CONNECTED HEALTH CONFERENCE • SAVE THE DATE • October 16-18, 2019 • Boston, MA
By Sherry Pagoto, PhD, President of The Society of Behavioral Medicine
Digital health companies are increasingly interested in incorporating behavioral science into the development of their products. They are well aware that the leading causes of death--cardiovascular disease, cancer, pulmonary disease, and diabetes--are all heavily influenced by lifestyle habits. Let’s take cancer as an example. Last year a study reported that we could eliminate nearly half of all cancers by addressing the following behavioral issues: smoking; excess body weight; alcohol intake; consumption of red and processed meat; low consumption of fruits/vegetables, dietary fiber, and dietary calcium; physical inactivity; and exposure to ultraviolet radiation. An extraordinary opportunity exists to improve public health and reduce the healthcare burden via technology that can successfully change behavior. Partnerships between technology developers and behavioral scientists could literally change the world.
So why isn’t this happening? One problem is that behavioral science is often incorporated into technologies narrowly, likely due to exposure to a single perspective. At times, behavioral science is equated to behavioral economics. At other times, it is equated to social psychology. Others associate behavioral science with Skinnerian and Pavlovian conditioning, yet others consider it exclusively from a consumer behavior perspective. So which is it? Also, does behavioral science account for biological factors affecting behavior (e.g., genetics, disease states)? Does it account for societal factors (e.g., literacy, public policy)?
In fact, behavioral science is all of these things. Behavioral science as a field acknowledges that human behavior is embedded in a rich tapestry of contextual factors--from cells to society. Changing human behavior requires a conceptual framework that addresses the unique context that brought the behavior to its current state. When behavioral science is considered via a narrow lens, what invariably results are solutions that have small or short-lived effects.
The field of behavioral medicine specifically addresses health-related behavior via this rich tapestry of contextual factors--we refer to it as the socioecological model. This model addresses behavioral drivers at all levels, including the individual, social, organizational, community, and public policy levels.
Solutions implemented at any one level will only be effective to the extent they are designed to account for forces affecting behavior at all other levels. For example, take a diabetes self-management platform that is designed for implementation at the level of the individual. Perhaps it uses incentives for medication adherence; provides an easy way to track and report blood glucose levels, diet, and exercise goals; offers tips for self-management; and provides positive feedback for meeting goals. It sounds great, but does it address the fact that Joe has bipolar disorder and takes medication that causes weight gain, making it impossible to meet his weight loss goals? Does it address how Susan’s family puts constant pressure on her to cook unhealthy meals, which thwarts her diet goals every time? Does it address how Gene’s neighborhood provides him no access to places to exercise or buy healthy foods? Does it take into account that Barb became ineligible for Medicaid because her state legislators changed the eligibility requirements and now she’s missing appointments until she gets it all sorted out?
Or does the platform treat all patients the same by ignoring all of these factors?
These patients may seem like outliers, but they aren’t. They are real people. Life is messy. Every one of us comes with our own set of challenges, abilities, and experiences. To design innovations that support long-term behavior change, we have no choice but to identify and address all the drivers. Admittedly, it is no small task, but with the right teams I believe it can be done.
At the Connected Health Conference 2018, we are bringing together behavioral medicine experts from academia, industry, and healthcare settings to discuss behavior change from this broad perspective. This Immersion Day Deep Dive event will occur on Wednesday, October 17 from 2:30pm to 5:30pm. Our behavioral medicine experts will be covering topics such as patient engagement, personalized behavioral medicine, motivation, and how to ensure digital health innovations bring value to the patient. Implications for user onboarding, engagement, adherence, and long-term behavior change will be discussed. We hope to generate some great discussion about how to leverage behavioral science models in the design process.
You can also join us before the Connected Health Conference for a primer discussion during a #BehavioralMedChat Oct. 11 at 11am CST and chat with our experts on Thursday, October 18, during our 2pm to 2:20pm Meet the Experts time slot in the Innovation Café.
We hope to see you at the Connected Health Conference in Boston!
Sherry Pagoto, PhD is the President of the Society of Behavioral Medicine, a licensed clinical psychologist, and Director of the University of Connecticut Center for mHealth and Social Media.