on preserving full freedom of choice for the elderly. It can also identify whether the municipalities are aware of biases and whether they take these biases into consideration when they design and implement a nudge. In addition to this, the research can help to identify which other factors are important when it comes to designing and

implementing a nudge. This can fill a gap in the literature of nudging.

Second, Selinger and Whyte (2011) criticize nudging for its patronizing character. Basically, nudges are implemented to change civic behavior and steer citizens towards right choices, based on the assumption that citizens cannot make the right choices themselves. Proponents of nudging deny this criticism by stating that nudges only changes the choice architecture and that people still have full freedom of choice to make their own decision. In addition to this, nudging is based on the bounded rationality assumption which means that individuals do not make optimal choices. The government is helping these individuals with nudges to steer them towards better decisions. Criticisms partially agree with proponents of nudging in the sense that choice architecture is unavoidable and cannot be morally

problematic in itself. On the other hand, changing individuals’ choice architecture to have them make better decisions tends to work best when these individuals are unaware that they are being nudged. Considering this assumption, criticisms think Thaler and Sunstein oversell the preservation of choice and non-intrusive credentials of nudges. Would individuals be okay with the idea that their behavior is changed in a way that they are unaware of when they value freedom of choice? This is why Selinger and Whyte (2011:928) argue that “though there is a

sense in which those being nudged have the same set of choices available to them, perhaps it is not one that is acceptable to those who worry in particular about their degree of freedom in society” (Selinger & Whyte, 2011:928).

2.3.5 Summary

Nudging strategies are strategies whereby the government tries to alter citizens’ behavior while preserving citizens’ full freedom of choice. The government tries to steer its citizens to more optimal choices for themselves as well as for society because citizens cannot make these optimal choices themselves due to a bounded rationality. Hausman and Welch (2009:126) developed the following definition of nudging: “Nudges are ways of influencing

choice without limiting the choice set or making alternatives appreciably more costly in terms of time, trouble, social sanctions and so forth. They are called for because of flaws in

individual decision-making”. In addition to definition from Hausman and Welch (2009),

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1. Freedom of choice: Nudges should not block off any options. An individual should be able to deliberately diverge from a nudge.

2. Transparency: The process of nudging should be as open as possible. The citizens should have the possibility to review nudges the same way as other governmental actions. A nudge should never be used as a form of trickery or a manipulative maneuver.

3. Effectiveness: When nudges are designed and implemented in a proper way, they should lead to a situation in which they protect citizens from economic and/or physical harm.

4. Evidence: It is important that nudges are based on evidence and thorough research just like other policy work in order to develop a relevant choice architecture. The most effective nudges tend to draw on the most valuable work in behavioral science. 5. Testing: Before a nudge is implemented, it should be tested. Testing a nudge helps to

anticipate on unintended or adverse consequences. Furthermore, it avoids extra expenses or efforts.

In this thesis, nudging is considered to be a communication strategy because the

municipalities communicate with their citizens by presenting a certain choice architecture to their citizens which is developed in a strategic way to change civic behavior. The nudge can be improved during the process of using it by setting benchmarks to measure success against and by processing feedback that is obtained from researchers or citizens. In the case of the Wmo, the municipalities try to nudge the elderly to a more independent and self-sufficient type of behavior. Also, municipalities try to nudge its citizens to participate as volunteer. This differs to some extent for informal caregivers. Informal caregivers are volunteers that already have a personal relationship with the individual that needs help. The informal caregivers do not really have a choice when it comes to the decision of helping the individual or not. The government expects that family or friends support an individual when it is possible for them to help. When an individual does not have family or friends who are able to help, municipalities look for volunteers to support the

individual. These volunteers do not already have a personal relationship with the individual.

2.4 Municipality theories

The goal of this research is to identify whether municipalities used nudging and framing and to explore how the communication strategies are used by the municipalities. This

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means that the focus lies on the mechanisms that take place at the municipalities. Since municipalities are researched, it is important to look for existing theories that might explain differences in use of the communication strategies and play part in the mechanisms. The following three sections describe three different theories that might play a role in how the municipalities use their communication strategies and might play a role in the choice for a certain communication strategy. The first theory that is described is a theory on the

administrative and technical capacity of municipalities. The second theory is about institutional isomorphism and the last theory is about cooperation between municipalities.

2.4.1 Administrative and technical capacity

The first theory is about administrative and technical capacity. Minzer et al. (2014:547-550) claim that nonprofits or municipalities with greater administrative and technical capacity are better able to offer more effective service delivery, achieve better outcomes for service recipients and their communities and are better able to communicate to its recipients since they have more resources. This claim is also supported by Plummer and Speak (2002) and Blore et al. (2004). Plummer and Speak (2002:1-2) claim that

municipalities with greater administrative capacity are better able to stimulate community participation. In addition to this, these municipalities are faster in drafting legislation,

reformulating programs when needed and reconsidering approaches. Blore et al. (2004) add to this that municipalities with greater administrative capacity are also better capable in

responding to governmental decentralizations. Since the Dutch Wmo is a decentralization from the government, it is interesting to see whether the Dutch municipalities that differ in terms of their administrative and technical capacity use their communication strategies in different ways. Because the administrative and technical capacity of a municipality is assumed to be very important in this case, I chose to investigate municipalities that differ in terms of their administrative and technical capacity. The administrative and technical capacity of municipalities is considered to be a decisive factor in the process of using a communication strategy since it determines the speed of developing and implementing a communication strategy, how the communication strategy is used by the municipality and how much resources a municipality has to execute the communication strategy. Based on the theory of administrative and technical capacity, it is expected that municipalities with a greater administrative and technical capacity have more resources, and therefore have more options when it comes to designing, implementing and executing their communication strategy. The expectation based on this information is that municipalities with greater administrative and

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technical capacity are able to implement their strategy in a broader way than municipalities with a smaller administrative and technical capacity since they have more resources. In other words, it is expected that municipalities with a larger administrative and technical capacity are better able to implement their communication strategies on a larger scale than municipalities with a smaller administrative and technical capacity since they have more resources.

Municipalities with a smaller administrative and technical capacity may not have the resources to implement and execute their strategy on a large scale. Also, it is expected that municipalities with greater administrative and technical capacity are better able to involve other parties or actors who can help to implement and execute the strategy since these

municipalities have more resources to attract these parties or actors than municipalities with a smaller administrative and technical capacity.

2.4.2 Institutional isomorphism

The second theory that plays a part in the mechanism of using communication strategies by municipalities is institutional isomorphism. DiMaggio and Powel (1983:147-149) claim that units within a population that are faced with the same set of environmental conditions will become more similar or identical to each other in form. While most early studies of isomorphism looked at nonprofits and business firms, Frumkin and Galaskiewicz (2004:283-307) focused on governmental agencies. The authors researched whether the institutional pressures for governmental agencies were different from institutional pressures for nonprofits and business firms. The authors discovered that government establishments are in fact more vulnerable to all three types of isomorphism, namely: coercive, mimetic and normative isomorphism. Coercive isomorphism stems from political influence and situations in which organizations have to deal with similar laws and regulations. The political influence and legislation forces organizations to be more alike. Mimetic isomorphism stems from uncertainty. When organizations are uncertain about their own structure and policies, they imitate other organizations that are faced with the set of environmental conditions but perform better. Lastly, there is normative isomorphism. This is a process of homogenization that is driven by pressures brought about by professions and moral norms (DiMaggio and Powel, 1983:150). The phenomenon of institutional isomorphism is also acknowledged by Villadsen (2013) and Rainey (2009). In the case of the Wmo for the elderly, all municipalities do not necessarily face the exact same environmental conditions but they do face the same objective, namely: stimulating the elderly to be more independent and self-sufficient and stimulating citizens to participate as volunteer. They also face this same objective under the same

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circumstances. All municipalities have to spend their money in a more efficient way since the decentralization of the Wmo from the government. Therefore, it is possible that municipalities with effective communication strategies are being copied by other municipalities that are struggling. This is when the process of isomorphism starts. Since this research also investigates why municipalities made certain choices within the process of developing,

implementing and using their communication strategies, it is interesting so see if isomorphism plays part in this process.

Based on the fact that units within a population that are faced with the same set of environmental conditions, or in this case are faced with the same objectives and

circumstances, will become more similar or identical to each other in form, it is expected that municipalities copy each other’s communication strategies when they seem to be effective or when a good communication strategy is absent in a municipality since the municipalities all face the same objective. This means that it is expected that municipalities may end up using the same communication strategies through institutional isomorphism. However, I do think that the execution of the municipalities may differ since all municipalities have to adjust the strategy in a way so it fits their own environment and citizens.

2.4.3 Cooperation between municipalities

The third and final theory that plays a part in the mechanism of using communication strategies by municipalities is cooperation between municipalities. When municipalities have a close relationship and cooperate well together, it is possible that these municipalities end up with the same choice of strategies and policies. An earlier research of Dutch municipalities from Homburg, Dijkshoorn and Thaens (2014) confirms this statement. In their study, the authors describe that municipalities are important providers of electronic public services to their citizens. All Dutch municipalities had to adopt new personalized services that fit the needs of the citizens. The authors found that the Dutch municipalities were cooperating and sharing knowledge when they had to seek for new electronic services and had to adopt their electronic services. While municipalities generally are relatively autonomous, they do

cooperate when they are faced with the same (difficult) challenge (Homburg, Dijkshoorn and Thaens, 2014:432). This indicates that it is possible that municipalities will cooperate with each other since they are facing the same difficult challenge, namely: stimulating the elderly to be more independent and self-sufficient and stimulating citizens to participate as volunteer. Because municipalities might cooperate while facing the same challenge, they may also end up with the same communication strategy. Based on this theory, it is expected that

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municipalities that do cooperate on a regular basis since the introduction of the Wmo will end up using the same communication strategy. The execution of the communication strategy will not be entirely the same since the communication strategies are fitted to the own environment and citizens.

2.5 Expectations

Applied to the research question of this thesis, different expectations were formulated based on the discussed theories. All the expectations are listed in table 1. The expectations are listed for each theory and will be discussed in the discussion.

Theory Expectations

Framing 1. Municipalities use specific issue frames where they elaborate on the shift in responsibility that emerges from the introduction of the Wmo and on the positive consequences of the behavior change. Municipalities also elaborate on the need for volunteers and the positive consequences of participating as volunteer.

2. Municipalities use a frame in communication to influence the frame in thought of the elderly.

3. The audience (elderly and other citizens) receive a dual message which is presented by the municipalities and citizens themselves.

4. The municipalities are able to deliver a dominant message over contrasting messages from other actors.

Nudging 5. Municipalities are as transparent/public as possible when they use nudges to avoid a situation in which the nudge is perceived as a form of trickery or manipulation, and thus a situation in which the nudge is less effective. 6. Municipalities use nudges since their implementation costs are relatively low compared to other intervention tools.

Administrative and technical capacity

7. Municipalities with a greater administrative and technical capacity are better able to implement their communication strategies on a larger scale than municipalities with a smaller administrative and technical capacity since municipalities with a greater administrative and technical capacity have more resources.

8. Municipalities with a greater administrative and technical capacity are better able to attract and involve other parties or actors who can help to

A multiple case study on the use of communication strategies by Dutch municipalities: How did the municipalities use communication strategies to achieve the goals of the Wet Maatschappelijke Ondersteuning for the elderly?