More Related Content Similar to Opportunities in Behavior change Similar to Opportunities in Behavior change (20) 1. © 2011 Institute for the Future. All rights reserved. | SR-1407
Building for Jane Doe
Opportunities in Behavior Change
BayCHI
Mary Cain, MPH
May 8, 2012
Transforming Health
Through Technology
2. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Agenda
• Current Context
• Motivation, Capacity and Environment
– What is it?
– How do health plans and employers
approach it?
– Where are there opportunities to
improve?
3. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
My Background
• IFTF
– Consumers and technology
• LifeMasters and StayWell
– Building behavior change programs for
the chronically ill
• Co-founded a consulting firm, HT3
– Trained motivational interviewing to case
management
– Writing about behavior change
4. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Current Context for Behavior Change
• Personal view of health
• Technology changes
• Who is paying for products and
services?
5. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Personal Health Ecology
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Transforming Health
Through Technology
Carma’s PHE
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Transforming Health
Through Technology
Technology Opportunities
• Smartphones as personal data collection
and network tools
• Multiple data streams in our PHEs (EHR,
PHR, real-time flows)
• Blended reality, geospatial web, data
layers and feedback loops
• Sensors, monitoring and social nudging
• Internet of Things
• Virtual reality, avatars and a future you
8. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Population SegmentationActivation
Level of illness/declining functionHealthy Sick
LowHigh
QS
Chronicallyill
Trying to stay well
Pre diagnosis
9. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
QS
Chronicallyill
Trying to stay well
Pre diagnosis
Health
insurance
DTC
Employers
PaymentActivation
Level of IllnessHealthy Sick
LowHigh
10. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
QS
Chronicallyill
Trying to stay well
Pre diagnosis
Emotional StatesActivation
Level of IllnessHealthy Sick
LowHigh
Overwhelmed
Working to get a handle on it
Unaware
Maintaining control
11. © 2011 Institute for the Future. All rights reserved. | SR-1407
Behavior Change
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Transforming Health
Through Technology
Who is good at behavior change?
• Consumer packaged goods companies
• Game developers
• Military and organized religion
13. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
What drives behavior?
• Motivation, Capacity, Environment
– What is it?
– How do health plans and employers
approach it?
– Where are the opportunities to improve?
14. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Motivation: Why am I behaving this way?
• Spectrum of motivation from extrinsic to
intrinsic
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Transforming Health
Through Technology
Motivation Spectrum
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Transforming Health
Through Technology
Motivation: Why am I behaving this way?
• Spectrum of motivation from extrinsic to
intrinsic
• Most behavior change programs are
designed for highly motivated individuals
• Badges, points and money provide
extrinsic motivation
17. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Motivation: Health Plan/Employer Approach
• Carve out the chronically ill and focus on
changing/motivating them while offering
generic (crappy) lifestyle programs for
everyone else
• Acquire a few innovative but fragmented
offerings
• Focus on extrinsic motivation with the
expectation that intrinsic will come using
financial incentives
18. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Motivation Opportunities
• Opportunity 1: Focus on the more
intrinsic end of motivation spectrum
• Opportunity 2: Focus on discrepancy
between today and what you want. Build
mindfulness and self-reflection.
– Challenge: make MI or cognitive
behavioral therapy DIY and scalable
19. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Capacity: What am I able to do?
• Health information (each is a spectrum)
– Self-knowledge, comparing self to others,
personal ability and skills
– Health behaviors, what to do to be healthy,
link between behavior and health
– Purchasing decisions, what’s the right
product, service, treatment for each
individual
– Health risks, awareness of environment and
genetic risks as well as risks related to
decisions and lifestyle
20. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Capacity: What am I able to do?
• Self regulation: Do something now for
long term gain
• Self efficacy: belief in ability to achieve
goal
• Resilience and persistence: ability to
maintain and come back from stress and
setback
21. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Capacity: Health Plan/Employer Approach
• Think knowledge is power and use the
foie gras method of creating awareness
• Offer one-size-fits-all information that the
consumer must seek out
22. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Capacity Opportunities
• Opportunity 1: Provide context-specific
information
• Opportunity 2: Filtering based on profile(s)
• Opportunity 3: Games for skill
development, self-efficacy and resilience.
Examples of teaching someone how to do
the right thing in a safe environment
23. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Environment: What support surrounds me?
• Social and physical environments
• Cue (or trigger) causes behavior to
happen
– A habit = No thinking involved
• Ability to program our environments to
support us
– Delegating/cognitive offloading to our
devices
24. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
digitalpotato
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Transforming Health
Through Technology
Environment: Health Plan/Employer Approach
• Health Plans: Not my problem
• ACOs: It will become my problem
• Employers
– Create a culture of health
– Physical plant communications and
health infrastructure
26. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Environment Opportunities
• Opportunity 1: Activate the social
network and focus on social norms
• Opportunity 2: Create context-specific
triggers
• Opportunity 3: Consider the flow of Jane
Doe’s day and her PHE
27. © 2011 Institute for the Future. All rights reserved. | SR-1407
Thank You
Mary Cain, MPH
mcain@ht3.com
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Transforming Health
Through Technology
Social Learning/Social Cognitive Model
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Transforming Health
Through Technology
Theory of Reasoned Action/Planned
Behavior
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Transforming Health
Through Technology
Health Belief Model
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Transforming Health
Through Technology
Learning Theory
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Transforming Health
Through Technology
Transtheoretical Model
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Transforming Health
Through Technology
Ecological Model
34. © 2011 Institute for the Future. All rights reserved. | SR-1407
Transforming Health
Through Technology
Patient Activation Model
Editor's Notes COMMENTS: I’m a little confused about the use of the IFTF templates throughout the presentation. Were you invited because you’re an IFTF affiliate? Should both logos be on all slides? At a minimum, I recommend putting an HT3 logo on slides 8 and 9 since they were created outside of IFTF. Main area of concern is the attribution of IP. You are tool builders. you can create tools to help. IFTFConsumers and technology LifeMastersBuilding behavior change programs for the chronically illTechnologically = phone Some links to tech but not prevalentHealth buddy was the main tech play when I was building DMGot acquired by wellness and responsible for the whole continuumActivation and motivational interviewing Started a consulting firm. First gig was training motivational interviewing to case management, expanding the continuum COMMENTSon “some links to tech but not prevalent” – I think you are minimizing what you learned; technology is not just a device.AIM was one of the early attempts at using data to direct care. Although embedded within LM and very specific to that environment, you were challenged on a daily basis with figuring out how to make the experience of using that tool more effective, i.e., managing all of the indicators WebApps was also a crude version of having multiple views into the same data for different usersWhile not as sophisticated as many of the tools today, you probably learned a lot about design (or how not to) from having to constantly workaround what was there. If you segment a population by level of illness or function against activation, the connection they make between their health behaviors and their health outcomes, you get something that looks like this. We would look at the whole continuum of potential users Asics, philz, coke, Demonstrativevs associative advertising http://www.health2news.com/2012/04/19/boss-wants-me-buff-the-psychology-of-health-incentives/?goback=%2Enmp_*1_*1_*1_*1_*1_*1_*1 http://her.oxfordjournals.org/content/22/5/691.long http://www.health2news.com/2012/04/19/boss-wants-me-buff-the-psychology-of-health-incentives/?goback=%2Enmp_*1_*1_*1_*1_*1_*1_*1 COMMENTS: byfoiegras method, I’m assuming that you mean forcing information at people …. http://techcrunch.com/2012/04/21/rise-of-smart-mobile-services/Delegating/cognitive offloading to our devices Saddleback 20,000 weekly attendance, 8th largest church in the US Rick warren preaching about health and realized he was fatChurch has lost 250,000 lbs in a year. Warren has lost 60 lbs. Mentoring framework: holding hands, bringing new people into the network and indoctrinating them with the community’s norms COMMENTS: where does this slide fit?
