Cognitive Design

Core77 has an interesting post on the keynotes given at the recent Interaction 09 conference held in Vancouver. Of special interest to cognitive designers is Robert Fabricant (Frog Design) keynote on irrational behavior . His thesis is that interaction design is NOT about computer technology but about changing human behavior.

Could interaction designers be taking on the challenge of behavior change? 

For a reaction check and additional info on the conference check out the post by Frogs on the Road.

I am working with a client that wants to determine if commonly available apps on cell phones can actually change our health-related behaviors. And if they can what is the “cogniiton behind it” and how can we use that to define new apps. 

For example, the iPhone alone has about 10 applications designed to help you quit smoking.

Would love to hear from anyone that has insights into why these work or not.  

In my course on Designing for How Minds Work at Northwestern University, I draw on the concepts, tools and interventions of cognitive therapy. The New Handbook of Cognitive Therapy Techniques is a great introduction and a required course reading.  Who better to help us understand how minds work than a therapist focused on how thoughts and emotions cause behavior?

For example, it turns out that the Antecedent, Belief, Consequent or ABC therapy technique is a powerful tool for mapping interactions, rapid prototyping and discovering unmet cognitive needs especially in service design.  Check out these slides for more more detail. 

Cognitive behavioral interventions (CBI) are especially useful for designers interested in creating features and functions that assist users in thinking differently, changing behaviors, managing emotions and the like. Importantly, there is literature on the effectiveness of the various techniques. For example, a recent study on the effectiveness of cognitive-behavioral training  in the journal Personality and Individual Differences demonstrated that CBI is able to show:

“Significant improvements resulted in employees’ attributional style, job satisfaction, self-esteem, psychological well-being and general productivity.” 

The intervention was a cognitive-behavioral training program delivered to financial services sales agents.

The bottom line for designers:  Want to create artifacts that move the hearts and minds of your customers?  Best study the tools, ways and insights of cognitive behavioral therapists!

Self regulation includes the automatic and conscious mental processes we use to manage our emotions, drive states (hungry, thirst, need for sleep, sexual urges), cravings and thoughts in order to control behavior and reach a goal.  Self regulation is fundamental for success especially when we need to make and sustain behavior change. 

Designing programs, products and services that help people make behavior change is big business and it requires deep insight into the cognition of self-regulation if it is to be done effectively.  

Recent research from the University of Miami  sheds some new light on the issue by suggesting that religion may have developed, at least in part, because of it ability to help people exercise self control.  

But why would the religious be more inclined to self control?

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Emergency vehicles are often slowed by traffic or are involved in accidents because drivers in pedestrian vehicles cannot hear their sirens. Effective interior sound proofing in your car, some hearing loss due to age, ear phones, blaring radios and other conditions means we sometimes cannot hear an emergency vehicle coming. 

Not hearing sirens (a cognitive or sensory design problem) is the number one cause of accidents involving emergency and pedestrian vehicles.

Increasing the volume of sirens is likely not the answer but changing the frequency so the sound penetrates the car and vibrates the driver’s body so that they feel it could be.  This is the idea behind the Howler siren.

The new “feel me coming” siren is being put to use in Tulsa Oklahoma and South Fort Meyers Florida.  At a cost of $400 per siren they are expected to pay for themselves immediately by avoiding accidents.

Resigning a pill bottle to meet specific cognitive needs doubles medication compliance.

Not taking meds properly is a major issue in healthcare.  Approximately 125,000 people die from improperly taking meds every year in the US. As much as $100B-$300B is wasted in hospital visits, tests and lost productivity associated with lack of compliance with medication regiments.

Studies show that we take our meds according to the doctor’s orders only 40-50% of the time.  The problem is we forget (or fail to remember to remember to take our meds – a prospective memory need), are boggled by the complexity of what to do (imagine taking 10-15 different meds per day) and have self esteem issues (taking meds makes us appear weak or a burden). In short, prescription pill bottles we get from the pharmacy don’t meet the complex cognitive needs (prospective memory, multi-pill complexity, self esteem) associated with personal medication management.

Fortunately a number of smart pill boxes have been designed to help us solve this problem. According to an excellent article on Medication Compliance by Allan Naditz in the November issue on Telemedicine and e-Health, these devices can take compliance from the 40-50% level to the 90-95% level.    

He discusses eight smart pill boxes ranging from simple reminder systems to personal med dispensers that provide multiple reminders and contact a service provider automatically if you don’t take your meds. A You Tube video outlining the problem and pitching the MD2 system, a top of the line model, can be found here.

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When applying cognitive design to organizational problems we approach change efforts, optimize work flows, implement benefit programs, facilitate decision-making meetings, plan team-building events and offer rewards and the like on the basis of how minds really work.

A classical example is the application of Kübler-Ross’s five-stage grief model to managing organizational change. Kübler-Ross observed terminally ill patients and argued that they went through five stages of grief including denial, anger, bargaining, depression and acceptance. 

[image source: Scientific American] 

Organizational theorists and management consultants picked this up and crafted models for employees that were doing something akin to grieving as they had to navigate a fundamental change/loss at work.  

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Avoiding unwanted behaviors – overeating, smoking, unsafe sex,  inactivity, acts of dishonesty, drinking and driving, not taking your meds and so on all require self control.   Self control or more broadly self regulation is a complex cognitive process.  Cognitive design (or designing based on how minds work) should come to the fore when we are creating artifacts that require self control or that try to help people avoid failures in self control.

Fighting for self control often takes tremendous mental energy – overcoming habits, smoothing out emotional responses, focusing on the future rather than the present, channeling visceral responses constructively (e.g. cravings) or otherwise using our executive function to regulate our thoughts and feelings to make sure we stay in control or reach our goal.  Many times we just don’t have enough mental energy to sustain the fight, or multiple fights, we face on a daily basis.

Designs that create mental energy and directly support the cognition of self regulation are an imperative.

 Some new scientific insights on how to do that can be found in the work of Dr. Kentaro Fujita, an experimental psychologist at Ohio State University.

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One way to know if a topic is really “in the air” is to see how it is treated in a US Presidential election.  Although it is not rolling off Wolf Blitzer’s tongue, I have found at least one solid reference to cognitive-design like thinking that might generate some buzz.

Wired magazine, recently ran a cover story highlighting the views of 15 people the next president should listen to. Fortunately, they included a short piece on David Laibson, a behavioral economist from Harvard entitled, Tweak Human Behavior to Fix the Economy. The basic idea is that we do not need to overhaul the principles of the free market economy to resolve our housing, healthcare, retirement and various economic woes. Instead, small changes in programs and policies that nudge consumer behavior in a different direction is enough to fix the problem. After all, these problems are chiefly rooted in how we make decisions and behave. 

The example nudge discussed is something we have covered in this blog several times namely, changing the default on 401k plans so that people are automatically enrolled and have to opt out if they don’t want to participate. Studies show that such a small change can go a long way to addressing the fact that 50% of Americans do not save enough for retirement.

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