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BEHAVIOR CHANGE

some basic principles.

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Change – impact – comes from behavior, from people doing something different, taking action. If nobody takes action, nothing happens. Given your mission and your idea, the question you need to ask is this:

“Who must do what differently?

Do this: Make an behavior map. Put the ultimate outcome you want to achieve at the bottom of the page, then list the most salient actions that must happen to achieve that outcome. For each, include the actor – the who – and the specific action – the what. Make sure you connect the dots all the way to impact. If there isn’t at least one action you hadn’t previously thought of, you may not be connecting the dots: there might be some behavior you didn’t think you had anything to do with you but absolutely needs to happen. See if you can arrange them as a flow diagram that leads to the outcome:

A good behavior map:

Sets out who does what all the way to the outcome

It’s about what they (people you can’t fire) do, not you

Includes the 3-6 most essential behaviors

Connects the dots all the way to the outcome

Is about actions, not thoughts, attitudes, desires, feelings

moms do A

kids do B

community does C

moms (again) do D

the wonderful outcome we hoped for

EXAMPLE

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Behavior

Not behavior

Mom seeks out community health worker

Fisherman follows local management plan

Senator votes for a bill

Kids attend school regularly

Patient takes correct TB meds at right time

Children wash their hands

Kids watch educational show

Parents send their girls to school

Farmers stop poaching animals

Customers buy product for $20

Mother understands danger signs of illness

Fishers realize that conservation is necessary

Senator changes his mind

Parents say they’ll make sure kid attends school*

Patient knows TB meds and regimen

Children say handwashing is important

Kids say they like educational show

Parents value girls’ education

Farmers say poaching is bad

Customers say they’ll buy product for $20

*saying something is a kind of “pseudo-action” - easy to do and often not acted upon.

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Action is behavior, to establish a new action is to change behavior. There’s a huge and growing science of behavior change. You can go down that rabbit hole later - it’s usually the case that the more you learn, the more you want to know - but we’re going to lay out the quick n’ dirty basics. The first principle is that for a behavior to happen, people have to be both willing to adopt it and able to do it successfully. Imagine that you have two sliders: One represents the spectrum from “unwilling” to “willing” and the other “unable” to “able:”

Behavior change

willing

eager

unwilling

unable

able

easy

Whomever you work with starts somewhere on each of the two axes. Your job is to get them as far as you can to the right ; in fact you want to get beyond able and willing to “eager and effortless.” For any behavior, if all you do is brainstorm with your team on how to get as far as you can to “eager and easy,” you’ve taken a huge first step toward designing for behavior change.

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MOTIVATION

ABILITY

PROMPT

With that basic principle in mind, we can get a bit more sophisticated. BJ Fogg, a Stanford psychologist, came up with this elegant approach to behavior change. Motivation = make the change as desirable as possible. Ability = make the change as easy as possible. Prompt = people can be motivated and able and still not move. They often need some kind of prompt to take action - but prompts are useless if people aren’t motivated and able. The point of the graphic here is people can do hard stuff if motivated enough, and they can do easy stuff without being that motivated. Stack the deck: Go for eager and easy.

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MOTIVATION 1

Motivation is the result of emotion and calculation: how we feel and how we think. Emotion is by far the most important driver, and in fact, it is impossible to decouple thinking and feeling. Decisions are mostly made emotionally and rationalized in a calculated way. Without real effort, we don’t make a coolly rational calculation of costs and benefits, risks and rewards. In fact, motivation happens along an effort continuum:

delight

coercion

satisfaction

compensation

more effort to maintain

less effort to maintain

Our emotions arise mostly from the fact that we are social creatures. We want to belong to the group, we want status and look to high-status people for direction, we want to be liked, we practice reciprocity, we do what the people around us do, we feel guilt and shame when out of line, we like to do things in groups. There’s so much more to our sociality, but the point is that there is so much that we can accomplish simply by thinking deeply about what it means to be social, what we feel that helps us thrive in a group.

more calculation

more emotion

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MOTIVATION 2

Another big driver of emotion is safety, or fear of loss. Loss is painful; the pain from a loss lingers far longer than the joy from a gain. We are on balance conservative; so much can be explained by the notion of loss aversion, the discovery of which essentially led to Daniel Kahneman’s Nobel prize. And safety doesn’t only mean physical; fear of loss extends to social, financial, cultural and virtually every other domain that matters.

Calculation - the rational consideration of costs vs benefits - matters. Spreadsheets and algorithms work, but real people in real life make calculations that are tweaked by emotions. People need tools and time to think rationally; mostly we take emotionally driven decision-making shortcuts that collectively are known as cognitive biases. There’s a huge literature on cognitive biases, but essentially it boils down to this:

Confirmation of your beliefs feels good.

Challenges to your beliefs feel bad.

It feels good to get along with your group.

Thinking is hard work.

Loss is painful and scary.

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ABILITY

There is an enormous literature and any number of specific methodologies focused on making things as easy as possible. it’s way too much to go into here, but the single most salient principle (and this applies to this whole Mulago design-for-impact approach) is this: Design in the midst of those you are designing for. The most successful approaches are human-centered design and the more specific user-centered design. This isn’t the right place to try to teach them, but every organization should adopt and master an effective approach. And the most important overarching principles are these: 1) design in the midst of those you serve; 2) draw from their knowledge; 3) make sure there people with deep domain and local knowledge on your team, and 4) iterate, iterate, iterate.

In the spirit of this deck, here’s is one simple tool that anyone can use: The “Customer Journey” (some people don’t like customer; use whatever you want: user, client, beneficiary - however you like to characterize those you’ve set out to serve). Do this: describe an archetype of your central customer. Now imagine in granular detail what it means for her to travel all that she needs to do to realize the benefit you hope to make possible. Carefully list the barriers that she might encounter. Figure out how to remove them, help her go around them, or empower her to get right over them.

Example: Mom takes her sick child to clinic

Mom

sees

danger

signs

Mom

finds

CHW

Mom

travels to clinic

Mom

gets in

to see

nurse

Mom

gets prescribed medicine from pharmacy

Mom

travels back

home

Mom

follows treatment

instructions

A lot can go wrong; a lot has to go right: your job is to design for a successful journey.

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Once you’ve optimized motivation and ability, you often still need a prompt to make things happen. Text reminders, pop-up windows, deadlines, picking a date, establishing a ritual, all those phone notifications they’re all prompts. Done wrong, they’re an annoyance; done right, they maximize the chance motivation and ability will turn into action.

PROMPTS

Here’s a bunch examples of prompts

  • that “next episode button” on netflix
  • “only three left in stock!”
  • that be-mindful bell in your meditation app.
  • “for the next 30 minutes, your donation matched 2:1”
  • any to-do list
  • April 15 tax day.
  • “write your congressman by Tuesday deadline!”

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FURTHER READING