The Science Behind Behavior
Change

@ehekler

Dr. Eric Hekler
Arizona State University
Welltok Health Optimization Leaders...
Why now?
Consumer-driven health

Image courtesy of Jawbone

@ehekler

Healthcare incentives shifting

Flickr - echo0101
Technology is becoming very
powerful
Deep Blue

Watson

Flickr - jntolva

@ehekler
Just in Time Adaptive Interventions

@ehekler
The DIY Self-Experimentation Toolkit

Home-based
Sensing/feedback

Selftracking

?
Design Portal
@ehekler
Married male, 47
• Symptoms
– Tired
– Lack of concentration
– listlessness

• Self-reported
behaviors
–
–
–
–
@ehekler

Sm...
Scenario

Flickr – DES Daughter
What drives behavior?

@ehekler

Flickr - JHTNS-
Image courtesy of Dr. BJ Fogg
@ehekler

http://iprofs.files.wordpress.com/2013/07/elephant_rider_path
Image courtesy of Dr. BJ Fogg
The COM-B system: Behaviour occurs as an
interaction between three necessary conditions
Psychological or physical ability
...
Slide courtesy of Dr. Susan Michie
Interventions

Interventions:
activities
designed to
change
behaviours

Slide courtesy of Dr. Susan Michie
Intervention functions

Policies:
decisions
made by
authorities
concerning
interventions

Michie et al (2011) The Behaviou...
Behaviour-change
techniques taxonomy

@ehekler
Married male, 47
• Symptoms
– Tired
– Lack of concentration
– listlessness

• Self-reported
behaviors
–
–
–
–
@ehekler

Sm...
What behaviors would you
prescribe?
• 30 minutes of
physical activity per
day
• 5 Fruits & Veggies per
day
• Avoid process...
How might you help him to enact
the prescribed behaviors?
• Refer to evidencebased/informed
program

• If doesn’t exist…
–...
• Rider
– Define destination
– Script critical moves

• Elephant
– Focus on the feeling
– Shrink the change

• Path
– Buil...
@ehekler

http://iprofs.files.wordpress.com/2013/07/elephant_rider_path
Define the destination

@ehekler

Flickr - lamont_cranston
Script critical actions

@ehekler

Flickr- Infidelic
@ehekler

http://iprofs.files.wordpress.com/2013/07/elephant_rider_path
Focus on the feeling

@ehekler
Shrink the change

@ehekler

Flickr - fisheye.at
@ehekler

http://iprofs.files.wordpress.com/2013/07/elephant_rider_path
Build habit chains

@ehekler

Flickr - Vanhap
• Trigger
– “Hot” Triggers

• Ability
– Tiny Habits®

• Motivation
– Ride the “Wave”

@ehekler

Image courtesy of Dr. BJ F...
Image courtesy of Dr. BJ Fogg
Hot triggers

@ehekler

Flickr - Waffles n'Nanas
Image courtesy of Dr. BJ Fogg
Tiny habits®
After I [existing routine or anchor],
I will [new tiny behavior].

@ehekler

Flickr - Awesome Joolie
Image courtesy of Dr. BJ Fogg
Ride the wave

@ehekler

http://images.cdn.fotopedia.com/flickr-7704358846-hd.jpg
• Motivation
– Incentivize
– Persuade
– Support Choice (not too
much)

• Capability
– Educate
– Tighten the feedback loop
...
Michie et al (2011) The Behaviour Change Wheel: a new method for characterising and
designing behaviour change interventio...
Incentivize

@ehekler

Flickr -Pewari
Consistency

Persuade

Authority
Social Proof

Scarcity
Reciprocit
y

@ehekler

Robert Cialdini et al, Persuasion
Support choice

@ehekler

William Miller et al, Motivational Interviewing

Flickr - doctorhandshake
Remember the paradox of choice

@ehekler
Michie et al (2011) The Behaviour Change Wheel: a new method for characterising and
designing behaviour change interventio...
Educate

@ehekler

Flickr giulia.forsythe
Tighten the feedback loop

@ehekler
Model

@ehekler

Flickr colemama
Michie et al (2011) The Behaviour Change Wheel: a new method for characterising and
designing behaviour change interventio...
Build effective choice architectures

@ehekler
Restructure the environment
Social

http://www.mfauscette.com/enterprise-social-network.jpg

@ehekler

Built

Flickr - MyW...
Use social norms
Descriptive

Injunctive

Flickr - thatmushroom

@ehekler

Flickr - Leo_Reynolds
Robert Cialdini et al, So...
Behaviour-change
techniques taxonomy

@ehekler
How to promote behavior change?
• Define the behavior and specific actions
• Identify what drives that behavior
• Find the...
• Rider
– Define destination
– Script critical moves

• Elephant
– Focus on the feeling
– Shrink the change

• Path
– Buil...
• Trigger
– “Hot” Triggers

• Ability
– Tiny Habits®

• Motivation
– Ride the “Wave”

@ehekler

Image courtesy of Dr. BJ F...
• Motivation
– Incentivize
– Persuade
– Support choice (not too
much)

• Capability
– Educate
– Tighten the feedback loop
...
Why now?

We have the need.

@ehekler

We have the means.
Thank you

Dr. Eric Hekler
Arizona State University
ehekler@asu.edu
@ehekler
Flickr -Espen_Faugstad
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The Science Behind Behavior Change: Keynote talk given at the Welltok Health Optimization Summit

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In this talk, I provide an introduction to different behavior change strategies and organize the discussion around three conceptual frameworks.

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  • What’s the problem here?What are solutions?What’s the normal medical solution? Tell them what to do.
  • Are they going to do it?
  • What’s the problem here?What are solutions?What’s the normal medical solution? Tell them what to do.
  • What’s the problem here? Big thing to talk about in WellTok – it is all about creating personalized itineraries; the actions you need to take; if you take these small actions, hopefully we will change your behavior. What are solutions?What’s the normal medical solution? Tell them what to do.
  • Goal
  • Big thing to talk about in WellTok – it is all about creating personalizeditineries; the actions you need to take; if you take these small actions, hopefully we will change your behavior.
  • Touch on changing motivation – It will be iterative, my motivation will suddenly change compared.
  • Big thing to talk about in WellTok – it is all about creating personalizeditineries; the actions you need to take; if you take these small actions, hopefully we will change your behavior.
  • Touch on changing motivation – It will be iterative, my motivation will suddenly change compared.
  • Mention the art and the science of it. Intrinsic vs. extrinsic motivation ; Self determination theory - Incentive design and reward platform ; theirs is mostly extrinsic motivation; particularly a way to offer them money; we are trying to analyze those data to predict if we offer this amount of money or a gift card vs. cash vs. paycheck; what will get an action; in our Café Well platform, we are building more of the intrinsic motivators; earning badges, and getting recognition, and what not; building on what people’s motivations are, there are a mix of different rewards; some might require a monetary reward; will get more from intrinsic motivation. Immediate behaviors vs. more long-term behaviors for incentive and reward; lose 5% of BMI.
  • Get into Cialdini’s rules of persuasion
  • The Science Behind Behavior Change: Keynote talk given at the Welltok Health Optimization Summit

    1. 1. The Science Behind Behavior Change @ehekler Dr. Eric Hekler Arizona State University Welltok Health Optimization Leadership Summit March 7, 2014 Flickr -Espen_Faugstad
    2. 2. Why now? Consumer-driven health Image courtesy of Jawbone @ehekler Healthcare incentives shifting Flickr - echo0101
    3. 3. Technology is becoming very powerful Deep Blue Watson Flickr - jntolva @ehekler
    4. 4. Just in Time Adaptive Interventions @ehekler
    5. 5. The DIY Self-Experimentation Toolkit Home-based Sensing/feedback Selftracking ? Design Portal @ehekler
    6. 6. Married male, 47 • Symptoms – Tired – Lack of concentration – listlessness • Self-reported behaviors – – – – @ehekler Smokes Inactive Eats only fast food Not sleeping very much Flickr – DES Daughter
    7. 7. Scenario Flickr – DES Daughter
    8. 8. What drives behavior? @ehekler Flickr - JHTNS-
    9. 9. Image courtesy of Dr. BJ Fogg
    10. 10. @ehekler http://iprofs.files.wordpress.com/2013/07/elephant_rider_path
    11. 11. Image courtesy of Dr. BJ Fogg
    12. 12. The COM-B system: Behaviour occurs as an interaction between three necessary conditions Psychological or physical ability to enact the behaviour Reflective and automatic mechanisms that activate or inhibit behaviour Physical and social environment that enables the behaviour Michie et al (2011) Implementation Science Slide courtesy of Dr. Susan Michie
    13. 13. Slide courtesy of Dr. Susan Michie
    14. 14. Interventions Interventions: activities designed to change behaviours Slide courtesy of Dr. Susan Michie
    15. 15. Intervention functions Policies: decisions made by authorities concerning interventions Michie et al (2011) The Behaviour Change Wheel: a new method for characterising and designing behaviour change interventions Implementation Science Slide courtesy of Dr. Susan Michie
    16. 16. Behaviour-change techniques taxonomy @ehekler
    17. 17. Married male, 47 • Symptoms – Tired – Lack of concentration – listlessness • Self-reported behaviors – – – – @ehekler Smokes Inactive Eats only fast food Not sleeping very much Flickr – DES Daughter
    18. 18. What behaviors would you prescribe? • 30 minutes of physical activity per day • 5 Fruits & Veggies per day • Avoid processed foods @ehekler • Stop smoking Flickr – DES Daughter
    19. 19. How might you help him to enact the prescribed behaviors? • Refer to evidencebased/informed program • If doesn’t exist… – Identify the driver of the behavior – Use appropriate techniques @ehekler Flickr – DES Daughter
    20. 20. • Rider – Define destination – Script critical moves • Elephant – Focus on the feeling – Shrink the change • Path – Build habit chains @ehekler http://iprofs.files.wordpress.com/2013/07/elephant_rider_path
    21. 21. @ehekler http://iprofs.files.wordpress.com/2013/07/elephant_rider_path
    22. 22. Define the destination @ehekler Flickr - lamont_cranston
    23. 23. Script critical actions @ehekler Flickr- Infidelic
    24. 24. @ehekler http://iprofs.files.wordpress.com/2013/07/elephant_rider_path
    25. 25. Focus on the feeling @ehekler
    26. 26. Shrink the change @ehekler Flickr - fisheye.at
    27. 27. @ehekler http://iprofs.files.wordpress.com/2013/07/elephant_rider_path
    28. 28. Build habit chains @ehekler Flickr - Vanhap
    29. 29. • Trigger – “Hot” Triggers • Ability – Tiny Habits® • Motivation – Ride the “Wave” @ehekler Image courtesy of Dr. BJ Fogg
    30. 30. Image courtesy of Dr. BJ Fogg
    31. 31. Hot triggers @ehekler Flickr - Waffles n'Nanas
    32. 32. Image courtesy of Dr. BJ Fogg
    33. 33. Tiny habits® After I [existing routine or anchor], I will [new tiny behavior]. @ehekler Flickr - Awesome Joolie
    34. 34. Image courtesy of Dr. BJ Fogg
    35. 35. Ride the wave @ehekler http://images.cdn.fotopedia.com/flickr-7704358846-hd.jpg
    36. 36. • Motivation – Incentivize – Persuade – Support Choice (not too much) • Capability – Educate – Tighten the feedback loop – Model • Opportunity – Choice architecture – Restructure environment – Use Social Norms Michie et al (2011) The Behaviour Change Wheel: a new method for characterising and designing behaviour change interventions Implementation Science
    37. 37. Michie et al (2011) The Behaviour Change Wheel: a new method for characterising and designing behaviour change interventions Implementation Science
    38. 38. Incentivize @ehekler Flickr -Pewari
    39. 39. Consistency Persuade Authority Social Proof Scarcity Reciprocit y @ehekler Robert Cialdini et al, Persuasion
    40. 40. Support choice @ehekler William Miller et al, Motivational Interviewing Flickr - doctorhandshake
    41. 41. Remember the paradox of choice @ehekler
    42. 42. Michie et al (2011) The Behaviour Change Wheel: a new method for characterising and designing behaviour change interventions Implementation Science
    43. 43. Educate @ehekler Flickr giulia.forsythe
    44. 44. Tighten the feedback loop @ehekler
    45. 45. Model @ehekler Flickr colemama
    46. 46. Michie et al (2011) The Behaviour Change Wheel: a new method for characterising and designing behaviour change interventions Implementation Science
    47. 47. Build effective choice architectures @ehekler
    48. 48. Restructure the environment Social http://www.mfauscette.com/enterprise-social-network.jpg @ehekler Built Flickr - MyWheelsareTurning
    49. 49. Use social norms Descriptive Injunctive Flickr - thatmushroom @ehekler Flickr - Leo_Reynolds Robert Cialdini et al, Social Norms
    50. 50. Behaviour-change techniques taxonomy @ehekler
    51. 51. How to promote behavior change? • Define the behavior and specific actions • Identify what drives that behavior • Find the right technique(s) • Iterate and support changes over time @ehekler Flickr -Espen_Faugstad
    52. 52. • Rider – Define destination – Script critical moves • Elephant – Focus on the feeling – Shrink the change • Path – Build habit chains @ehekler http://iprofs.files.wordpress.com/2013/07/elephant_rider_path
    53. 53. • Trigger – “Hot” Triggers • Ability – Tiny Habits® • Motivation – Ride the “Wave” @ehekler Image courtesy of Dr. BJ Fogg
    54. 54. • Motivation – Incentivize – Persuade – Support choice (not too much) • Capability – Educate – Tighten the feedback loop – Model • Opportunity – Choice architecture – Restructure environment – Use social norms Michie et al (2011) The Behaviour Change Wheel: a new method for characterising and designing behaviour change interventions Implementation Science
    55. 55. Why now? We have the need. @ehekler We have the means.
    56. 56. Thank you Dr. Eric Hekler Arizona State University ehekler@asu.edu @ehekler Flickr -Espen_Faugstad

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