Sustainable Behavior Change

We have worked with industry partners, health systems, and community organizations to apply incentives, nudges, and gamification to significantly change clinician and patient behaviors. This includes developing high-level strategic initiatives, designing mobile and service products, and providing oversight for real-world implementation.

Key learnings from our research and consulting projects

Sustaining healthy behavior is key

Many different elements from behavioral science can be applied to programs to improve healthy behaviors such as physical activity. Here are a few key learnings from our prior work in this area.

Gamification works

Game elements such as competition, collaboration and encouragement from a support person can not only motivate individuals to increase their physical activity, but have also been shown to have sustained effects in the months following a physical activity program.

Loss framed incentives work better

Financial incentives are another great way to motivate and sustain behavior, especially when they’re loss-framed. But this should be used judiciously as they can be expensive to roll-out at scale.

Selected publications

- Effectiveness of Behaviorally Designed Gamification Interventions With Social Incentives for Increasing Physical Activity Among Overweight and Obese Adults Across the United States.

- Loss‐Framed Financial Incentives and Personalized Goal‐Setting to Increase Physical Activity Among Ischemic Heart Disease Patients Using Wearable Devices: The ACTIVE REWARD Randomized Trial.

Changing clinician behavior

While interventions and the target of the interventions will vary depending on the required behavior, several options exist to influence behavior. The choice depends on access (to systems and clinicians), phenotying and targeting options.

Multiple tools exist

A combination of automated dashboards, active choice framing, and peer comparisons are just some effective tools to nudge behavior change in clinicians.

Peer comparisons work

Leveraging the competitive nature of individuals tends to work well. However, the choice of language and how the information is communicated is critical in the success of the program.

Reduce work

Make the right thing, the easy thing. When designing a behavior change program, it’s essential to consider existing workflows in order to enhance the effects of a behavior change program. Any intervention that requires additional effort is unlikely to succeed at scale.

Selected publications

- Effect of an Automated Patient Dashboard Using Active Choice and Peer Comparison Performance Feedback to Physicians on Statin PrescribingThe PRESCRIBE Cluster Randomized Clinical Trial.

- Effect of Introducing a Default Order in the Electronic Medical Record on Unnecessary Daily Imaging During Palliative Radiotherapy for Adults With Cancer.