Change is Hard, But Not Impossible

A lot of “Health 2.0” tools seek to help people change their behaviors to lead more healthy, productive lives. This is an admirable goal, and one I wholeheartedly endorse. Some of the tools are really “gee-whiz” neat!

However, many people involved with building Health 2.0 tools have little or no formal background in human behavior. How do you expect to build tools that seek to change human behavior, with no human behavior experts — you know, psychologists — consulting with you or on your staff?

That’s like trying to write a piece of software without a programmer.

In reply to a query on this topic, and how people change their behavior, I wrote the following over at the Society for Participatory Medicine’s e-patients.net blog. I think it encapsulates my experience with understanding human behavior (as a supposed expert in human behavior)…

Here are some of my simplistic beliefs about behavioral change:

• Humans are complex.
• Change is difficult, even under ideal circumstances.
• No one model is going to work for everyone.
• Methods should adapt to meet the individual and personalized needs of the person.

Something to keep in mind — if behavioral change were easy, 400,000 psychotherapists in the U.S. would be out of business tomorrow. Changing behavior — even when it’s life threatening, such as smoking — is extremely difficult. There are a set of complex interactions at work that differ from person to person.

Psychologists have been studying human behavior for over 120 years. It’s not like we just stumbled upon this subject. There are literally thousands of research studies and papers and hundreds of books on this topic. There are dozens of different models that attempt to explain human behavioral change.

So with all due respect to the many people who think that since they majored in psychology in college, they’re somehow qualified as a human behavior expert, I think if you’re going to get serious about this topic, you need to hire a few experts. If you’re spending money to build a software tool, you should be spending money to understand how people really will likely interact with your assumptions about that tool as well.

Changing ourselves, changing our behavior — this is hard stuff. If it were easy, we’d all go out and become our perfect selves by just gaining insight, and be done with it. It’s not a matter of just having the right incentives in place, or making it easy as pie. It’s not a matter of just being given the data on a health dashboard, or mobile app, so we can track our data until our heart’s content.

So here’s the message to all of you Health 2.0 startups — get some behavioral experts — psychologists — on staff if you want to really understand people (not “users”). This isn’t about “user experience,” this is deeper. This is about understanding what will motivate people to stick with your tool after a day or a week of using it. This is about really getting an individual to change — even ingrained, difficult behaviors.

Change is hard. But it’s not impossible. With the right tools, the right motivation, and often with someone helping you out directly, one-on-one, you can change something you want to change. It just takes patience, time, and a lot of effort on your part.

Read the full blog entry: What’s the point of Health 2.0? (Some answers this time)