9 Apr 2015 - Digital Strategy // By Productive Edge Team

Developing Effective Behavioral Change Technology

Many industries now use technology as a tool to alter human behavior, so for technology development agencies to stay competitive it is paramount they understand the concept of Behavioral Change Technology and have the ability to implement it. Powerful consumer electronics, ubiquitous satellite Internet connections, and interactive software applications have changed the way we behave. The field of Behavioral Change Technology (BCT) emerged to design systems specifically for making targeted behavioral changes. These systems are often used to improve the health or wellbeing of their users; because of this, industries such as healthcare and wellness/fitness began to implement these systems as services for their customers.

Demand for BCT systems has increased in popularity because it demonstrates a feasible method for increasing adoption of positive behavioral changes.The healthcare industry is one of the largest adopters of this type of tech. As early as 2004 doctors used interactive software programs to help counsel patients who needed psychological therapy beyond that which they had time or resources to administer. Time-consuming therapies including nutrition or fitness counseling are often administered for maintenance of chronic disorders such as type-2 diabetes. While it is nearly impossible to task physicians with administering this therapy, new forms of interactive technology were created to fill the gap.

Today, many businesses proactively leverage psychological theory embedded in systems to similarly modify human behavior. Many technology development teams are tasked with implementing these systems. However, projects can go awry if the system for behavioral change is incomplete. Technology teams attempting to implement BCT require multiple competencies. Successful implementation entails the interplay of three constructs: psychological concepts, user experience design, and system design.


Leveraging Basic Psychology

The first key skill needed for BCT implementation is an understanding of the underlying psychological technique. For the purposes of altering human behavior a persuasion technique based on psychology must be built in to the system from its beginning. Applicable persuasion techniques leverage positive reinforcement or feedback, model a target behavior or provide social support to someone undergoing a change.

Several notable applications recently gained traction using one or more persuasion techniques. These primarily focus on simple use cases, such as motivating people to reach pre-defined goals. One app called Coach.me had humble beginnings as a social support system for people creating small habit changes like flossing or sleeping more. Coach.me helps users make their desired change by holding them accountable with social announcements, reinforcement from an online community, and behavior modeling from others who already made a successful change. Coach.me is so popular that users now leverage it for more difficult types of behavioral change including improvements to mental health, personal development, and physical fitness. Their CEO states that he plans to continue to advance the Coach.me framework and one day use it as a tool for educators.


Another example of psychological persuasion in technology is the Stickk website. Stickk was created by Dean Karlan, an economics professor at Yale with the idea for an online “Commitment Store.” He believed that today’s increasingly health-conscious and socially-conscious society needed a way to ensure that they followed through on what they set out to do. The site incentivizes behavioral change using negative reinforcement feedback. The user selects an “anti-charity” and offers automated donations if a weekly action towards their stated goal is not taken.


Personal improvement applications are early examples of how technology teams have applied psychological concepts to serve their users. However, many teams fail to create effective behavioral change applications despite proper application of psychological concepts. Failed attempts at engineering BCT can often be attributed to a lack of front-end usability.


Designing a High Quality User Experience

The application of psychological principles in creation of BCT applications is no guarantee of their efficacy. Once the proper behavior change technique is implemented, the team must engage their user experience discipline in the development process. A piece of technology cannot begin to change a behavior unless the user continually interacts with it. Great UX design will enable the interaction volume needed for successful BCT application development.

Studies have shown that aesthetically pleasing technology is perceived as more useful and enables more effective task completion. Although this may seem like common sense, it is the Achilles Heel for many teams attempting to implement BCT applications today. Without an inviting user experience the users provide fewer inputs and receive less feedback from the application. Therefore they are less likely to make actual behavioral changes.

Wearable devices provide a great example of teams implementing UX practices in their BCT systems. When properly designed, wearable devices provide unprecedented access to health and fitness metrics, allowing for entirely new pathways of personalized treatment. Unfortunately, many consumers lose interest in their wearable devices after only a few months. Without frequent wear, the BCT system ceases to add value. For this reason, wearable hardware design is studied extensively and design practices are highly integrated into development.

For the development organization there is no one-size-fits-all answer for creating high quality user experiences. The UX is specific to each application, device, and intended user. There are several well-documented processes that bolster UX practice for building highly usable devices and interfaces.  A very high level list of steps in the UX process includes: listening to user feedback, documenting their journeys, brainstorming/wireframing, finalizing creative, and testing changes. A tool set for enhancing UX can be found here:


When the development team creates an engaging user experience the reward is large amounts of user input. This is due to a higher number of active and vocal users. The final piece needed to design successful BCT systems is effective control over the data collected and creation of meaningful user feedback.


Creating an Interactive Engagement System

As the development team puts a psychological technique in place and creates a pleasing user experience, they must consider the interactions between the system and the user. The key is leveraging the data collected to deliver an intervention with the right messaging at the right time. Incorrect interventions drive users away from the system, which hampers the business goal.

From the businesses perspective the interaction strategy may be very simple. After all, just reminding someone that they committed to an action is one of the best ways to create a behavioral change. A great example is in the mobile space, where push notifications are used to gently nudge users in to building their habits. The Calm app exemplifies a good interactive practice by offering daily notifications to help users begin a meditation practice.


Research tells us the key to implementing a technology system with the correct mode and frequency of interventions is a three-step process: monitor behavior, learn and infer behavioral patterns, then deliver the behavioral change technique. By following these three steps, a system consistently delivers timely and appropriate messages.

The authors of a recent study summarize this concept well: "Ultimately, it's the engagement strategies -- the combinations of individual encouragement, social competition and collaboration, and effective feedback loops -- that connect with human behavior."


What does this mean for your development organization?

For a team to create an application that will change human behavior in some way, it is necessary to consider the psychology, user experience, and engagement pattern. The solution design process can be summarized into three steps: First, select a method to incentivize the user. Then, design a pleasing front-end user experience that consumers willfully and frequently interact with. Finally, add a back-end system for controlling interaction and engagement with the user.

Implementing all of the necessary requirements gives technologies created by development organizations the capability to make lasting behavioral change and contribute more value to users than ever before. Ultimately, it is important to remember that even the best designed BCT system cannot inspire users to begin on a path of change. The BCT system is meant to aid to the process of change, and a technology team with the right competencies can give the application user the tools they need to succeed.



How Smart Phones are Changing the way we Bank and Drive

American Journal of Preventative Medicine - Interactive Behavior Change Technology

American Diabetes Association - Interactive Behavior Change Technology to Support Diabetes Self-Management

Persuasive Technology - Using Computers to Change what we Think and Do

The Influence of Aesthetics in Usability Testing - The Case of Dual-domain Products

Tech Republic - Wearables Have a Dirty Little Secret: 50% of Users Loose Interest

Institute for Complex Engineered Systems - Design for Wearability

Sage Journals - A Methodology for Quantifying Effects and Psychological Functioning of Behavior Change Techniques 

Science Daily - Wearable Devices Alone Won't Drive Health Behavior Change, According to Researchers

The Journal of the American Medical Association - Wearable Devices as Facilitators, not Drivers, of Health Behavior Change


Productive Edge is a digital transformation consultancy that bridges the gap between digital business consulting and technology development. Headquartered in Chicago, we have clients across the country and around the world. Our focus is on digital strategy, customer experience, and cutting edge technology solutions in the healthcare, retail, and insurance industries. Contact us for more information.

Developing Effective Behavioral Change Technology