Cognitive Design

Wellness programs are a key application area for cognitive designers.   These programs seek to shift employee health behaviors in an attempt to lower employer costs and improve workplace productivity.   Wellness is big business as over 90% of larger employers have some plan in place and there are many provisions in the Affordable Care Act (aka Obamacare) that focus on health, wellness and prevention in the workplace.  So I am always on the look out for scientific studies of what works in wellness.

For example,  Rand just released a must-read report that provides a Review of the US Workplace Wellness Market.  They examine 33 studies and outline core elements in a program, itemize interventions used, provide uptake and participation statistics and draw some important conclusions.  It is clear that wellness programs have passed the “proof of concept” phase but we don’t have a clear evidence base for interventions that work.   The key conclusion on impact:

“Based on the available literature, we find evidence for a positive impact of workplace wellness programs on diet, exercise, smoking, alcohol use, physiologic markers, and health care costs, but limited evidence for effects on absenteeism and mental health. We could not conclusively determine whether and to what degree the intensity of a wellness program influences its impact.”

The report is quick to point out most wellness programs are not even assessed and those that are often lack rigor in assessment.   From a cognitive design standpoint we know that without frequent assessment and feedback at the individual level it is nearly impossible to do the learning from experience necessary for lasting behavior change. And this must go far beyond the individual health risk assessments wellness programs use. Same for the program level. Without frequent assessment and feedback at the program level it is not possible to do the continuous improvement  and organizational learning needed to optimize a wellness initiative.

More bluntly, you won’t get deep, broad and lasting behavior change at the individual and group level unless your wellness program is designed to measure and provide frequent feedback on physiological, activity, process, participation and financial measures.  The more transparent (shared) and real-time the better.

There are big opportunity for cognitive designers in wellness!

The answer is yes, at least according to a recent meta-study that reviewed five projects including some 9000 smokers.   More specifically,

“… smokers who used mobile messaging interventions were twice as likely to make it six months without smoking than those who didn’t.”

Messages included scheduled motivational statements, hints for managing  temptations and rapid response to texts about cravings. Motivation, skill and help from someone else when you are about to fail  is powerful cognitive design for making any type of behavior change.  Unlike many other health apps this solution  reaches out and engages the smoker acting as a nudge, reminder and coach.

Changing the behaviors of people that have problem with drinking and driving or drinking and violence is tough.  An interesting sobriety program in South Dakota claims to be having success with six years of data and an independent RAND study to back them up. Key features of the program include:

“…frequent alcohol testing with swift and moderate sanctions for those caught using alcohol reduced county-level repeat DUI arrests by 12 percent and domestic violence arrests by 9 percent.”

Frequent testing means two breathalyzers daily ( morning and evening)  and those that fail or don’t participate get a day or two in jail, no exceptions.   This supports the idea that daily crisp measurements that drive immediate and modest corrective feedback can reprogram even drug-based habits.

We are hardwired to finish what we start. That is, unfinished tasks will bug us until we complete them. More formally:

“The Zeigarnik Effect is the tendency to experience intrusive thoughts about an objective that was once pursued and left incomplete (Baumeister & Bushman, 2008, pg. 122). The automatic system signals the conscious mind, which may be focused on new goals, that a previous activity was left incomplete. It seems to be human nature to finish what we start and, if it is not finished, we experience dissonance.”

The effect is named for the Russian psychologist that first noticed it at work with waiters in a restaurant. The waiters were able to remember complex orders until they were served. Once the order was complete the waiters lost all memory of them. An incomplete task is remember far more often than a completed one.

From a design standpoint this means we can use incomplete tasks to create specific cognitive effects. The PsyBlog suggests that we can use it to help beat procrastination and the BBC has an post that uses it to explain the psychological punch of the wildly popular game of Tetris.

“Tetris holds our attention by continually creating unfinished tasks. Each action in the game allows us to solve part of the puzzle, filling up a row or rows completely so that they disappear, but is also just as likely to create new, unfinished work. A chain of these partial-solutions and newly triggered unsolved tasks can easily stretch to hours, each moment full of the same kind of satisfaction as scratching an itch.”

If you don’t believe it try it out.

I’m interested to hear from readers with ideas on how else to apply the Zeigarnik Effect to interesting design problems.  For example, how can we use it to improve change or innovation efforts?

Likeable people have more influence and get more offers. Likeable employees sell more products and delivery more satisfying customer service. Likeable leaders and managers are far more effective. It is little wonder that becoming more likeable and creating lovable products and services is big business for designers.

Likeablility is a bit illusive so I am always on the lookout for positions and studies that make it concrete enough to be useful for cognitive designers.  I’ve found six positions strong enough to offer a design framework and have developed two of my own.

For a good introduction I suggest you start with Likeonomics: The Unexpected Truth Behind Earning Trust, Influencing Behavior and Inspiring Action.  The book does a good job of clarifying the link between being liked and economic value creation in business and stressing that being likeable is not about being nice. It also explains how likeability is driven by truth, relevance, unselfishness, simplicity and timing. Each of these general principles is further analyzed. For example, being relevant (get people care)  is broken down into having a meaning point of view, active listening and working the surrounding context.

I am interested to hear from readers that have worked on likeability applications. What was the challenge? How did you define and operationalize likeability?

Source of  image: The True Storyof the Making of Likeonomics

Awe is a unique psychological state brought on by an emotional response to something we find profound or worthy of reverence. Awe can be positive or negative.  A great deed, stunning jewel, massive thunderhead, atomic blast or spiritual moment can invoke awe.

New research claims that some of the psychological effects of awe come from it ability to alter our perception of time by slowing it down:

“Across three different experiments, they found that jaw-dropping moments made participants feel like they had more time available and made them more patient, less materialistic, and more willing to volunteer time to help others.”

This is akin to being more mindful or living in the present moment rather than reflecting on the past or anticipating the future.   As the researchers point out in the early draft of their paper, “awe offsets our feeling that time is limited.”

Nature is replete with awe inspiring objects and events while there are few in the designed world (e.g. shuttle launch, cathedrals and art).   Interested to hear from readers that have examples of human designed artifacts that inspire awe. What makes them work?

Source of Photo:  National Geographic

Source of infographic-  Healthcare Reform: Center Stage 2012

In the last presidential election we saw how important the use of social media was.  In the 2012 election we may see how the web can be used to level the playing field for third party candidates.  Checkout Americans Elect 2012. They literally reinvent the nomination process by allowing you to prioritize the issues, nominate someone, become a candidate and select the candidate that best meets your interests.  Here is the most impressive part:

The winner of this on-line nomination process will be on the ballot in all 50 states. 

And yes there will be a convention:

“In our secure online convention next June, American voters will choose our first directly-nominated presidential ticket. Your voice, your choice.”

This could transform our political decision-making process, opening the way to less  partisan thinking and more solutions-based thinking.

Outstanding cognitive design. They are meeting deeply felt and long neglected psychological (cognitive, emotional, motivational and volitional) needs many American’s have concerning the political decision making process.

The process and site is still under development but they are real. They have 1.7M signatures towards getting on the state ballots and some 5.5M answers to questions about national priorities.

IBM has a vision for a smarter planet. The vision is rooted in taking a scientific approach to services and the emerging internet of things. The pitch is that we can instrument (slap a sensor or servo on) anything, interconnect it with everything and add intelligence.

Instrument, interconnect and add intelligence is a design pattern that shifts the cognitive load off people, extends the intelligence of individuals and groups and can otherwise be used to a wide variety mind-optimized designs.  

Applications big and small are popping up everywhere.

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Source of Image: Nudge