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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.

So you’ve set yourself a New Year’s resolution…

So, you’ve set yourself a New Year’s resolution… That’s great, but how do you turn this expressed desire into a real, lasting improvement? The evidence for successful adoption of New Year’s resolutions isn’t encouraging. According to Forbes overall success is about 8%. However, before we abandon any hope of self-improvement let’s look at ways we can change our habits. Erasmus wisely said that “A nail is driven out by another nail; habit is overcome by habit.” This view is supported by our increasing knowledge in neuroscience.

Why we form habits

We form habits, essentially, to save precious energy. The brain consumes energy at 10 times the rate of the rest of the body per gram of tissue. Even at rest it uses around 20% of the total consumed energy of the human body. So, anything that automates processes and reduces that demand is of great evolutionary benefit. Habits are about short cuts. The more often we repeat them the more likely it is that we will do it the next time without even thinking about it. They are automated processes that, with each repetition, are wired further into our neurones. So how do we form good habits?

  • Step 1:  Understand what triggers your current habits. To change a habit, you first need to recognise what triggers that response? Does receiving a deadline for a major project trigger immediate procrastination?
  • Step 2:  Decide which behaviours you would like to become your new habit. For example, would you like to replace the procrastination with an immediate period of outline planning? Be very specific.
  • Step 3:  Decide how you are going to reward yourself for each successful deployment of your new behaviour. Rewards are important. The establishment of habit is closely linked to dopamine reward, which is often how we get into bad habits. Problem gambling is strongly linked to this mechanism. Augmenting the brain’s reward system helps establish the new habit.

So, try this. Imagine you’ve received a deadline. You’ve immediately done some rough planning and role allocation. Try going out and getting a coffee or having a 5-minute walk… or something else simple that you enjoy doing. Repeated often enough, your brain will rewire your neurones to create a new habit to replace the old one, giving you the best chance to be one of the 8% who succeed over time. Good luck!