Effective Behavior Change Design Strategies

Have you ever had difficulty using a product? Maybe using an airline kiosk you can’t understand, trouble pairing your phone to a Bluetooth speaker, or accidentally (and messily) opening your friend’s dishwasher when it’s already running. You may have found workarounds for some of these products, such as making checklists or putting tape over the buttons you don’t want to press. Some products are just difficult to use by design.

When kiosks and dishwashers difficult to use, they tend to introduce moments of frustration or inconvenience into our everyday lives. Well, what happens when a product being difficult to use puts lives on the line? What if you can’t figure out how to use your fire extinguisher when you need to? What if an EMT can’t figure out how to use the defibrillator? In these situations the difficulty creates problems beyond mere frustration and inconvenience.

Products which, if misused, can have safety consequences are often designed with a focus on safety, quality, rigorous testing, and in-depth training for the user. These efforts are important, but they sometimes make products even more complex and can be tedious and limiting for the people who use them. How can such products be designed in a way that promotes correct use and also creates an engaging, desirable experience?

Effective behavior change design strategies can keep the user engaged and motivated while promoting (and sometimes enforcing) the correct use of a product. In some cases, to keep users engaged and motivated while properly using a product, it is necessary to position the product within a connected supporting ecosystem.

Going Beyond a Traditional Approach to Behavior Change

The prescription pill bottle is a relatively simple product that lives in a difficult use environment where it is often used incorrectly. People forget to take their medications, take the wrong medications, take the wrong amount of medication, and purposefully or unintentionally take other peoples’ medications.

The color, visual design, labeling, function, and shape of pill bottles are all heavily designed with traditional behavior change techniques. These design elements are all intended to result in the correct use of the pill bottle and yet incorrect use is still persistent.

Let’s take a look less engaging behavior change strategies as well as a few that engage the user by leveraging their motivations within a supporting ecosystem, using our pill bottle as an example.

Using Constraint, Instruction, and Precaution to Drive Behavior Change

While common and effective, design strategies that focus on preventing the user from doing the wrong thing or that tell them what to do can limit how engaged the user gets with a product among other drawbacks. Let’s look at a few of these strategies applied to a pill bottle.

 Constraint: Add defensive or constraining elements to the design, making it more difficult to be used incorrectly.  Constraint strategies can be effective, but some users dislike being “prevented” from doing things by their products. There is also potential for users to intentionally use the product improperly by using “workarounds”.

Example: the child-proof cap on a pill bottle might make it difficult for the adult to open the bottle, so they may transfer it to a different container that is child accessible.

Instructional/Precautionary: Provide information to the user to instruct correct behaviors and warn against incorrect ones.

Example: A pill bottle may have instructions to take 1 pill twice a day and a precautionary warning to avoid taking the pill on an empty stomach.

Instructions and warnings are important design features. However, users are often overburdened with instructions and warnings and there is a possibility they won’t be noticed or will be intentionally ignored.

Example: If a patient’s been taking the same medication for years, and the instructions and warnings change on the bottle, it’s likely they won’t change their use of the pill. 


Tapping into Internal Motivations to Drive Behavioral Change

 In many cases, behavior change design strategies are more effective when they engage the user and leverage their motivations. For example, gamification and meeting the need for affiliation and belonging can promote engagement and give the user a more active role the appropriate use of a product.

To accomplish these methods, it is often necessary to look at the underlying goals and create an ecosystem that supports the correct actions to accomplish that goal. This could require additional products or integration with other existing products. While potentially requiring more effort to design than a simple pill bottle, this strategy has the potential open the doors to new opportunity in the form of new products and innovation.

How can a pill bottle motivate patients to adhere to their medications within an engaging supportive ecosystem?

Gamification: Provide rewards, points, and encouraging sounds and visuals. These can make the user an actively engaged “player” in the correct use of a system.

Example: A pill bottle that communicates with the patient’s phone. When they take their medication correctly, their phone plays a pleasing tone and congratulates a patient that they are 95% of the way to being back to normal health. This bottle could better motivate them to take that remaining 5% of the medication and feel proud of their accomplishment.

Gamification can be very successful or very unsuccessful depending how it’s designed into a product. In-depth research to create an engaging game-like feature is essential for success.

Affiliation & Belonging: Design elements that support feelings of social connection, competition, or cooperation.

Example: A pill bottle intended for youth patients could have a feature that notifies the parents when the medication has been taken and allows the child to see that their parents have “liked” that they took their medication.

Affiliation and belonging are universal human needs which is why they make for effective motivators. Other human needs can also be leveraged to change user behaviors using a product.

With the addition of an engaging ecosystem and motivational design elements, we start to look beyond the pill bottle into a larger patient healing system. What if the ecosystem communicated with the EHR? If doctors had a more accurate understanding of their patients’ compliance with medications, they could more accurately track how medication relates to healing and tailor treatments to each patient. This is just one example of how going beyond traditional behavior change techniques could lead users to a better experience with their products.

Testing Behavior Change Design Strategies

So how do we make sure our design elements are working? Traditionally, scientists will perform in-depth, long-term studies to measure how behavior changes over time, often over months or years. For product design programs, these studies would typically take too long and cost too much money. Most importantly, the results won’t tell the designer which improvements to make or what isn’t working about the design.

At Lextant we deploy tools like our System Learnability Assessment Method (SLAM) to quantitatively and qualitatively understand learning and behavior change at important moments in during user’s experience with a product. By focusing on these key moments in learning and use, we can understand how successful design elements are at changing behavior. We can also look for parts of the experience that could be preventing success.

Most importantly, we can give the designers the information they need to improve and innovate their products.

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