Day 2-Harnessing behavioral science to uncover deeper truths

— Excited to talk about passion of behavioral science and how it applies to design to sustain behavior change

  • Behavioral scientist and applying BS to design of digital expereinces

— Way to understand what people do and why, in more long-term and meaningful way

— In healthcare, goal to get people to pick a new way of behaving for outcomes like better health

— Often feels like on hamster wheel and short-term metrics, but unfortunately this is not how we should measure success

  • File of people’s feedback on digital experience with us, but site visitors were strong, so successful
    • Founder had attitude to coach people to not need us anymore, and had lot of churn, but strong outcomes and improved health

— Often see above, and little shift in 15 or so years

 

— Introduction term of “nudge” into design, has opened up appetite for behavioral change

  • Shift in choice architecture, that makes it more likely for one choice for another

— Lot of business owners and leaders look at way to infuse design with behavior change capabilities, and expectation of magic wand

— Examples of nudges in 401(k) and urinals having fly to keep things a little cleaner

— But my example will focus on driver’s license and organ donation

— In U.S. it’s an opt-in, but there was nudge to make any opt-out and affirmatively choose not to do this

  • Registries to see if opt-outs could work

— Great for organ donors

— Not really though, but nudge countries have greater donation among deceased donors, and not impact you might think, but also follow-up and following up on behavioral pathways

  • By not thinking about nudges systematically, not leaning into promise of it

— Headlines from academic journals is that nudges aren’t worth it

  • I believe nudges have place in behavior change journey and if used intelligently, and can be really effective and throw baby out with bath water

— Analogy of road for behavior change

  • Imagine driving at night and bored and by self

— Nudge as fast food signs on an exit, and long stretches of road between exist

— BCTs as long-stretches of road, and different theory based methods to change behavior, and more long-term to keep you focused on the road

— Think of engagement on two levels

  • “Little e” in building out engagement hooks to get people to engage with what’s building, and establish personal relevance to capitalize on cognitive biases people have, and encourage engagement
    • Good design is great for this kind of engagement
  • “Big e” is where change applies the most. By giving people skills to overcome barriers to new behaviors and do it long term

— Rich toolkit and framework to pull from to do this, and which one to use, depends on those that aren’t trendingand looking for long tail of evidence for the work, and flexibility of models and tools need to be compatible

  • Use literature review to figure out what tools would work best

— Focus on COM-B and behavior change wheel

— TLDR on this is here, where if person performs capability, must have elements of CMO

  • Capability: Psychological and physical ability to do something
  • Motivation: Reflective and Automatic of mental models and what we have to understand behavior
  • Opportunity: Where environment takes place, digital or physical and what’s acceptable

— Opportunities about that, and checking boxes will get behavior

— Simplified view, but you can do a lot with this from behavior and design perspective

  • Have theoretical domain framework and skills for why someone can do a behavior or not, and like this framework for decision tree

— Long-tail of evidence stopping people from performing behavior

— Can focus on techniques to drive behavior and then sustain it

— In action, love using mixed-methods

  • Self-report like survey and interviews. Telling story to understand how org influences behavior and requires active listening on part of researcher and come through it afterwards

— Starts with what it’s like to do behavior and people are equipped to tell a story

  • Much richer answers come from this
  • Follow-up
    • COM-B domains that make behavior easier
    • Can do survey to provide with longer full-text answers and which COM-B determinants are at play

— Limitation to any self-report in accuracy

— Action-Intention Gap: People intend to do behavior but don’t do it for whatever reason

    • So we can’t accept self-reported data blindly.

— We also don’t introspect that deeply about why they behave in a particular way

  • Mental models around behaviors and like asking goldfish to tell you about water
    • Hard for anyone to report how culture has impacted your experience, as no contrast to compare it to
  • Need other methods for self-report to get business

— Participatory design methods are very helpful and hard for participatory design sessions, and express things in traditional ways and not obvious to themselves

— Two specific mixed methods projects I’ve taken on

— First project from design consultancy, and problem of consturction safety got far better, consistent amount of high fataltities in the US

  • Visited three sites across the US and interveiws with workers and supervisors, and observing behavior on site

— First few interviews, and ask about time of safety risk, and people said they didn’t do so

  • Site observations said otherwise

— Once pointed it out, could get commentary of why they were doing it

  • Took risk because of competing pressures. People understood safety, but also pressure to get work done on certain time, and that would win out

— At Lirio, did nudging for people to get vaccinations, and people could be eligible for 1-4 different vaccines, and history of Covid-19 vaccines and doing this right

  • Doing something that wouldn’t create negative reaction, but as comfortable as everyone to get

— Focus on flu and other vaccines and eligible vaccines

— Found overwhelming that people preferred seeing all vaccines listed out, and implemented content token with how message appears

— Saw that self-report was accurate and when nudged specific type of vaccine and taking up shortly thereafter

— If done well, nudges are sparingly used, but for sustained behavior need other behavioral principles

  • Grasp how people are behaving the way they area

— Promise of psychology of getting people started and going for the long-term

— Hope this is something you should apply for your own work

Q&A

  1. Any favorite examples where expertise and science applied for ill in support of negative outcomes and ethics of this work?
    1. Book of Design for Evil by Chris Notter, and goes through nudge type designs for evil purposes, and in real-life no ones that are more subtle
    2. Collect pop-ups for newsletter, and “No” will be labeled as something else
    3. Facebook using tests on different language framing and how it impacted moods, as formal research study — strong feelings that this was how it impacted person throughout the world
  2. Differences between COM-B and Fogg model
    1. Don’t use Fogg model, but behavior is what happens when trigger occurs for a motivated person and ability part — and analogues
    2. COM-B model came out 2010-2011, and top-down approach for framework and evidence for me
      1. More bottoms up and Dr. Fogg’s Labs and motivation and self-determination theory of motivation
  3. Good ways help to think of stakeholders as relational tool versus nudge enabler?
    1. Challenge of my career, and do work with logic models and boring tool to help map out expected timeline of behavioral science approach and big meaty results— mapping out what happens for us to get there
    2. If you can get buy-in to logic model and getting someone to click and attend appointment and changing diet and take medication and agreed upon artifacts to go to, and makes conversation less defensive
  4. Examples of where self-report more accurate?
    1. Self-report is not as bad as where it gets report from. Gold-standard for certain phenomena— i.e. understanding pain someone is in
      1. Used validated data results to see how accurate self-report was in healthcare, but relatively small and pharmacy data
    2. Research and psychology where people will be honest with stigmatized health, and using Cloud Research for AI interviewer to talk people after presidential debates, and automated thing in loop might lead to different type of data.