One of the toughest problems for instructional designers is dealing with behavior change. Whether it’s changing habits that interfere with life and work or interrupting undesirable communication patterns, designers often have to find a way to make a difference in personal and social behaviors.
Julie Dirksen addresses some of the challenges and the solutions in this interview.
BB: What have we learned in the last 20 years about getting people to change their behavior?
JD: I think one of the big developments is that we're moving beyond “use will power to change behavior”. But one of my favorite researchers into motivation is a woman named Michelle Segar at the University of Michigan, and she frequently talks about how willpower is overrated. We can white knuckle our way into certain kinds of behavior change, like exercising more. But as long as we’re viewing something as an unpleasant task that we just have to force ourselves to do in the absence of some other kind of extrinsic motivation, we're going to do it until we have that really bad day where everybody's tired and overloaded and things will just fall by the wayside. In the last 20 years, there's been a lot of understanding—whether it comes from the areas of behavioral economics and nudge theory or whether it comes from the work that researchers are doing in domains like exercise, wellness, nutrition, or smoking cessation—that just telling people to try harder is probably not enough and that we need to get into other ways to support people if we really want to be effective.
BB: What is nudge theory?
JD: I don't know if I'd consider “nudge” an actual fully thought-out theory but the idea comes from a book by Richard Thaler and Cass Sunstein titled Nudge: Improving Decisions About Health, Wealth, and Happiness. What they were looking at is behavioral. The power of nudges as they talked about the book itself is called nudge, which is applying behavioral economics to certain human behaviors. A nudge is also referred to sometimes as choice architecture: “How can we construct the choices in a way that makes it more likely that people are going to take the professional or beneficial behavior?”
BB: Has technology affected the design of interventions for behavior change?
JD: Looking at technology and behavior change, a lot of interesting things are happening. Most behavior change problems involve situations where people know what to do but they still aren't doing it. A tough behavior change challenges something that’s not really just a knowledge problem. There's something else that’s standing between people in that behavior and the desired behavior. One of the common denominators in difficult behavior change problems is the issue of delayed or absent feedback. Absence of feedback in the system makes it hard to maintain the behavior.
An example that’s easy to understand is the issue of hand washing and healthcare. We know that people are not washing their hands and 100 percent of recommendations are that people in healthcare should wash their hands frequently. The last study I saw says that rates are maybe around 70 percent. So what's the issue with that? If people’s hands are visibly dirty, they don't have much trouble washing them. But a lot of times your hands look the same before and after you've washed them and so you don't have any kind of visual cue, even though you know that there were bacteria there before and there's less after. Additionally, if you don't wash your hands, patients may get sick.
Most healthcare settings are complex environments and the staff are interacting with a lot of people. You don't know that a patient got sick because you didn’t wash your hands at 3:45 on Thursday afternoon. Usually, the actual indicators that hand washing is a problem don't show up until you get information such as infection rates for a facility compared to other facilities around it. That’s a pretty distant form of feedback for individual behavior.
In the same way, the consequence for smoking could be lung cancer but it's still 20 years later and so it's not as effective a deterrent as it should be. Or there's no feedback at all...situations where nobody's going to comment or nobody's going to notice. Those tend to be the hard problems. One of the interesting things that we look at with technology is trying to improve the feedback mechanism so that you're getting much more immediate feedback. Take exercising, for example. If you started exercising today, you might not start to see benefits from that exercise for a month or longer, depending on the intensity of the exercise you're doing. That's where things like the Fitbit and other wearable devices start to come in. You did better today than yesterday and you know that immediately because you're tracking your steps or your level of activity and checking against goals. It's a way of making feedback more immediate. A lot of the technology apps focus on that.
BB: Instructional designers have been guided by ADDIE in their design work. Is there a better strategy for behavior change?
JD: ADDIE as a model doesn't really zoom in on the behavior change. I think ADDIE is more of a process model than a design philosophy. It's the steps that you're going to take but it's not necessarily going to tell you anything. There's a disconnect between the A (analysis) and the first D (design). There's nothing that really tells you that if you find “this” out in the analysis, it should point to “that” in the design.
A much better model if you're looking at behavior change is one developed at University College London, called COM-B (Capability-Opportunity-Motivation-Behavior). It’s also called the Behaviour Change Wheel. This is a model put together by Susan Michie and her colleagues. They found that there were a lot of behavior change models popping up that focused on motivation or habits. They did a massive literature review and tried to bring them into a single model. They look at defining the actual behaviors, not the outcomes. It's not “lose weight”; it's “walk 20 minutes a day”. It needs to be a behavior. Then they analyze what needs to be present in order for this behavior to occur.
You need to have physical capability, you need to have psychological capabilities. This is where I think learning and development sits a lot of the time because it's about education or training in psychological capability. You need to have a physical environment that supports it; you need to have a social environment that supports it. That's a physical opportunity and social opportunity. Then you need to have motivation. Motivation could be reflective motivation where you're deliberately setting goals and you're thinking about the change and it's attached to your values. Or it could be automatic motivation; which is feelings, habits, biases, things you do without thinking about it.
That’s a framework of six things—the two kinds of capabilities, the two kinds of opportunities, the two kinds of motivation. You can analyze your behavior according to those, and then that starts to point you to solutions. Michie and her co-authors have started to create a behavior change taxonomy, which is currently a library of about 93 different interventions that they were finding in the research literature around behavior change. Certain interventions will map better to certain kinds of behaviors and that makes it possible to work through some different solutions. It's a model that's much more deliberately focused on behavior change, rather than ADDIE.
From the editor: Want more?
At the Learning Solutions Conference & Expo in Orlando, March 30, 2020, Julie Dirksen will address the challenges of getting people to change their behavior. In her pre-conference workshop "Design for Behavior Change", you will discover what eLearning designers can learn from neuroscience, behavioral economics, behavioral psychology, persuasive technology, and habit formation when it comes to changing hard-to-control behaviors and habits. Designers and managers will leave the workshop understanding:
- How to identify and understand the barriers to behavior change
- Research-based methods to design solutions that not only inform learners but also inspire behavior change
- How to use specific models and techniques for designing a change effort
- Approaches to designing a behavior change strategy
Registration is open. Registration for the full Learning Solutions Conference and Expo 2020 is required in order to attend this workshop, and you can do it all in one stop, right here.