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

1. Design for Behavior Change
When people know what to do and still
aren’t doing it.

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. 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. So, why?

5. Answer: Logical decision-making isn’t
logical
From Jonathan Haidt’s The Happiness Hypothesis

6. The Rider

7. The Elephant

8. So, when there’s
a conflict…
Who do you think
wins?

9. Tell me of your pain
What are some of
the behaviors you
are hoping to
help change?

10. Defining the behaviors
▪ What behaviors will
support the goal?

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. 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. With 2-3 people near you, pick a challenging behavior
that you will work on as a group.
Choose a behavior

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. COM-B Model

16. Com-B
Components
http://www.behaviourchangewheel.com

17. Let’s apply this:
▪ Physical Capability
▪ Psychological
Capability
▪ Physical Opportunity
▪ Social Opportunity
▪ Reflective Motivation
▪ Automatic Motivation

18. Now you try:
▪ Physical Capability
▪ Psychological
Capability
▪ Physical Opportunity
▪ Social Opportunity
▪ Reflective Motivation
▪ Automatic Motivation

19. UCL Theories and Techniques Working Group: 2017 MRC Grant
Mechanisms

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

22. BCTs – Behavior Change Techniques
▪ BCT Taxonomy App
▪ 93 different
interventions

23. Common problems
Yikes!!!
What are some common
problems that the elephant
struggles with?

24. 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

25. 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.


26. Making it visible
26
https://www.youtube.com/watch?v=M8AKTACyiB0

27. Making it visible:
From Perfect Time-Based Productivity by Francis Wade

28. Visceral Experience
http://vhil.stanford.edu/pubs/2011/VHIL-technical-report.pdf

29. And it’s not just the amount of
feedback…
What’s better? This? Or this?

30. Hyperbolic Discounting
Image Credit: http://commons.wikimedia.org/wiki/User:Moxfyre

31. and Competing Priorities
Increased Effort
31
Task
Task
Task
Task
Task
Email
Email
Email
Voicemail
Facebook
Voicemail
Twitter
Messages


32. Unclear Goals
What specific
behaviors will support
the goal?
▪ Improve Customer
Service
▪ Give better
feedback
▪ Be healthier


33. 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

34. 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?

35. Unlearning
▪ Familiarization
▪ Comprehension
▪ Conscious Effort
▪ Conscious Action
▪ Proficiency
▪ Unconscious Competence
From Gloria Gery – Electronic Performance Support Systems
When we learn something, we go through:


36. We develop unconscious competence
(Haier)
Glucose Metabolic Rate after several weeks of Tetris Practice

37. Change is hard

38. Unawareness of Consequence
or Bigger Picture
38
https://www.youtube.com/watch?v=3Lzsu8SXaWY


39. Lack of Environment or Process
Support
39


40. Barrier Reduction
Increase Motivation
Lower
Friction
Image adapted from Joshua Porter

41. 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

42. Source http://abcnews.go.com/Health/google-diet-search-giant-
overhauled-eating-options-nudge/story?id=18241908

43. Anxiety / Fear / Discomfort
43


44. Lack of Confidence
44
I can
do it.
Can I
do it?
OR


45. 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

46. Social Proof 

47. Should you order wine with dinner?

48. We listen to authority figures

49. Social norming

50. Opinion Leaders, Testimonials,
Success Stories

51. 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


52. 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?

53. Learned Helplessness
53
https://en.wikipedia.org/wiki/Learned_helplessness


54. Negative Prior Experience or
Shame
Is this how you look
when you exercise?
54


55. Which if these is
the slowest and
hardest to
change?
Lack of Identity or Value
Alignment
55


56. 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.

57. Emotional Arousal
Is it an impulse control
issue?
57


58. Make it easier: Have the plan ready
Implementation
Intentions:
If X happens,
I will do Y.
Gollwitzer, 1999

59. 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


60. Mistrust or Construal
60


61. 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

62. 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

63. ▪ 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