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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 really shouldn’t text
while driving.
It’s dangerous.
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?”
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 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
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?
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. 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
COM-B Model
Com-B
Components
http://www.behaviourchangewheel.com
Let’s apply this:
▪ Physical Capability
▪ Psychological
Capability
▪ Physical Opportunity
▪ Social Opportunity
▪ Reflective Motivation
▪ Automatic Motivation
Now you try:
▪ Physical Capability
▪ Psychological
Capability
▪ Physical Opportunity
▪ Social Opportunity
▪ Reflective Motivation
▪ Automatic Motivation
UCL Theories and Techniques Working Group: 2017 MRC Grant
Mechanisms
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
Design for Behavior Change
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
 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
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.

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
Twitter
Messages

Unclear Goals
What specific
behaviors will support
the goal?
▪ Improve Customer
Service
▪ Give better
feedback
▪ Be healthier

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
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?
Unlearning
▪ Familiarization
▪ Comprehension
▪ Conscious Effort
▪ Conscious Action
▪ Proficiency
▪ Unconscious Competence
From Gloria Gery – Electronic Performance Support Systems
When we learn something, we go through:

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://abcnews.go.com/Health/google-diet-search-giant-
overhauled-eating-options-nudge/story?id=18241908
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
overcoming reluctance or
anxiety.
http://www.projectalert.com/resources/posters
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
▪ Outcomes
▪ Feeling of confidence
or mastery
▪ Sense of relatedness

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?
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 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.
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?
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

Mistrust or Construal
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
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
▪ 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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Design for Behavior Change

  • 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?”
  • 5. Answer: Logical decision-making isn’t logical From Jonathan Haidt’s The Happiness Hypothesis
  • 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
  • 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. 
  • 27. Making it visible: From Perfect Time-Based Productivity by Francis Wade
  • 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
  • 38. Unawareness of Consequence or Bigger Picture 38 https://www.youtube.com/watch?v=3Lzsu8SXaWY 
  • 39. Lack of Environment or Process Support 39 
  • 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
  • 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
  • 47. Should you order wine with dinner?
  • 48. We listen to authority figures
  • 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?
  • 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 
  • 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