Cognitive Design

Yes if we can preserve the cognitive factors that make them work.

Mississippi is in trouble when it comes to health and healthcare.   According to the National Institute of Health (NIH) they have the highest rates of obesity, hypertension and teenage pregnancy in the country. Their infant mortality rate is 50% higher than average and 20% of the population has no health insurance.

They have spent millions but report in a recent NIH news story:

“We’ve been attacking this problem over and over again with just heartbreaking results,” said Shirley, chairman of the Jackson Medical Mall Foundation, a one-stop health care facility for Mississippi’s underserved.

Now they are trying to import a health service delivery model, called the Health House from the middle east.  The Health House developed during the 1980-88 Iran-Iraq war is simple but apparently very effective.  

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Wiley InterScience just announced a new journal, WIREs Cognitive Science, that should be very useful for designers. Full access to content is free (for a limited time) and part of the purpose of the journal is to be:

“An authoritative, encyclopedic resource addressing key topics from diverse research perspectives” 

This should make it a goldmine for the cognitive designer interested in taking a evidence-based approach. For example, in the very first issue, an article on Deductive Reasoning, looks at the role of deductive reasoning from the point of view of logic, psychology and artificial intelligence. It provides a precise review of logical inference, probabilistic models, mental models and conditional reasoning.

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Self control or the ability to regulate our own thoughts and emotions to achieve a behavior change is a complex high-load cognitive process. In the best case, when designing programs for behavior change, we invoke groups, devices and environmental factors to help distribute some of this cognitive load.  Leaving all the mental work for behavior change with the individual is likely to lead to failure.

So I am always on the look out for new scientific studies that shed light on how to distribute the cognitive load of behavior change to other people, devices, workspaces and even smart machines. Found an excellent post describing a new scientific study on Self-Control and Peer Groups on the Frontal Cortex.  To quote:

 ”…according to a new study by Michelle vanDellen, a psychologist at the University of Georgia, self-control contains a large social component; the ability to resist temptation is contagious. The paper consists of five clever studies, each of which demonstrates the influence of our peer group on our self-control decisions.”

 In short, under many circumstances, watching someone else exert self-control increases the likelihood that we will exert it too.  No surprise to the cognitive designer but such studies lend scientific evidence to the view.

As we age we begin to bind or encode non-relevant bits of information into the memories we form.  This is called hyper-binding and reveals an interesting increase in bandwidth but decrease in discrimination in memory formation in the elderly.   This may have significant implications for the cognitive designer.

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Cognitive design is about understanding the psychological (intellectual, affective, volitional and motivational) needs of individuals and groups and optimizing the artifacts we create to meet those needs.  Cognitive designers are by profession catalogers of psychological needs. The results are often cast in psychographic profiles that show how clusters of needs work together to create a “cognitive type” that we can design for.

 So I am always on the look out for new scientific studies that shed light on the psychological needs of specific groups.  The blog, Speak the Culture has a recent post that does an excellent job summarizing five major studies that shed light on the cognitive needs of employees. I won’t repeat the great reporting in the post but will quote the conclusion:

 “All this research seems to reiterate the same thing! Inspiring employees to be engaged and productive is not just about the money — it’s about winning their heads and hearts by offering an optimal amount of challenge, ensuring they feel valued and exhibiting sincere concern for their well-being. Confirmation bias at its best? Perhaps it’s simply the truth.”

The post and referenced reports are definitely worth a read for anyone looking to take a cognitive approach to workplace design issues.

How we perceive the world, learn, think, plan, emote, imagine the future and perform other mental activities is strongly influenced by our physical bodies. In short, cognition is embodied and as designers we need to factor that into our work.

The Association for Psychological Sciences has an excellent article on their site, The Body of Knowledge: Understanding Embodied Cognition that is written in a designer friendly way.  There are a number of scientific insights loaded with design implications including how:

1. Physical sensation of temperature is related to judgments about friendliness and other social relationships.
2.  Perceptions of environmental cleanliness and color is related to our judgement about morality. Or as the authors point out “Just as feeling distant from other people makes us feel cold, feeling immoral makes us feel physically unclean.”
3.  Our bodies sway back and fourth as we reflect on the past or project into the future.

And many more.   Seemingly small bodily effects with big mental impact. Just the stuff a cognitive designer wants to leverage.

I occasionally work with graduate students at Northwestern University to reverse engineer designs that have exceptional impact on cognition or how we think-and-feel. The goal is to discover what unique set of cognitive needs they satisfy and what special features/functions they deploy that move our hearts and minds so effectively.

A student recently sent a link to Questing for Well-Being at Weight Watchers, that reveals some insight into the unique set of cognitive needs the program satisfies:

“We find that among Weight Watchers members in the United States, the support group acts as a venue for angst?alleviating therapeutic confession, fosters the enactment of the support group as a benevolent system of therapeutic oversight, and facilitates a revitalizing practice of autotherapeutic testimonial.”

In short it relieves negative emotions associated with set-backs, makes members comfortable with surrendering some control to the group and promotes wellbeing through helping others.  Weight Watchers is effective at achieving sustained weight loss for its members.  One reason it works is that it attends to cognitive needs that other programs fail to meet.

With the growing wave of aging baby boomers sporting multiple chronic diseases, there are services emerging to help care for them at home.  Intel is on the leading edge with Health Guide.

The success or failure of such services turns on their cognitive design.

Will they improve compliance with treatment plans and promote change in health behaviors in patients? Will they support timely and accurate clinical decision-making and treatment planning?  Clearly, we can have all the gadgets and information in the world and still not produce the outcomes we need.

Check out Elder Care by Remote for a little insight into Health Guide’s effectiveness and an overview of other players in the aging-in-place market.

My hope is that we do not apply the same dated assumptions about patient and clinician cognition that have dominated design in traditional healthcare setting to the emerging opportunities for remote management and care.

Most would agree that good designs are intuitive or easy to understand. But how do you create intuitive designs? In cognitive design we can reformulate that question in more specific terms and appeal to the latest scientific thinking to try and answer it.   More specifically:

What are the cognitive processes associated with intuition and how can we modify our designs (add, refine, and delete features and functions) to support or accelerate those processes?

A new book just published, Foundations for Tracing Intuition, provides a great overview of the cognitive science and modeling techniques needed to answer this question. The author offers a four-process theory of intuition and shows how modeling techniques ranging from talk-aloud protocols to physiological measurements can be used to understand it. This is a must read for the research-oriented cognitive designer. I will be blogging more on the specifics in February.

I am doing some work for a small firm that specializes in providing products and services to new entrepreneurs.  The conditions for starting new businesses have changed dramatically over the last few years. My client  wants to be sure their offerings are optimized for how the “entrepreneurial minds actually works” in this new environment.  A perfect problem for a cognitive designer.

One interesting thing has surfaced already is the demographics of their customers. Turns out your typical entrepreneur is near middle age, well-educated, married and with kids. That seems a bit odd but is backup by the literature.  For example, Strategy+Business reports in The True Characteristics of Entrepreneurs that:

 ”The authors surveyed 549 company founders in a dozen high-growth industries — including health care, aerospace, defense, and computers — and found that their average age when they launched their business was 40. Contrary to popular perception, most entrepreneurs came from middle- or upper-lower-class families and were married with two or more children, in addition to being highly educated (less than 5 percent reported having a degree below a bachelor’s).”

Such individuals are likely to think-and-feel (have cognitive needs) very different than the 20 something, risk-taking, single, workaholic entrepreneur we hear about in the media so often.