Mad*Pow's Amy Bucher shares her insights on Moral Issues in Behavior Change at SXSW 2017.

1. Moral Issues in Designing for Behavior Change
#MoralsinBC
Amy Bucher, Ph.D.
Mad*Pow
abucher@madpow.net
@amybphd
Raphaela O’Day, Ph.D.
Johnson & Johnson Health
and Wellness Solutions
roday@its.jnj.com

2. Think about your best healthcare
experience . . . .
#MoralsinBC

3. . . . And your worst healthcare experience.
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4. In just one sentence, what was the
difference?
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5. How do we think about designing for
behavior change?
#MoralsinBC

6. Moral Issues in
Designing for
Behavior Change

7. Design for People
Mad*Pow is a design agency that strives to help people improve their health
and wellness, meet their financial goals, learn and connect.

8. DIAGNOSIS
Define Problem
& Context
PRESCRIPTION
Define Intervention Strategy
& Outcome Goals
EXECUTION
Design & Implementation of
System Components
EVALUATION
Randomized Controlled
Experiments
« One-on-one Interviews
« Literature Review
« Client / Public Dataset Analysis
« Observation Studies & Intercepts
« Experience Sampling / Diary Studies
« Problem Definition & Context
Frame
« Priority Audience Identification
« Theory of Change Mapping
« Select & Specify Target Behaviors
« Actor, Action, Artifact, Outcome
map
« COM-B Analysis
« TDF Analysis
« Value Proposition Statement
« Engagement Strategy
« Voice and Tone Definition
« Promotional Campaign Creation
« Intervention & Protocol Content
« Wireframe Flows
« Interface & Interaction Design
« Interaction Rules & Logic
« Aesthetics, Visual Design &
Branding
« Interactive Prototyping
« Interaction Spec & Style Guide
« Full Stack Development
« Playtest & Prototype Testing
« Acceptability & Usability Testing
« Select Intervention Functions
& Available Program Components
« Select Behavior Change
Techniques
« Identify Methods of Delivery
« Intervention Design Workshop
« Define Outcome Measurements
« Intervention Design Strategy
« Develop Logic Model
« System & Journey Map/Modeling
« Core Loop Definition
« Design Concept Generation
« Concept Testing & Refinement
« Develop Operational Launch Plan
« Design & Implement Evaluation
Plan
« RCT, A/B, Factorial or other Testing
« Post-Test Dataset Analysis
« Predictive Modeling
« Focus Group
« Ethnographic Research
« Synthesis & Reporting
« Journal Writing & Submissions
B E H A V I O R C H A N G E D E S I G N – M E T H O D O L O G Y
#MoralsinBC

9. COM-B System– Michie et. al
B E H A V I O R C H A N G E D E S I G N – T O O L S
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10. COM-B As Applied to Medication Adherence Factors
Capability
Physical and psychological capacity to
engage in the behavior
Motivation
All brain processes that energize and direct
behavior toward goals
Opportunity
All factors lying outside the person that
make performing the behavior possible or
prompt it
Psychological: Capacity to engage
in necessary thought processes
Reflective: Evaluations and plans Physical: Physical opportunity
provided by the environment
• Comprehension of disease and treatment
• Cognitive functioning (e.g. memory,
capacity for judgment, thinking)
• Executive function (e.g. capacity to plan)
• Perception of illness (e.g. cause, chronic
vs. acute, etc.)
• Beliefs about treatment (e.g. necessity,
efficacy, concerns about adverse events,
general aversion to taking medication)
• Outcome expectancies
• Self-efficacy
• Cost
• Access (e.g. availability of medication)
• Physical characteristics of medicine (e.g.
taste, smell, size, shape, method of
administration)
• Regimen complexity
Physical: Capacity to engage in
necessary physical processes
Automatic: Emotions and impulses
arising from associative learning and/or
innate dispositions
Social: Social and cultural milieu that
dictates the way we think about things
• Physical capability to adapt to lifestyle
changes (e.g. diet or social behaviors)
• Dexterity to take medication (e.g. open
bottle, inject, etc.)
• Stimuli or cues for action
• Mood state / disorder (e.g. depression or
anxiety)
• Social support
• HCP-patient relationship /
communication / autonomy support
• Stigma of disease, fear of disclosure
• Religious / cultural beliefs

11. #MoralsinBC
Types of Motivation:
Self-Determination Theory
AutonomousControlled
Long-term change happens here!
Sources:
Ryan & Deci (2000)
Segar & Hall (2011)
Amotivated
I have no desire
to do this.
External
Someone told
me I have to
do this.
Introjected
I’ve internalized
the nagging:
Better do this.
Identified
Doing this will
help me achieve
goals I really
value.
Integrated
Doing this is part
of who I am.
Intrinsic
I love doing this;
it feels great!

12. “I can make my own meaningful choices”
“I am learning, growing, and succeeding.”
“I am part of something bigger than myself. I belong.”
Autonomy
Competence
Relatedness
Motivation
The Levers of Motivation
Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55, 68-
78.
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13. What are you challenged with?
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14. Moral Issues in Designing for Behavior Change
#MoralsinBC
Amy Bucher, Ph.D.
Mad*Pow
abucher@madpow.net
@amybphd
Raphaela O’Day, Ph.D.
Johnson & Johnson Health
and Wellness Solutions
roday@its.jnj.com

15. Our passion for health led us to found the HxRefactored conference, which is dedicated to exploring how
human centered design and technology can improve the quality of health service delivery and digital
experiences, and help us all achieve better health. Founded eight years ago, the conference attracts more
than 500 executives, innovators, practitioners, entrepreneurs, and clinicians.
Health Experience Design Conference
H x R E F A C T O R E D 2 0 1 7