Designing for Behaviors in Healthcare

Notes from “Designing for Behaviors in Healthcare” 

 

CREATING Behaviors – Behaviors are a response to a unique Trigger, require a specific Ability, and are generally in response to a precise Motivation. 

COMMUNITY – Essential to long-term success of a behavior. People adopt the behaviors of their peers.

 

The Fogg behavioral model: B=MxAxT

 

Behaviors are specific. “Quitting smoking” or “losing weight” is not a behavior.  A behavior is “smoking every day after lunch” or “eating something sweet after dinner.”

 

Changing behaviors is hard and can be a lifetime struggle. People who have difficulty losing weight will spend a lifetime struggling to lose weight. Recidivism in smoking-cessation is dramatic and most smokers require 9-10 attempts before they will finally quit smoking.

 

There is a spectrum from a conscious behavioral change to a (sub)conscious habit to an (un)conscious reflex. Moving a desired behavior from one end of the scale to the other is a slow and   continuous process.

 

Generating a positive emotional state immediately in response to a change in behavior is critical in making that behavior lasting. Positive emotional states can be as simple as expressions of positivity, or the receipt of unanticipated praise/recognition. Financial rewards and repetitive stimuli rarely have a lasting impact in behavior matainenance. 

 

Identifying the (often unconscious) Triggers are key to altering a behavior. Triggers are often environmental, which is why changing the built environment in the home or the office (placing exercise equipment everywhere; banishing high-calorie snacks and replacing them with fruit & nuts) can have a dramatic effect on habit formation.

 

Generating a specific Activity in response to an undesired behavior is hard and a better attempt is to chose a very simple activity (a “tiny habit”) which can be completed quickly requiring little cognitive load. Generating praise for the completion of the tiny habit (even if it feels false) tricks the mind into rewarding itself for each subsequent iteration of the habit.

 

Cognitive load (self-dicipline) is like a muscle: it needs to be continually worked out to become strong and is easily exhausted. Attempting to perform many cognitively demanding behaviors  results in faulty behaviors as one’s will-power progressively declines.

 

Community and Social Network are essential to the success of long-term behavior modification. People mirror the behaviors of others, particularly those they perceive as being in their peer group. Many behavioral characteristics (loneliness in seniors, for example), can be alleviated by creating social groups focused around a pleasant activity that have as a byproduct the alleviation of undesired behavior (cooking circles, for example.) Finding peer groups that exhibit a desired behavior and associating with them is a major driver to adopting that behavior.