Cognitive Design

We are clearly a nation of spenders not savers in the US. You can see that at both the national level (current federal debt = $14.7 Trillion) and the individual level (total personal debt = $16.7 Trillion).   Our total debt (federal, state, local, household) is some 55.7 Trillion dollars! At the individual level this is primarily a behavior change challenge. I need to spend less and save more. It is very similar to losing weight. I need to eat less and be more active.

Consciously changing behaviors takes a lot of effort. We must learn what works from experience. This means trying a lot of small experiments with ideas that have proven practical for others.   We must fail many times before unlocking the simple tactics that work for our specific circumstances. Learning to change behaviors from experience is a major cognitive design challenge. One way to meet that challenge is to be sure to provide a fresh supply of small steps that aspiring changers can try.  Each step should be an easy but potent way of experimenting with the desired new habits.

A good example is the attempt by the American Institute of Certified Public Accounts to help us develop the saving habit. They created a website called Feed the Pig  that includes a section on savings tips. These tips cover everything from buying makeup to dining out and using premium cable. Note how they are structured:

Each tip offers three experiments you can try.  This is a good way to stimulate the personal learning from experience that is so essential for effective behavior change.

Good cognitive designs pay particular attention (by dedicating features and functions) to psychological moments of truth (PMOT) in the customer experience. Casinos that use real time analytics to know when a high-value gambler is just getting ready to leave the table or a behavior change program that includes a “call your buddy” option when you are nearing relapse are two service designs focused on PMOT. These go far beyond the traditional PMOT of making a good first impression that many designs focus on. Product and service interactions are loaded with PMOT.

Anytime you have a strong emotional reaction (e.g. we often hear I love my phone, I hate my insurance company and performance evaluations are a pain) you are experiencing a PMOT success or failure.  Products or services that directly involve cognition – education, healthcare behavior change, decision support at work – are dominated by PMOT.  These psychological moments of truth are not nice-to-haves or frosting on the service cake, they involve fundamentally important outcomes.

Take for example the need for watchful waiting in healthcare. Patients and clinicians can deal with symptoms that may be best resolved by careful watching versus prescriptions, expensive tests or trips to the emergence room. Yet patients are fearful and clinicians may feel the need to practice defensive medicine.   When the emotional stress hits the decision making process we have a psychological moment of truth.  Combine that with the cost of care being diffused by a third party and a fee for service model that links not waiting with making money and the PMOT becomes even more intense.  We are not dealing with this very well. The result of not adequately supporting the cognition of watchful waiting is a major cost and quality driver in the US healthcare system.

Self control is complex cognitive process that is fundamentally important for personal, professional and social success. We use self control to avoid temptations, delay immediate gratification for longer term rewards and achieve lasting behavior change.

I have studied or implemented a little over 100 programs that make use of the cognition of self control to achieve behavior change. In each case,  a key feature of the design included simple tactics or corrective actions participants used to avoid failures in self control.  An interesting article on How Self Control Works, makes the same point.  In reviewing Mischel’s  famous marshmallow study, where children are asked to chose between receiving a marshmallow now or more later, researchers made a critical observation:

“Some children sat on their hands, physically restraining themselves, while others tried to redirect their attention by singing, talking or looking away. Moreover, Mischel found that all children were better at delaying rewards when distracting thoughts were suggested to them.”

Simple tactics that can be taught to others to improve self control.  This is great news for anyone in the business of making behavior change (all of us).  The key is to discover and teach simple corrective actions that help avoid failures in self control.

Very interested to hear from readers that have used this strategy. What teachable tactics for improved self control  have you discovered?

All cognitive designers and change managers should check out the work by Dr Neff, an associate professor of human development and culture at the University of Texas at Austin on Self Compassion.  The site includes assessment instruments, exercises, research articles, videos and more.

The concept of self compassion is straightforward  - having a mindful and open hearted or kind reguard for yourself especially when faced with your shortcomings. But according to the latest research it can have a big impact on how well we adapt to change. For example, a recent study showed that even a modest self-compassion intervention could significantly impact eating habits.

Including specific self-compassion interventions (positive self-talk, journaling, best/worse trait analysis, mindfulness training, etc.)  in your next organizational change program could improve outcomes. This is especially true since our traditional approach to organizational change tends to emphasize what is wrong and implicitly encourages people to be self critical.

Interested to hear from readers that have used self-compassion interventions in change programs.

Angry Birds is a strong candidate for the most successful game of all time. With nearly 100 million downloads it sees some 1.2 billion of hours of play every year! A masterful cognitive design on the order of lottery tickets.  To understand which features and functions are generating the impact check out the excellent post on the cognitive teardown of the user experience.

I will quote some key findings from the post below but strongly urge you get the game, play it yourself and share insights into why it works.

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Designs that put us to sleep, literally, are an important application area for cognitive designers. Sleeping well is essential for brain health and peak cognitive performance.  Not sleep well impacts mood, relationships and work performance. Lack of sleep creates brain fog.

The problem (or opportunity) is huge.  According the National Sleep Foundation’s 2011 sleep in America Poll, 63% of American’s say their sleep needs are not being met.  Seems like we have developed a wide range of behaviors that inhibit sleep or degrade its quality. From using light emitting screens after dusk, to eating big meals, not sticking to a sleep schedule and too little physical activity all contribute to poor sleep. Sleeping well is a major behavior change challenge.

We have designed our lives to go at full speed.

The National Sleep Foundation is an excellent resource on the causes of cures for our sleep troubles. What we need are designs that entice us to make the necessary behavior changes.

For example, imagine a simple smart phone app that prompts us with a daily nudge (or knowledge card) suggesting a small but important sleep-friendly behavior.

Check out The Strange Powers of the Placebo Effect. It is a well produced 3-minute video recap on the research about placebos, suggesting that size, color, cost, branding, tech-intensity and geographical location all matter when it comes to effectiveness. Placebos can improve sports performance, prevent death, relieve pain, help depression, become addictive and just make use feel better or worse.

Placebos are chemically and therapeutically inactive. They work by shifting our beliefs, reshaping our expectations, reframing our thinking and changing our behavior. They play off of our deepest mental models about authority and science and the need to do something rather than nothing.  They combine hope and fear in a one two punch and reduce complexity down to simple acts. Great cognitive design.

The amazing thing is that they produce life altering and reproducible outcomes. Sometimes they even work when someone knows they are taking a placebo!

The design question is how can we ethically harness these effects to produce positive outcomes in organizational and behavior change programs?  Said another way, how much of successful organizational behavior change is due to placebo effects rather than leadership with therapeutic impact? 

I am spending time writing chapters for a new book on the Five Pathways to Lasting Behavior Change. A major theme is the living room or household entrepreneur. This is an individual that has learned from hard experience how to influence behavior change in themselves or those around them. Like garage entrepreneurs, they sometimes develop innovations that will scale and impact the lives of millions.  Good examples are the 12-steps programs and Weight Watchers. These behavior change programs were hatched by individuals working in their living rooms (a metaphor) not from a corporate R&D lab.

In my research I have found that nearly every case of lasting behavior change has involved some form of consumer innovation. That happens when consumers modify existing products or create new ones to meet their individual needs.   It made me wonder, if consumer innovation appears rampant in services designed to change behavior, how much does it happen in other cases?

A colleague sent me a link to Comparing Business and Household Innovation in the Consumer Sector.  You can download the full paper for free. The study was national in scale and was done in the UK. Key findings include:

* Over a 3 year period 2.9 million consumers in the UK (6.2% of the population) have innovated by making a change to an existing product or creating their own. On average they did so 8  times over the 3 years.

* Consumers invested twice what all the business in the UK did on innovation. More specifically, “In aggregate, consumers’ annual product development expenditures are 2.3 times larger than the annual consumer product R&D expenditures of all firms in the UK combined.”

* Males with a university degree and technically trained dominate the process, especially if they are college aged or 55 years old and not working.

The table below (taken directly from the article) gives examples of what counts as a household or consumer innovation.

For students and practitioners of innovation the key findings and examples provide important insights into what looks to be a major source of practical creativity. But this is just the beginning of the research.

I am interested to hear from readers that have their own examples of consumer innovation to share. I am considering a website dedicated to the topic and designed to collect, promote, diffuse and study consumer innovations big and small.

We seek to change behavior (stop, start, avoid starting) in order to achieve some outcome such as better health, more savings, superior customer service, killer communications and the like. There are only five pathways for achieving and sustaining a behavior change:

1. Eliminate the need to change behavior but still achieve the outcome.  For example, healthy foods well disguised as your favorite snack. I can continue to eat the same food but am now emulating healthier eating habits.

2. Engineer hard stops or gos into the environment that make it impossible to do unwanted behaviors or avoid desired behaviors. For example, no more vending machines in schools.

3. Engineer soft stops or gos into the environment that nudge us towards the preferred behaviors. For example, making healthy choices easier to see and access in the lunch line.

4. Provide guidance or support to individuals as they go through the process of learning the new behaviors from experience. For example, joining Weight Watchers.

5. Observe individuals with advanced skills in self-regulation as they work solo through the process of learning the new behaviors from experience.  For example, losing weight on your own.  20-25% of the population have this capacity and more can develop it.

From a cognitive design standpoint we can see how the different pathways leverage insights into the nature of decision-making, self-regulation or control, learning from experience, self efficacy and individual autonomy.  For example, the first three pathways (eliminate,  hard and soft) focus on changing the environment. As such the need for self-control is minimized and learning is at the stimulus-response level. But ethical issues can emerge as these pathways may impinge on individual liberty and personal choice. They work well in case were there are clear safety concerns and behavior changes are not complex (e.g. healthcare workers washing their hands).

The last two pathways on the other hand (guided, solo) involve the much higher cognitive load associated with self regulation and learning new mental models from experience but are unavoidable when we need to master more complex behavior changes.

I have yet to find a behavior change program that does not follow one or several of these pathways.  Even work on the cutting edge seems to fit. Take for example, the recent story in the Wall Street Journal about how food scientists are designing foods to trick our brains into thinking we are full:

“Nestle, one of the world’s largest food companies, hopes to develop new types of foods that, essentially, seek to trick the gut brain. The foods could make people feel full earlier, or stay full longer, in order to curb the desire to eat more. For example, cooking french fries in oil that gets digested more slowly than regular oil could confer a longer-lasting sense of satiety, researchers speculate.”

The gut brain refers to the large neural mass in our gut sometimes called the second brain. Designs that satiate in this way are an example of the first pathway – eliminate. I am redesigning the environment to eliminate the need to change behavior. It happens automatically.

Very interested to hear about behavior change programs or approaches that don’t seem to fit into the five pathways framework.

Childhood obesity is alarming.   Creating lasting changes in eating and activity habits is the way to resolve it.  But how do you change a child’s behavior?  The Research Digest reports an interesting new study that claims Bribing Kids to Eat Their Greens Really Does Work.

Bribes in this case include a sticker or positive comment (social reward). This was a large-scale study and defeats the worries that bribes can backfire.

“They conclude that rewards could be an effective way for parents to improve their children’s diet. ‘…rewarding children for tasting an initially disliked food produced sustained increases in acceptance, with no negative effects on liking,’ they said.” 

Understanding how to use rewards to change eating habits is one dimension of designing an effective choice architecture.