Cognitive Design

The standard model for driving organizational change is to tell employees a compelling story of why they must change; have leaders model the new behaviors; create reinforcing mechanisms (systems, processes, incentives) and build capability or the employee skills required to enact the new behaviors.  Despite it common sense appeal and academic grounding, this model rarely if ever fully works. But why?

According to the authors of The Irrational Side of Change Management in the McKinsey Quarterly, the answer is that change leaders fail to take into account the “irrational but predictable” aspects of how employees interpret their environment and decide to act.  This is of course just another way of saying that they don’t factor the cognitive needs of employees into the implementation and therefore fail to produce results.

The authors offer nine suggestions and insights, and I quote:

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For those involved in the design of weight loss programs, check out the post, Brain’s response to seeing food may be linked to weight loss maintenance, on the brain mysteries blog.  First, they summarize very nicely the problem of maintaining behavior change versus achieving behavior change:

 ”Long-term weight loss maintenance continues to be a major problem in obesity treatment. Participants in behavioral weight loss programs lose an average of 8 to 10 percent of their weight during the first six months of treatment and will maintain approximately two-thirds of their weight loss after one year. However, despite intensive efforts, weight regain appears to continue for the next several years, with most patients returning to their baseline weight after five years.”

Second, the investigators found via a brain scan study, that to maintain weight loss, the self-regulation that is learned to lose the weight must become hardwired or automatic over time. The effort must shift from a conscious, energy intensive, effort to one that is automatic or effortless.

Sleep is a unique mental state and designing things to “get a good night’s sleep” is definitely within the scope of cognitive design. So I am always on the look-out for devices, scientific studies and techniques that relate to sleep.

 Check out the Zeo personal sleep coach. It is a home sleep monitoring device including headband  that captures the electrical activity associated with your sleeping patterns.

The product comes with web-based journaling software to help you gain insights into the causes and effects of a good night sleep.

Finally, you are encouraged to develop a 7-step sleep fitness program to optimize the quality of your sleep.

The most urgent cognitive design problems we face today have to do with creating artifacts that help us make and sustain the lifestyle changes needed to improve health. Much of the cost of healthcare and the morbidity and mortality we experience in advanced countries (especially the US) can be linked to lifestyle choices and otherwise avoidable health risks.

Designers that work in this space need to be aware of the enormous range of literature on causes, assessments, interventions and effectiveness that have grown up over the last 20 years or so.  A great source is the new initiative on lifestyle medicine launched by the American College of Preventative Medicine. They focus on lifestyle interventions (nutrition, physician activity, smoking cessation, safe sex, stress reduction, etc.) and the effective management of chronic diseases (asthma, diabetes, obesity, cardiovascular disease, cancer, etc.).

Of special interest to cognitive designers  is a set of evidence-based guidelines and a supporting  literature review  for making health-related behavior change.

It is a single source for generating scientifically-grounded design insights and evaluating competing designs across the full range of health-related behavior change challenges.

Small reminders at just the right time can have a powerful impact on making health-related behavior changes. They support our efforts at self regulation and control and help us jump the gap between knowing what to do and actually doing it.  This approach has been popularized through small-step programs and the idea of Nudges.

Habitwise is putting this principle into action in an interesting and visual way using bracelets and tokens. Check out this application for kids:

As they explain on the website:

“Self-care begins each morning by placing your wristband collection on one wrist. Throughout the day, simply shift the appropriate color and quantity of wristbands to your other wrist with each meal, snack and activity. One wrist shows goals for the day; the other tracks accomplishments.”

For people that don’t want to wear bracelets they offer:

The use principle is the same only you are shifting tokens from one pocket to another during the day.

The fact that these are portable, tactile, use color to convey information, offer a friendly reminder and can potentially be points of pride or self-competition means they are well-designed to support behavior change.

Yes, at least for some people in some circumstances according to an interesting new fMRI study covered in Seed Magazine as Truth or Lies:

“What they found is that honesty is an automatic process—but only for some people. Comparing scans from tests with and without the opportunity to cheat, the scientists found that for honest subjects, deciding to be honest took no extra brain activity. But for others, the dishonest group, both deciding to lie and deciding to tell the truth required extra activity in the areas of the brain associated with critical thinking and self-control.”

For cognitive designers working on ethics/moral related challenges this has some important implications.

First, develop a psychographic profile for picking out those folks in your target group that require behavior change, short of doing an fMRI study. Bombarding folks that have already learned the “moral behaviors” with irrelevant attempts to change will be disorienting and counter productive.  Second, design policies, rewards, processes and other environmental factors to make the honest choice require far less mental energy (critical reasoning and self control) than the dishonest choice.

I have blogged many times on various designs aimed at improving medication adherence. Remembering to take your meds and remembering to refill your perscriptions are serious cognitive design challenges, especially for the elderly taking many medications.

Enter the GlowCaps product from Vitality. You use special caps:

and this gadget that plugs easily into a wall socket.

The gadget pulses orange when it is time to take a pill, sends a weekly update to someone you designate (for social support), connects to your pharmacy and automatically reorders and sends a monthly report to you and your doctor indicating if you missed, met or exceeded your compliance goals. You are provided an incentive to exceed your goals.

I imagine there is some set up involved. Although I have not tested it yet, this appears to have a lot of the right stuff from a cognitive design perspective.

We mimic the behaviors around us especially those in our “in group”.  Behaviors spread through groups sometimes as swiftly as a contagion. Yawning, laughing, happiness, skipping school, smoking, obesity, cheating, and bullying are a few of the behaviors that have been shown to spread contagiously.

Some of these vector through biology, others direct influence and still others through social network effects. Contagious behavior, like an idea virus or viral product (e.g. a video clip) has a unique design pattern or set of features and functions that make it irresistible and effortless.  But what is the design pattern for contagious behavior? How can we for example, invent contagious behaviors for achieving and sustaining health weight loss, managing chronic illness and the like?

Some have offered answers on how to design and seed contagious behavior (e.g. The Tipping Point) but none that have led to reproducible results. Until the design pattern for contagious behaviors is discovered we will have to follow the advice of mothers and effective leaders – hang out with the good kids and surround yourself with talented people.

Recently, a group of cognitive design students at Northwestern University set about the task of creating behavior change programs aimed at lowering the carbon footprint of the typical American home.   A fascinating array of programs were developed which I will blog on later.

Just saw an announcement from EurekAlert! on how Psychological factors help explain the slow reaction to global warming.  It provides strong support for the approach the students took, namely, focusing on unmet cognitive needs.  A task force from the American Psychological Association (APA) looked at decades of psychological research and isolated these cognitive factors (and I quote): 

• 1. Uncertainty – Research has shown that uncertainty over climate change reduces the frequency of “green” behavior.
• 2. Mistrust – Evidence shows that most people don’t believe the risk messages of scientists or government officials.
• 3. Denial – A substantial minority of people believe climate change is not occurring or that human activity has little or nothing to do with it, according to various polls.
• 4. Undervaluing Risks – A study of more than 3,000 people in 18 countries showed that many people believe environmental conditions will worsen in 25 years. While this may be true, this thinking could lead people to believe that changes can be made later.
• 5. Lack of Control – People believe their actions would be too small to make a difference and choose to do nothing.
• 6. Habit – Ingrained behaviors are extremely resistant to permanent change while others change slowly. Habit is the most important obstacle to pro-environment behavior, according to the report.

They also reviewed interventions that worked including, for example,  providing immediate feedback on energy use rather than waiting for a monthly bill and combining financial incentives with other forms of behavioral influence (e.g. peer pressure). For those that want to dig deeper there is a 230-page PDF covering the research available from the APA.

Speakers from the leading edge of the Science of Decision Making that provide a clear and compelling explanation of what is going on. Certainly worth listening to in the background as you do other tasks, like work on your cognitive design problems.