Since the 2nd century AD, humans have been fascinated by one thing: ourselves.
Roman Emperor Marcus Aurelius’s To Myself (Τὰ εἰς ἑαυτόν), written around 180 AD, is one of the first existing diaries ever written. Today, most of us have smartphones for life-logging and many even have technology that keeps track of our lives for us. (I have been wearing a FitBit for the past few weeks. This device records the number of steps I take, calories I burn throughout the day, and other data.)
The digital age has made the process of recording everything we do even easier, and the Quantified Self movement, as it has come to be known, is gaining in popularity. We may bemoan our friends instagramming their every bite and tweeting their every trip to the gas station. However, there are some useful applications of these activities for the management of chronic diseases.
In conditions like diabetes it is known as self-monitoring: paying attention to changes in symptoms and other data like blood glucose levels or the effects of medications. Patients and their providers can use information gathered through self-monitoring to make treatment decisions and reinforce positive behaviors. For example, if a patient with diabetes feels more energetic and sees their blood glucose levels drop when they stick to a healthy diet, they may be more likely to make that lifestyle change a habit.
So whatever your opinion on life logging, it isn’t going away anytime soon. Let’s just hope we use our obsession with ourselves for good.(Read full post)
I don’t go to the grocery store that often. At work, we have a group called Expedite Group who will do our shopping for us. This not only saves me time, but probably money, too, because I’m not able to just pick up extras that look “interesting” or “tasty.” I also don’t have to worry about falling victim to purchasing extra snacks and junk food as a result of hunger. I have friends who tell me this happens to them all the time, and apparently they’re not alone. An ABC News report investigated this exact topic and found that hungry shoppers not only purchase higher calorie and less diet-friendly foods, but as a result they eat worse all week. So one day of hungry shopping dooms you for seven days.
OK. So if you must physically go to the store, the solution is to just make sure to have a good snack or meal before shopping. If you do this, then you’re good. You won’t mess up your new diet or overspend. Sadly, no.
According to a new study in the journal Obesity, even if you go to the grocery store on a full stomach, shopping after a night of poor sleep can also have deleterious effects on your food choices. Not only are people hungrier when they get less sleep, but it’s long been known that decision-making, in all aspects of life, is affected by sleep deprivation.
In this fast-paced society we live in, five to six hours of sleep is sadly normally for many. So many of us are walking around sleep-deprived. Groups like Expedite Group are wonderful solutions for companies looking to improve work-life balance for employees. They take the burden of grocery shopping, returns, and other errands off the plates of employees to help them focus on work and family life. But this new obesity research shows that helping to improve work-life balance shouldn’t be their only hook for prospective clients. While hiring someone else to do your food shopping is certainly not the only way to stay on track with food choices and health management, it may be a start.(Read full post)
Technology has been connecting us to one another in more ever-present ways, and networking has become virtually a requirement for getting a job. So it is sort of ironic that introverts are now experiencing their time in the sun… before scurrying away to avoid all of that attention.
There have long been misperceptions about what it means to be an introvert, or an extrovert for that matter. Introverts are “quiet” and “shy”. They avoid social contact and don’t like to speak up. Extroverts on the other hand are “loud” and “outgoing”. They like parties and always need to make their opinions known. Personality research tells us, however, that 1) Introversion and extroversion, at their core, reflect where people focus and get their energy, and 2) Most people fall somewhere along an intro-extroversion spectrum. Introversion and extroversion each come with their own strengths, whether it be a tendency to give things careful consideration before speaking, or feeling comfortable voicing opinions on the spot.
To me, the most interesting aspect of personality research is its capacity to help people realize things about themselves. It helps us to uncover our own strengths, tendencies, and motivators, as well as understand others a little bit better.
So toss aside those stereotypes of wallflowers and party animals and really get to know the introverts and extroverts in your life.(Read full post)
Did your parents ever forbid you from hanging out with that kid who was a “bad influence”? What about those friends who eat McDonald’s for every meal? Do people actually do that? And would you think of them as bad influences? You probably should. It turns out that poor health habits are contagious and may have decades-long implications.
We public health geeks call this social norming, or the effects of ones’ peers on their health. Bottom line: The people we surround ourselves with influence our environment, our behavior, and ultimately our health.
For those of us who like to look at the upside of social networks, determinants of health, the combined influence of our interpersonal, community, and ecological environments on our… Maybe this is really just me. In any case, I am happy to hear that people who are healthy tend to encourage their friends to keep healthy habits.
Personally, I am stretched to fit in either social or physical activity time into my busy schedule of nerding out at MMC and trying to keep my life together at home. My similarly strapped friends and I have a solution: A bi-weekly activity-based meet up. By changing up the typical dinner-and-drinks social routine, we hope to encourage and motivate each other to get moving, while still giving us a chance to catch up.
So far our ideas include beach volleyball, tennis, and swimming… Last week we went for a looooooong walk. We may have followed it up with a taco binge, but hey, at least we’re trying!(Read full post)
What do these entities all have in common?
Unless you looked at the tags for this post, you will probably be surprised to hear that they all have departments dedicated to behavioral science. From the U.K.’s national behavioural insights team, to the FBI’s Behavioral Science Unit, to our own Behavioral Services team, there are specific groups dedicated to figuring out what makes people tick. As someone who has always been interested in the quirks of human behavior, I am fascinated to see the variety of problems that are being solved with behavioral science research:
- Reducing energy consumption on a national scale
- Helping patients with chronic conditions to have a better healthcare experience
- Convincing people to pay their taxes
- Helping law enforcement agencies to better understand criminals
This is all to say, our task of using behavioral science to take over the world is almost complete. Mwahahahaha!(Read full post)
What do parents, teachers, doctors, and public health professionals have in common?
We all want kids to eat healthy foods.
Those of us interested in school nutrition have been fighting for decades to get healthy lunches available in schools. Unfortunately, things things don’t always go our way. (In what universe is pizza a vegetable?) Then there is the challenge from school boards who are convinced that vending machines are the key to their financial viability. Some schools have actually been able to remove unhealthy options from the cafeteria… resulting in kids bringing chips from home in record numbers. It sometimes seems like we just can’t win here, and the reason is simple: We, kids and adults alike, do not like to be told what to do.
Enter classic behavior modification techniques and the power of choice. You may be surprised to learn that there are a few simple and interesting strategies to encourage healthy eating. Read on to learn how to prevent kids from rebelling against healthy lunches, and to build their skills choose healthy options in the future.
- Apples on impulse
Rather than keeping candy bars, chips, and other less desirable snacks near school cafeteria cash registers, put fruits and vegetables there. That way, impulse buyers will be choosing from a healthier set of options.
- Shifting the salad bar
In many school cafeterias, salad bars are pushed off to the side so students have to go out of their way to select this option. One school moved the salad bar to the middle of the cafeteria so that kids had to walk around it to get to the cash registers. They subsequently saw a 21% increase in salad sales.
- Carrots or cauliflower?
When students are given a choice of which vegetable they eat, food waste decreases and vegetable consumption increases. What more could a fiscally and nutritionally conscious school board want?
So there you have it. Getting kids to eat broccoli is easy. You just have to convince them that it was their idea.(Read full post)
Dismayed television viewers collectively sucked in their breath — and their stomachs — when former White House doctor Connie Mariano chose an all-too-public forum for her fears that New Jersey Governor Chris Christie might “die in office” because of his weight. I couldn’t help thinking how different that unfortunate moment might have been if Dr. Mariano had used behaviorally sound strategies to deliver her message more effectively.
Late-night jokes and running pun-laden headlines aside, Dr. Mariano no doubt has Gov. Christie’s best interests at heart. Although it is doubtful she routinely uses that sort of alarmist language in the exam room with her patients, the episode demonstrates why well-meaning and even urgent healthcare advice goes unheeded by patients. Gov. Christie’s strident rebuke of Dr. Mariano also dramatically illustrates the emerging power of the patient and the changing doctor-patient dynamic in this age of healthcare reform.
During a press conference, after saying Dr. Mariano should “shut up,” Gov. Christie said he has a plan for dealing with his weight, adding, “My doctor continues to warn me that my luck is going to run out relatively soon, so believe me, it’s something I’m very conscious of.”
A behavioral science–based approach might have helped Dr. Mariano view Gov. Christie’s awareness of his blood pressure and blood sugar levels (normal, according to him when he appeared on Letterman) as positive indicators for change. His “luck” terminology could indicate a belief he has little control over the situation. Rather than jumping to negative conclusions, if Dr. Mariano was armed with the proper insight, she could have employed positive framing, and used an approach that tapped into Gov. Christie’s heath behavior drivers that might motivate him to take action.
Instead, the dramatic public backlash, which played out on the political stage shows how there continues to be a gap in communicating and managing chronic conditions. Dr. Mariano’s cringe-worthy comments, along with Gov. Christie’s outrage and subsequent good humor and surge in the polls to a 74% approval rating need little analysis. What they do require, however, is recognition that it takes more than good advice to move patients toward positive lifestyle change. In today’s complex (not to mention politically charged) healthcare environment, it’s not enough for doctors to diagnose the problem and provide information. Patients demand a greater say in their own care, and everyone involved is being held accountable for better patient outcomes. Fortunately, doctors can use effective patient-centric approaches to help patients overcome barriers to improving those outcomes.(Read full post)
So lately I’ve been thinking a lot about rewards and health. There’s been a lot about “gamification” in the press lately. I am really not one to jump on bandwagon. I guess I am just more curious than anything. Being in the behavioral science field for 13 years –I have always had the strong opinion that games and rewards don’t drive lasting behavior change. The motivation and drive must come within in – an individual must want to change for it to happen. A little reward here and there can’t roll a rock uphill.
But here I am at a point in my own life where I really do want to feel good, have energy and be healthy. But I’ve just got too much to do. Exercise comes last. Well, let’s be honest, exercise doesn’t come at all for me. I have no intrinsic motivation. There’s always some laundry to fold, a lunch to make, a client meeting to prepare for – or “I just have to stay in bed 20 more minutes to function.” My list of excuses (some of them legitimate) could go on, but I won’t bore you with the details.
So I’ve been thinking – maybe there is something to gaming and health. Maybe I am one of those people who just need a little push on a daily basis. Maybe a thumbs up or smiley – just a little positive reinforcement – would break through my inertia (AKA daily chaos) and cause me to re-prioritize.
So, I am going to conduct my own personal experiment over the next couple of months. I am going to ask some of my more technology-savvy friends and colleagues to recommend for me some sort of digital exercise tool that incorporates rewards or gaming. Not that n=1 is a proof point. But it is a starting point.(Read full post)
This week I had the opportunity to host an internal Sparkology session. Sparkology is our agency’s internal forum for cross-sharing ideas and expertise – and it’s also a great opportunity for free lunch and to hang out with some pretty cool people that I don’t get to see every day.
The focus this week was on behavioral science – taking a look at the history of behavioral science and examining the innovative ways that our agency is applying this health behavior expertise to develop campaigns that drive positive patient outcomes.
We looked at examples of marketing campaigns –and peeled back the layers to look at not just the insight behind the campaigns, but also how behavioral science provided practical strategies for changing both patient and healthcare professional behavior.
Below are highlights of our discussion that summarize how applying behavioral science is innovative, relatable and practical:
- Behavioral science is old, but not that old if you compare it to astronomy – it’s only been around since the 1930’s-40’s. We tap into decades of proven strategies from behavioral science to craft solutions that are relevant to today’s healthcare landscape.
- Behavior is complex and solutions that drive lasting behavior change need to challenge conventional thinking – for example, information alone won’t change behavior.
- Behavioral science is relatable…
- Kim Kardashian, Albert Bandura, Diane Parrott, Jo Frost, B.F. Skinner and Dr. Cliff Huxtable are all behavioral experts according to our poll – I won’t reveal which one received the highest rating.
- Internally, we all have behaviors that we know we should engage in more often – flossing teeth, calling parents and praying were top mentions.
- Behavior comes down to choices – some voluntary and some involuntary – that are driven by an interplay of beliefs, motivators and our environment.
- We explored some recent MicroMass and outside-industry work that demonstrated use of behavioral techniques such as experiential learning, cues to action, motivational interviewing and problem solving.
And I will leave a parting thought that I did not share at Sparkology – applying behavioral science is not boring. Take a look at this innovative initiative which uses cues to action (and humor) – putting a prompt or cue in the environment to change a behavior – in this case, to slow down speeding cars.
Now that’s what I call resourceful!(Read full post)
The goal of game mechanics and game dynamics is to drive a user-desired behavior predictably. The same ideas apply to human health behavior and the application of behavioral models and frameworks in health intervention design. This requires an understanding of how humans behave. This is where all those behavior models come into play.
There are many such models and frameworks, each useful in specific contexts. A model/framework is chosen based on whether it can give us the understanding we need to address the particular problem. Specifically to game dynamics and game mechanics, we can use the multi-factor model behavior model by J. Fogg of Stanford University known as Fogg’s behavior model (FBM). FBM asserts that there are three required factors that underlie any human behavior:
- Motivation (the want or desire to do something )
- Ability (the necessary resources)
- Trigger (the ‘spark,’ ‘signal,’ or ‘facilitator’)
According to FBM, these factors must converge at the same time to successfully drive a behavior. Any temporal misalignment in these three factors will degrade effectiveness. FBM also asserts that for the target behavior to happen, users usually require a minimum level of ability and motivation called the activation threshold for the behavior. When the trigger (something that prompts or tells the users to carry out the target behavior now) is introduced at the right time (above the activation threshold), the user is lead to the inception of the predictable behavior.
Of course, more than one behavior model or framework can be applied to a health intervention. For example, we can leverage the Power Law of Practice into a task-based intervention. The Power Law of Practice states that people make fewer errors and are faster with the more time they spend doing the task. About 80% of improvement along the power function comes from figuring out a good strategy for getting the task done, while about 20% of improvement comes from getting better at the same strategy.
There is good evidence that the steep part of the power function is actually composed of a combination of step functions where each step is a learning event – where one acquires new knowledge or develops a better model for how the system works. An intervention designer needs to understand what learning events occur so that individuals don’t get stuck and stop using the technology or some of its features.
From a motivation perspective, we can utilize a model by Daniel Pink. Pink hypothesizes that in the modern society where the lower levels of the Maslow’s hierarchy are more or less satisfied, people become more and more motivated by other intrinsic motivators, specifically: autonomy, mastery and purpose. From a game dynamics perspective, purpose is satisfied by quests, discovery, epic meaning; mastery is satisfied by points, progression and levels.
As you can see, when the appropriate behavior models and frameworks are applied a health intervention, behavior change can occur in a more effective and predictable manner.(Read full post)