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Design for Behavior Change
When people know what to do and still
aren’t doing it.
In our ideal world, behavior change
would work like this:
Oh my goodness! You
are right.
I will never do it again.
Um, you...
I know, but…
“I know it’s a bad idea, and I never
do it (except when I do, and then I
feel guilty).”
“I know it’s a bad id...
So, why?
Answer: Logical decision-making isn’t
logical
From Jonathan Haidt’s The Happiness Hypothesis
The Rider
The Elephant
So, when there’s
a conflict…
Who do you think
wins?
Tell me of your pain
What are some of
the behaviors you
are hoping to
help change?
Defining the behaviors
▪ What behaviors will
support the goal?
Make sure you’ve got a behavior
Which of these are a behavior?
1. Walking for 20 minutes
2. Improving health
3. Taking blo...
The photo test
▪ If your behavior
seems vague, ask
yourself this question:
▪ If I took a photo or
video of it, what
would ...
With 2-3 people near you, pick a challenging behavior
that you will work on as a group.
Choose a behavior
1. Doesn’t know at all about the behavior
2. Knows about the behavior, but doesn’t understand why it’s important
3. Unders...
COM-B Model
Com-B
Components
http://www.behaviourchangewheel.com
Let’s apply this:
▪ Physical Capability
▪ Psychological
Capability
▪ Physical Opportunity
▪ Social Opportunity
▪ Reflectiv...
Now you try:
▪ Physical Capability
▪ Psychological
Capability
▪ Physical Opportunity
▪ Social Opportunity
▪ Reflective Mot...
UCL Theories and Techniques Working Group: 2017 MRC Grant
Mechanisms
INTERVENTION FUNCTION DEFINITION HEALTH EXAMPLE
EDUCATION Increasing Knowledge or Understanding Providing information to p...
BCTs – Behavior Change Techniques
▪ BCT Taxonomy App
▪ 93 different
interventions
Common problems
Yikes!!!
What are some common
problems that the elephant
struggles with?
Some common reasons
 Lack of feedback
(specifically visible
feedback)
 Increased effort
 Unclear goals
 Unlearning
 U...
Specifically visible feedback
Lack of Feedback
25
If people’s hands turned blue when
they had bacteria on them, we
probabl...
Making it visible
26
https://www.youtube.com/watch?v=M8AKTACyiB0
Making it visible:
From Perfect Time-Based Productivity by Francis Wade
Visceral Experience
http://vhil.stanford.edu/pubs/2011/VHIL-technical-report.pdf
And it’s not just the amount of
feedback…
What’s better? This? Or this?
Hyperbolic Discounting
Image Credit: http://commons.wikimedia.org/wiki/User:Moxfyre
and Competing Priorities
Increased Effort
31
Task
Task
Task
Task
Task
Email
Email
Email
Voicemail
Facebook
Voicemail
Twitt...
Unclear Goals
What specific
behaviors will support
the goal?
▪ Improve Customer
Service
▪ Give better
feedback
▪ Be health...
Make sure you’ve got behaviors
1. Walking for 20 minutes
2. Having the confidence to ride your bike to work
3. Taking bloo...
The photo test
▪ If your behavior
seems vague, ask
yourself this question:
▪ If I took a photo or
video of it, what
would ...
Unlearning
▪ Familiarization
▪ Comprehension
▪ Conscious Effort
▪ Conscious Action
▪ Proficiency
▪ Unconscious Competence
...
We develop unconscious competence
(Haier)
Glucose Metabolic Rate after several weeks of Tetris Practice
Change is hard
Unawareness of Consequence
or Bigger Picture
38
https://www.youtube.com/watch?v=3Lzsu8SXaWY

Lack of Environment or Process
Support
39

Barrier Reduction
Increase Motivation
Lower
Friction
Image adapted from Joshua Porter
Changing the environment
“in seven weeks, New York Googlers consumed 3.1 million fewer calories from
M&Ms”
Source http://a...
Source http://abcnews.go.com/Health/google-diet-search-giant-
overhauled-eating-options-nudge/story?id=18241908
Anxiety / Fear / Discomfort
43

Lack of Confidence
44
I can
do it.
Can I
do it?
OR

Practicing the behavior
▪ Practice is particularly important
in emotionally-fraught situations.
▪ Can be necessary for
ove...
Social Proof 
Should you order wine with dinner?
We listen to authority figures
Social norming
Opinion Leaders, Testimonials,
Success Stories
Lack of Autonomy or Ownership
51
Competence
RelatednessAutonomy
What’s the actual reward?
▪ New skill or ability
▪ Outcome...
It can be little things
52
New Behavior
Let me tell
you why this
is important…
New Behavior
Is this
important?
Why do you
...
Learned Helplessness
53
https://en.wikipedia.org/wiki/Learned_helplessness

Negative Prior Experience or
Shame
Is this how you look
when you exercise?
54

Which if these is
the slowest and
hardest to
change?
Lack of Identity or Value
Alignment
55

Can you align with existing values?
“How do you get
people to change
their values about the
environment?”
56
The campaign ...
Emotional Arousal
Is it an impulse control
issue?
57

Make it easier: Have the plan ready
Implementation
Intentions:
If X happens,
I will do Y.
Gollwitzer, 1999
Misaligned Incentives
59
Based on a true story:
Can we emphasize the importance of
accuracy in the data entry course?
Beca...
Mistrust or Construal
60

So which apply?
▪ Lack of feedback
(specifically visible
feedback)
▪ Increased effort
▪ Unclear goals
▪ Unlearning
▪ Unawa...
Any questions?
You can access the checklist here:
http://bit.ly/rightthinglist
My facebook group for instructional design:...
▪ Ms Claire Stevens, Claire, and Dr Lion Shahab, Prof Robert West, Evaluating the Risk Acceptance Ladder (RAL) as a
basis ...
Design for Behavior Change
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Design for Behavior Change

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From the PromiseDagen conference in Sweden. Includes diagnostic tools for analyzing a behavior change problem.

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Design for Behavior Change

  1. 1. Design for Behavior Change When people know what to do and still aren’t doing it.
  2. 2. In our ideal world, behavior change would work like this: Oh my goodness! You are right. I will never do it again. Um, you really shouldn’t text while driving. It’s dangerous.
  3. 3. I know, but… “I know it’s a bad idea, and I never do it (except when I do, and then I feel guilty).” “I know it’s a bad idea, but I only do it once in a while, and I’m very careful.” “I know it’s a bad idea for other people, but I can do it because I’m really good at it.” “Huh? What’s the big deal?”
  4. 4. So, why?
  5. 5. Answer: Logical decision-making isn’t logical From Jonathan Haidt’s The Happiness Hypothesis
  6. 6. The Rider
  7. 7. The Elephant
  8. 8. So, when there’s a conflict… Who do you think wins?
  9. 9. Tell me of your pain What are some of the behaviors you are hoping to help change?
  10. 10. Defining the behaviors ▪ What behaviors will support the goal?
  11. 11. Make sure you’ve got a behavior Which of these are a behavior? 1. Walking for 20 minutes 2. Improving health 3. Taking blood pressure medicine daily 4. Losing weight 5. Enunciating words clearly 6. Improving Customer Service 7. Greeting the customer with a smile 8. Reducing cholesterol
  12. 12. The photo test ▪ If your behavior seems vague, ask yourself this question: ▪ If I took a photo or video of it, what would the person be doing?
  13. 13. With 2-3 people near you, pick a challenging behavior that you will work on as a group. Choose a behavior
  14. 14. 1. Doesn’t know at all about the behavior 2. Knows about the behavior, but doesn’t understand why it’s important 3. Understands the explanation for why it’s important, but doesn’t believe that explanation 4. Accepts that the behavior is important, but doesn’t care enough to do anything about it 5. Thinks the behavior is worth it, but not a priority at the moment 6. Thinks the behavior is a priority, but doesn’t know how to do it 7. Thinks the behavior is a priority, but thinks it’s too hard in the environment (physical or social) 8. Thinks the behavior is a priority, but isn’t confident about their ability to do it 9. Is ready to try, but is having a hard time getting started 10. Has started, but is having trouble staying motivated 11. Is continuing, but isn’t consistent or successful 12. Has been consistent or successful, but is falling off the behavior Where are your learners getting stuck? (Modified from Stevens et al) 14 Modified from https://www.ucl.ac.uk/behaviour-change/files/conf16-presentations/claire-stevens.pdf
  15. 15. COM-B Model
  16. 16. Com-B Components http://www.behaviourchangewheel.com
  17. 17. Let’s apply this: ▪ Physical Capability ▪ Psychological Capability ▪ Physical Opportunity ▪ Social Opportunity ▪ Reflective Motivation ▪ Automatic Motivation
  18. 18. Now you try: ▪ Physical Capability ▪ Psychological Capability ▪ Physical Opportunity ▪ Social Opportunity ▪ Reflective Motivation ▪ Automatic Motivation
  19. 19. UCL Theories and Techniques Working Group: 2017 MRC Grant Mechanisms
  20. 20. INTERVENTION FUNCTION DEFINITION HEALTH EXAMPLE EDUCATION Increasing Knowledge or Understanding Providing information to promote healthy eating choices TRAINING Imparting Skills Advanced driver training to increase safe driving PERSUASION Using Communication to induce positive or negative feelings or stimulate action Using Imagery to motivate increases in physical activity INCENTIVIZATION Creating an expectation of reward Using prize draws to induce attempts to stop smoking COERCION Creating an expectation of punishment or cost Raising the financial cost to reduce excessive alcohol consumption RESTRICTION Using rules to reduce the Opportunity to engage in the target behavior (Or to increase the target behavior by reducing the opportunity to engage in competing behaviors.) Prohibiting sales of antihistamines to people under 18 to reduce the use for recreational drug creation ENVIRONMENTAL RESTRUCTURING Changing the Physical or Social Environment Providing on-screen prompts for GPs to ask about smoking behavior MODELING Providing an example for people to aspire to or imitate Using TV drama scenes involving safe-sex practices to increase condom use ENABLEMENT Increasing means/reducing barriers to increase Capability (beyond education and training) or Opportunity (beyond environmental restructuring) Behavioral support for smoking cessation, medication for cognitive deficits, surgery to reduce obesity, prostheses to promote physical activity. Intervention functions
  21. 21. BCTs – Behavior Change Techniques ▪ BCT Taxonomy App ▪ 93 different interventions
  22. 22. Common problems Yikes!!! What are some common problems that the elephant struggles with?
  23. 23. Some common reasons  Lack of feedback (specifically visible feedback)  Increased effort  Unclear goals  Unlearning  Unawareness of consequences / Bigger picture  Lack of environment or process support  Anxiety/Fear/Discomfort  Lack of confidence  Social Proof  Lack of Autonomy / Ownership  Learned helplessness  Negative Prior Experience  Lack of Identity or Value Alignment  Emotional Arousal  Misaligned incentives  Mistrust or Construal Available at http://bit.ly/rightthinglist
  24. 24. Specifically visible feedback Lack of Feedback 25 If people’s hands turned blue when they had bacteria on them, we probably wouldn’t have a hand washing problem. 
  25. 25. Making it visible 26 https://www.youtube.com/watch?v=M8AKTACyiB0
  26. 26. Making it visible: From Perfect Time-Based Productivity by Francis Wade
  27. 27. Visceral Experience http://vhil.stanford.edu/pubs/2011/VHIL-technical-report.pdf
  28. 28. And it’s not just the amount of feedback… What’s better? This? Or this?
  29. 29. Hyperbolic Discounting Image Credit: http://commons.wikimedia.org/wiki/User:Moxfyre
  30. 30. and Competing Priorities Increased Effort 31 Task Task Task Task Task Email Email Email Voicemail Facebook Voicemail Twitter Messages 
  31. 31. Unclear Goals What specific behaviors will support the goal? ▪ Improve Customer Service ▪ Give better feedback ▪ Be healthier 
  32. 32. Make sure you’ve got behaviors 1. Walking for 20 minutes 2. Having the confidence to ride your bike to work 3. Taking blood pressure medicine daily 4. Losing weight 5. Enunciating words clearly 6. Intending to replace food options with lower fat items 7. Greeting the customer with a smile 8. Reducing cholesterol
  33. 33. The photo test ▪ If your behavior seems vague, ask yourself this question: ▪ If I took a photo or video of it, what would the person be doing?
  34. 34. Unlearning ▪ Familiarization ▪ Comprehension ▪ Conscious Effort ▪ Conscious Action ▪ Proficiency ▪ Unconscious Competence From Gloria Gery – Electronic Performance Support Systems When we learn something, we go through: 
  35. 35. We develop unconscious competence (Haier) Glucose Metabolic Rate after several weeks of Tetris Practice
  36. 36. Change is hard
  37. 37. Unawareness of Consequence or Bigger Picture 38 https://www.youtube.com/watch?v=3Lzsu8SXaWY 
  38. 38. Lack of Environment or Process Support 39 
  39. 39. Barrier Reduction Increase Motivation Lower Friction Image adapted from Joshua Porter
  40. 40. Changing the environment “in seven weeks, New York Googlers consumed 3.1 million fewer calories from M&Ms” Source http://abcnews.go.com/Health/google-diet-search-giant- overhauled-eating-options-nudge/story?id=18241908
  41. 41. Source http://abcnews.go.com/Health/google-diet-search-giant- overhauled-eating-options-nudge/story?id=18241908
  42. 42. Anxiety / Fear / Discomfort 43 
  43. 43. Lack of Confidence 44 I can do it. Can I do it? OR 
  44. 44. Practicing the behavior ▪ Practice is particularly important in emotionally-fraught situations. ▪ Can be necessary for overcoming reluctance or anxiety. http://www.projectalert.com/resources/posters
  45. 45. Social Proof 
  46. 46. Should you order wine with dinner?
  47. 47. We listen to authority figures
  48. 48. Social norming
  49. 49. Opinion Leaders, Testimonials, Success Stories
  50. 50. Lack of Autonomy or Ownership 51 Competence RelatednessAutonomy What’s the actual reward? ▪ New skill or ability ▪ Outcomes ▪ Feeling of confidence or mastery ▪ Sense of relatedness 
  51. 51. It can be little things 52 New Behavior Let me tell you why this is important… New Behavior Is this important? Why do you think so?
  52. 52. Learned Helplessness 53 https://en.wikipedia.org/wiki/Learned_helplessness 
  53. 53. Negative Prior Experience or Shame Is this how you look when you exercise? 54 
  54. 54. Which if these is the slowest and hardest to change? Lack of Identity or Value Alignment 55 
  55. 55. Can you align with existing values? “How do you get people to change their values about the environment?” 56 The campaign is credited with reducing litter on Texas highways roughly 72% between 1986 and 1990. The campaign's target market was 18- to 35-year-old males, which was statistically shown to be the most likely to litter.
  56. 56. Emotional Arousal Is it an impulse control issue? 57 
  57. 57. Make it easier: Have the plan ready Implementation Intentions: If X happens, I will do Y. Gollwitzer, 1999
  58. 58. Misaligned Incentives 59 Based on a true story: Can we emphasize the importance of accuracy in the data entry course? Because they just don’t seem to care about entering accurate information.Client Oh, they are paid by the number of applications they do per hour.Client Sure, but can you tell me more about how they are evaluated and compensated? Me 
  59. 59. Mistrust or Construal 60 
  60. 60. So which apply? ▪ Lack of feedback (specifically visible feedback) ▪ Increased effort ▪ Unclear goals ▪ Unlearning ▪ Unawareness of consequences / Bigger picture ▪ Lack of environment or process support ▪ Anxiety/Fear/Discomfort ▪ Lack of confidence ▪ Social Proof ▪ Lack of Autonomy / Ownership ▪ Learned helplessness ▪ Negative Prior Experience ▪ Lack of Identity or Value Alignment ▪ Emotional Arousal ▪ Misaligned incentives ▪ Mistrust or Construal
  61. 61. Any questions? You can access the checklist here: http://bit.ly/rightthinglist My facebook group for instructional design: https://www.facebook.com/groups/designforhowpeoplelearn/ My contact info: Julie@usablelearning.com www.usablelearning.com
  62. 62. ▪ Ms Claire Stevens, Claire, and Dr Lion Shahab, Prof Robert West, Evaluating the Risk Acceptance Ladder (RAL) as a basis for targeting communication aimed at prompting attempts to improve health related behaviours: A pilot randomised controlled trial. Frontiers in Public Health 2016 https://www.ucl.ac.uk/behaviour-change/files/conf16- presentations/claire-stevens.pdf ▪ Wash Your Hands Video – YouTube https://www.youtube.com/watch?v=M8AKTACyiB0 ▪ Book - Perfect Time-Based Productivity by Francis Wade ▪ Stanford Virtual Reality Study http://vhil.stanford.edu/pubs/2011/VHIL-technical-report.pdf ▪ Hyperbolic discounting https://en.wikipedia.org/wiki/Hyperbolic_discounting ▪ Book - Electronic Performance Support Systems by Gloria Gery ▪ Regional Glucose Metabolic Changes After Learning a Complex Visuospatial/Motor Task: A Positron Emission Tomographic Study, R.J. Haier, B.V. Siegel, A. MacLachlan, E. Soderling, S. Lottenberg, and M.S. Buchsbaum (1992). Brain Research, 570, 134-143. ▪ Sorting and Recycling Facility - Follow the Process Video – YouTube https://www.youtube.com/watch?v=3Lzsu8SXaWY ▪ Google Kitchen Example Source http://abcnews.go.com/Health/google-diet-search-giant-overhauled-eating- options-nudge/story?id=18241908 ▪ Book – Mindset by Carol Dweck ▪ Project ALERT http://www.projectalert.com ▪ Self-determination Theory: http://selfdeterminationtheory.org/ ▪ Learned Helplessness https://en.wikipedia.org/wiki/Learned_helplessness ▪ Don’t Mess with Texas https://en.wikipedia.org/wiki/Don't_Mess_with_Texas ▪ Peter Gollwitzer and Implementation Intentions http://www.psych.nyu.edu/gollwitzer/ ▪ COM-B and the Behaviour Change Wheel http://www.behaviourchangewheel.com/ ▪ BCT (Behaviour Change Techniques) Taxonomy Smart Phone App: https://www.ucl.ac.uk/health- psychology/bcttaxonomy/BCT_app1 References 63

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