Where do you start when designing for behaviour change?
- Efi Chatzopoulou
Borrowing wisdom from health psychology to propel design.
Somewhere in central London, Anna is finishing her lunch. There’s one quick thing she wants to do before going back to the office, sign up to the Lands end to John O’Groats cycling event. At almost 1000 miles in ten days, cycling the length of the UK isn’t going to be easy but she’s been feeling really excited since the very moment she heard about it a couple of weeks ago.
Her sister thought she was being over confident but she felt that with the right training she could soon build up her fitness. She loved cycling anyway and often went for long rides for fun. Now at a cafe nearby her work Anna is looking at the event page on her mobile.
She skips all the pictures of smiling cyclists in stunning locations followed by quotes of inspiration and heads straight to the ‘Join now’ button. Job done. She’s so excited she could scream.
Meanwhile 100 miles up the road…
In Norwich, Kevin is looking at the local gym website for the 13th time this week. He knows he has to go for it but finds it really hard to click ‘Join now’. He’s frustrated with himself for procrastinating for so long.
He’s determined to get more active before his baby is born and has already done huge amounts of research on what type of exercise would best suit him. The gym he’s been looking into has a swimming pool and a good selection of classes. Most importantly, it’s only around the corner so no excuses for not getting there at least a few times a week.
In his living room, Kevin is staring at his laptop with his credit card in his hand and keeps scrolling up and down the page. He’s read all the case studies and studied the price plans with great rigour.
The ‘Join now’ button is right in front of him and he knows exactly what he needs to do. But all he feels is dread. He might have to go make himself a cup of tea first.
Two people wanting to keep active (in different ways) with the same call to action in front of them: ‘Join now’. Both websites are pretty decent; they are informative and well laid out. The branding is just right, the imagery is rich and inspirational, the case studies are life changing, the pricing easy to find… Yet the results for two people can be startlingly different.
What is happening here? And why should we care as designers?
This article is about how we can do more to help people reach their destinations by paying due attention to their starting point.
Borrowing from established research in the field of Health Psychology, let me take you through one of the most widely applied models commonly used to develop successful health interventions involving behaviour change.
When it comes to design (product, digital or service), being aware of well-researched psychological models such as this can help with:
- Organising our thinking around who we’re designing for
- Adopting a more rounded view of the challenges ahead
- Ultimately getting on the right path to implementing effective solutions
The challenges of designing for behaviour change
As UX specialists, we design solutions that best fit people’s needs for all sorts of “things” (and by things I mean products, services or whole omnichannel experiences).
It can be helping people navigate through a choice of events to buy tickets to a memorable concert – (we helped See Tickets with this), or making sure they get the information they need in order to help them choose the right mattress etc, etc.
Implementing effective solutions to this type of design problem is undoubtedly complex but tends to be fairly contained, involving a short journey with a clear beginning and end. Its success is usually measured by getting people from A to B: Did the person find what they were looking for? Did they put it in the basket? Did they buy? Tick, tick, tick.
But what happens when it comes to solving problems involving repeating behaviours or even customer-product relationships that aim to be long term?
When we’re asking people to click a button that goes beyond getting them a new pair of shoes once but rather commits them to going to the gym three times a week for a whole month, it’s a whole different ballgame. And how do we play to win? How do we help people like Kevin become more active?
Behaviour change design is a tough nut to crack BUT it’s totally worth it. I’m not giving up on Kevin and neither should you.
As designers, we need to understand human behaviour. This isn’t just another tool to use occasionally, it’s a super power. Understanding different people’s starting points, the mysteries of cognitive biases, the intricacies of motivation and so on is an absolute MUST for effective design.
So here’s a useful tool to add to your ‘human behaviour’ box.
The Transtheoretical model of change
Enter the Transtheoretical model of change (DiClemente & Prochaska 1982; TTM from now on).
It all started from trying to figure out why some people were able to quit smoking and others weren’t. This led to a very simple but eureka finding: people were more likely to quit when they were ready. No surprises there!
BUT before you ask for your money back there’s more to it. Prochaska and team went on to define different levels of “change readiness” by introducing the concept of five (or sometimes six) distinct change stages. Which is helpful because if we know HOW ready someone is, we know what to expect, meaning that we can handle things more appropriately. If we push for actions people aren’t ready for, all we’re likely to get back is resistance.
So here are the five change stages:
When there’s no intention to take action towards changing a particular behaviour in the near future (about 6 months). People in this stage might not even recognise there’s a problematic behaviour to face or might lack confidence they could change. Needless to say this is the trickiest one to crack.
In this stage, people are more aware that change is needed, they intend to take some action within the next six months (doesn’t always mean they will) and are mulling things over in their heads.
Contrary to contemplation, in this stage, people have strong intentions to take action within the next month and have even taken concrete steps towards change rather than just thinking things through.
When people have started doing the new behaviour in some way but for less than six months.
Includes those who have been doing the behaviour for more than six months.
So here you have it, five simple stages of change.
Since its conception, the TTM has been widely used in Psychology, mostly for designing interventions around changing health habits or beating addiction. There’s a lot of (mostly academic) stuff about it out there, but it’s also what’s at the heart of Sports England’s strategy for tackling inactivity and the ‘This girl can’ campaign. The cycling charity, Sustrans, also used it to help make their ‘Online cycling challenge’ a success.
How can the TTM help design?
For those of us involved in design the main takeaway is this:
The people we design for are humans, who, when changing a behaviour, go through a particular set of change stages. The stages are always the same although people can go through them in their own unique ways and pace.
So for our example, Kevin is in preparation stage, having acknowledged a problematic behaviour (too inactive) and is taking some steps towards becoming more active. He is hesitant and low in confidence and will need different handling from Anna, who is in maintenance stage. She’s been cycling for years, she’s fit and knows she can handle a big cycling event. All she needs is clear action and off she goes.
So what? I hear you ask.
For a start, when it comes to designing for behavioural change, before we even start thinking about the details of the product, the research methodology we’re going to follow or the questions we’ll be asking, we’d benefit from first building a fuller picture of the behaviour in question and working out the relevant change stages.
Beyond just focusing on the final destination, if we better understand the starting point, we’ll be better equipped for designing a smoother journey along the way, even when things get tough. It’s about being prepared to face what’s coming.
This knowledge can be used in the following ways:
- Speccing the problem space
To better understand the complexities and intricacies of the challenge(s) ahead
To identify where the most value lies and make an informed decision on whether certain stages should be prioritised over others
- Research planning
To make sure we ask questions that further dig into the variables relevant to each stage so that we get the right insight into people’s needs
- Persona design:
To overlay change stages on the personas we’re creating for that extra depth of behavioural insight, specifically focusing on change
To make informed design decisions based on behavioural insight that incorporate the complexities of behaviour change
Fundamentally, the thing to remember is that when it comes to designing for behavioural change, not everyone is ready to go ahead and make that change (Action stage). In fact, when it comes to unhealthy behaviours, the number of people in ‘Action stage’ tends to be less than 20% of ‘at risk’ populations, such as smokers or people not doing enough exercise!
So when we design solutions only for those who are action-ready we’re leaving out people that need that extra bit of nudging (Contemplation stage) or at the other end of the spectrum those who have-been-there-done-that and simply want to continue the good work and get the t-shirt (Maintenance stage). A huge opportunity loss.
Applying the TTM principles onto design
It gets better.
What I love about this model (yes, I can love a model if I so fancy!) is that it takes into consideration other behavioural models and interventions and bakes them into one holistic theory of change that can be applied to different settings, problems and people — hence, fittingly named Transtheoretical.
Rather handily, numerous health psychologists have gone on to, not only apply this theory to different health behaviours, but they have also worked out WHAT helps nudge people through the different stages. Bingo!
So how do we get to move people through the stages? Fundamentally it’s about designing for shrinking resistance and increasing self efficacy.
In particular, there are two key TTM constructs:
- Decisional balance
…which basically means the weighing up the pros and cons of taking up the new behaviour. As individuals move through the change stages, decisional balance shifts in critical ways. The earliest the stage of a new behaviour the more the balance tends to tip towards the relative cons for the change
- Self-efficacy vs. Temptation
…which is all about how much confidence people have about taking up and sticking to a particular behaviour, even when things get tough and the temptation to give up is there. Naturally, during the earlier stages, confidence that someone can stick to a new behaviour is low and giving in to temptation is more likely
“As individuals move from Preparation to Action, the disparity between feelings of self-efficacy and temptation closes, and behaviour change is attained.”
So when we’re designing for behaviour change, if we concentrate on helping people with the above in mind, we are more likely to successfully help them get to the desired behaviour more quickly.
Implementation can take a multitude of different forms. For example, if we’re hoping for more people to ‘Join now’ for taking part in a cycling challenge, we can support those in the contemplation and preparation stages with personalised content emphasising what’s good about cycling and how to work around the bad bits (which we’ll have a good understanding of through research).
Or for those in the Action stage, by incorporating some type of log to keep track of their progress that can help increase their confidence about completing a bigger challenge.
And there are also the ten processes of change, a number of activities people commonly engage with when going through change.
There’s a lot to say about this, including how those processes work and how they can or have been applied before. But it’s just too much to fit into this blog so I’ll stop here for now. There’s work to do, places to be…
So here you’ve been introduced to a common sense and straight forward model to ignite your behavioural thinking which we know works really well in terms of facilitating behaviour change from signing up to monthly charity donations, commuting by bike or starting going to the gym. Good.
We also know that at each stage certain processes and principles can help reduce resistance, speed up progress, and prevent relapse. Awesome!!
Let’s harness that for designing awesome things!
Let me know how it goes.
Useful things to read:
We get used to the normality of our own lives, so it can be easy to forget just how different other people’s lives and needs can be
Zooming out and looking at the big picture is the best way to prioritise how we can use different technologies across a customer journey