If you design health behavior change interventions, you’ve probably heard of behavioral economics. Concepts from behavioral economics—often called “nudges”—can inform incentive design, participation strategies, and the feature sets of interventions with the goal of impacting behavior to achieve positive outcomes.
However, many behavioral economic-inspired features don’t achieve their desired goals. Reasons why not include:
*Not all practitioners share an evidence-based understanding of how behavioral economics works, and therefore may misapply concepts;
*Users are more responsive to different behavioral economics concepts at different points in the behavior change experience, so an experience map must be layered into the design process;
*And individual differences also influence which behavioral economics concepts most affect behavior, so a deep understanding of the user is required.
In this talk, we’ll review several of the core concepts in behavioral economics. We’ll share examples of how they can be misapplied in digital design and explain why they are not effective in those contexts.
But don’t fret; we’ll also share best practices for applying these concepts based on the evidence-based literature. We’ll dive into how human-centered design—understanding the user’s needs and context—can save the day. We consider the user’s experience with an intervention over time and identify critical milestones and touchpoints. At each stage, the user’s needs change, and as a result, the particular behavioral economics principles that most effectively influence behavior do too. We’ll add nuance by considering the different “flavors” of features that can be used depending on the user’s psychological and environmental status.
You’ll learn:
*Strategies for evaluating longitudinal user needs in health interventions
*Options for better understanding a user’s psychographic profile
*Tactics to select the most effective behavioral economics technique(s) to effect change for specific users at specific timepoints
*Best practices to translate concepts to intervention features
Presented at UXPA Boston, May 19, 2007.
The Art and Science of Applying Behavioral Economics to Digital Health Interventions
1. THE ART AND SCIENCE OF
APPLYING BEHAVIORAL
ECONOMICS TO DIGITAL
HEALTH DESIGN
Amy Bucher, Ph.D.
Steven Schwartz, Ph.D
2. AGENDA
Our story
What is behavioral economics, anyway?
And where do people go wrong?
How do you effectively pull behavioral economics into design?
Designing for the person
Designing for the journey
Questions and conversation
3. WHO WE ARE AND WHY WE’RE
HERE
Amy Bucher, Ph.D.
Steve Schwartz, Ph.D.
18. WHY
BOTHER?
Recommended minutes of
moderate or high intensity
exercise per week
1500
Carl’s typical minutes of
moderate or high intensity
exercise per week
450
Ironman Dan’s typical
minutes of moderate
or high intensity
exercise per week
MISPLACED ANCHORS
21. BETWEEN DIFFERENCES INCLUDE:
Personality characteristics (OCEAN)
Experiences and acquired learnings
Skills and talents
Individual circumstances like
relationships, work status, housing
situation, etc.
23. MEET MARY ELLEN
BMI – 32
Recently diagnosed with hypertension
Had gestational diabetes with all 3 of her
kids
Was diagnosed with Type 2 diabetes after
the birth of her youngest
Has moderate depression, which came on
gradually
24. MEET MARY ELLEN
46 years old
Works part-time in an auto shop as an
office manager
Primary caregiver for her 3 kids, ages 6-
14
Tech savvy
25. MEET SARAH
BMI – 32
Recently diagnosed with hypertension
Had gestational diabetes with all 3 of her
kids
Was diagnosed with Type 2 diabetes after
the birth of her youngest
Has moderate depression, which came on
gradually
26. MEET MARY ELLEN
Uses multiple devices each day; a work
laptop, a shared family desktop, her iPhone,
and a family iPad where she plays games at
night.
Has low confidence in her ability to
understand the science of her health, so she
relies on her doctors to tell her what to do
and is not likely to do her own research
Because she had gestational diabetes that
went away after giving birth, she doesn’t feel
too worried about this diagnosis
With 3 busy kids, she spends most of her
non-work hours attending to their needs
rather than her own
Mary Ellen is organized and conscientious
about her work and her kids, but can’t seem
to find that same level of investment in her
own health. This makes her feel ashamed.
27. MEET SARAH
After 20 years with T2D, she knows how to
manage it well. Sarah stays on top of new
advances in T2D thanks to her good friend who
is a physician and regular conversations with
her own care team, including her therapist.
She works as a sculptor so doesn’t go online
much as part of her job. She has a smartphone,
but uses it mainly to talk and look at photos of
her grandkids.
Now that her kids are grown, Sarah has more
time in the evenings to indulge her own
hobbies and needs. She’s willing to spend
some extra time on her health.
After having T2D for so long, Sarah knows that
new behaviors will be hard at first. She’s used
to structuring very deliberate plans to make
sure healthy changes stick, and feels confident
based on some of her past successes.
32. CASE STUDY: DIABETES
MANAGEMENT Type 2 diabetes
can be:
Highly complex to
manage
Expensive and time-
consuming
Life-long
Scary
Different for
everyone
33. CASE STUDY: DIABETES
MANAGEMENT
What are some of the critical milestones for a person with Type 2
diabetes?
Diagnos
is
Treatme
nt
Decision
Choosin
g
Devices
Learnin
g SMBG
& Meds
Setting
Goals
with
HCP
How To
Handle
Sick
Days
Figuring
Out Diet
&
Exercise
Sharing
Your
Diagnos
is
Find An
Educato
r
Calibrati
ng
Treatme
nt
Dealing
With
Travel &
Holiday
s
Find
Your
Speciali
sts
Logging
Data
Assembl
e Your
Kit
41. In-the-moment
feedback
Badges!
And the badges
expire if you don’t
keep it up!
Compare everything the
user does against
guidelines
Reinforce the user’s
identity as someone who
takes good care of her
health
User determines
feedback frequency
Badge milestones
based on user EXP
level, and make
them more resistant
to expiry for
veterans
Users collaborate to
select appropriate goals
Language is consistent
with history and
experience
42. DESIGN DECISIONS PRIORITIZE:
Understanding a user’s baseline status
Calibrating guidelines and feedback to
their level
Offering users choice to optimize their
experience
Acknowledging individual differences as
appropriate
43. A PROCESS FOR DESIGNING WITH
BEHAVIORAL ECONOMICS
1. Identify behaviors to change and desired outcomes
2. Document who will use your intervention and when
they will use it
3. Determine opportunities to baseline and personalize
4. Create visual artifacts to help your team visualize
between and within differences at the same time
(e.g. journey map + personas)
5. Map behavioral economics techniques to elicit the
desired behavior from the specific user at the right
milestones
44. BEST PRACTICES FOR DESIGNING
WITH BEHAVIORAL ECONOMICS
Think about systems, not rules not
what these tactics are, but why they work
Put heuristics into context:
Person
Situation
Take advantage of personalization tactics
Technology
Targeting