Image illustrating behaviour change due to dopamine in the brain

Implementing the reward mechanism to encourage behaviour change

As grown-ups in the 21stcentury, we are all patently aware of what we should do to live a healthier life. So why is there still a large proportion of the population that seems unable to do the right thing and make the correct decisions for their health?

A couple of things in this statement bear further scrutiny.

First is the vaguely judgemental tone employed by those of us involved in the healthcare industry to express our frustration. We tend to do this when large swathes of the population don’t take their medication, won’t increase activity, won’t eat the right food and won’t quit smoking. However, our judgment is often based on what we would do. This assumption makes us victims of what’s known as the false consensus effect. This is an attributional cognitive bias where we believe that our own personal beliefs, opinions, behaviours, likes and dislikes are also normal for most other people. Unfortunately, that bias is often reinforced by reflection from our friends and colleagues in our industry. The reality is very different.

The truth is that only a small proportion of the population actually spends its waking and working hours thinking about its health. Now let’s look at it from another, incredibly obvious, point of view. A lot of positive health behaviours, especially those that many people REALLY need to adopt, aren’t particularly attractive. Why? Simply because they often involve doing less of stuff that people like and more of stuff that they really don’t want to do.

Which brings us to the second thing.

Rewards are only rewards if they feel good to people. Again, from a healthcare industry perspective, what could feel better than a new personal best on a Strava segment, or smashing my 25,000-step record on Fitbit? Quite a lot, as it turns out. Non-health obsessed people (i.e. most of the population) are constantly expected and encouraged to replace things that have a built-in reward with something for which the reward is completely and utterly intangible. Reducing the odds of something bad happening at some unspecified time in the future does not get those dopamine juices flowing in quite the same way as a nice carb and fat laden meal, a drink, a cigarette or a Victory Royale in Fortnite. Tragically however, none of these aforementioned delights will do much to improve anyone’s type 2 diabetes, for example…

The key to making differences here is to make rewards for healthy behaviour relevant to the audience in whom we are interested, rather than to us. Harnessing the reward mechanisms in our brains is very helpful here. The interesting thing is that the way we process reward doesn’t appear to differ for real or virtual rewards. Creating surrogate, virtual rewards that are immediate for healthy behaviours is a powerful way to reward behaviour change. The most important thing to do here is to define rewards that our audiences find attractive and to keep changing and adding to those rewards over time to maintain interest.

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