a really cool product, but you’re not going to make bigger transformations unless you follow some of the traditional rules of health care. If you’re taking something that came from a more traditional format and you’re bringing a technological revolution to that, you still need to prove yourself and show what your product can do.
How can you balance research with product development?
I use the phrase “pragmatic scientific rigor” pretty frequently. What I aim for is the best science possible, understanding all the other conditions that are in place for whatever stage the product is in. Sometimes, it’s necessary to get your product out there while there’s interest in it, even if you haven’t done years of highly crafted validation studies on it. A lot of behavior scientists struggle with dialing back their desire to be pristine with their science and trying to marry good science with the other pressing contingencies of product development.
It’s part of my job to understand our product vision, what we’re aiming for, what the benchmark is in traditional medicine that we are targeting with our program, and when those elements are scheduled to launch. Then I know what I can make happen and when, in terms of evidence generation.
How do you use user data for research?
Our standard setup allows us to use participant data for our product improvements. So we’re watching to see how they’re responding to different features and what’s being used and what isn’t to help us improve the product. When we want to use their data for public-facing research or evidence, then we need to layer in a separate level of consent, permissions, data use, and sharing. I need to show that I’ve done my due diligence and gotten permissions, and am acting responsibly and ethically in the use of that data. I use an IRB for using my own company’s data quite often. We need to be very mindful about when we’ve collected permission to use data and for what.
How does the science message change for different audiences?
We actually write the same story for different audiences. It’s more of a process of distilling and tailoring the right message for the audience. We tend to come out with what we call our power statements, undisputed facts. Then our communications, marketing, brand, and creative teams will craft them into messages for different audiences. Then we have another team of people who review from all angles to make sure what we’re saying is true, accurate, appropriate, and can stand up under scrutiny.
And it’s not always just about the evidence. There’s the user experience, the implementation process, the marketing—there’s a bunch of other pieces that you have to weave together to tell the right story. We’ll shape the message toward what is most salient and what information we think is most accessible and important for the audience and their decision-making.
Cynthia Castro Sweet, Ph.D., is a health psychologist and behavior scientist. After earning her Ph.D. in clinical psychology from the University of California, San Diego School of Medicine, she took a series of research roles focusing on improving health habits in diverse populations. Cynthia worked for the Stanford Prevention Research Center before joining Omada in 2015. She is now Omada’s Senior Director of Clinical Research and Policy. Cynthia’s research at Omada focuses on externally validating the efficacy of their programs, particularly their flagship CDC-recognized digital Diabetes Prevention Program.
CHAPTER 3
It’s My Life
Making Meaningful Choices
Whatever . . . I Do What I Want
Align Choices with What Really Matters
The Upshot: Let There Be Choice
Vic Strecher and the Meaning of Life
A key ingredient in successful behavior change is motivation. What’s really important about motivation is not how much of it people have, but its quality. The people who will be most effective at making a behavior change and maintaining it over time will have one of the types of autonomous motivation, where their reasons for the behavior are tied to their values, goals, or identity.
As behavior change designers, you can create products that bring people’s values, goals, and identities to the surface so that it’s easier to connect their behaviors to them. You can also offer people opportunities to make choices about how they pursue behavior change. The more people have chosen a path as a result of their own free will, the more resilient their commitment will be. Someone who has knowingly chosen something will be more willing to stick with it if it becomes difficult. Finally, being clear with your users from the outset about what your behavior change program will involve helps them make informed choices and ensure that their experiences and expectations are in alignment.
Ownership Is Key
The ability to make meaningful choices is one of the most important motivational factors people can have—it supports the basic psychological need of autonomy. Meaningful choices start from the most important goals, like choosing to try to change behavior in the first place, and trickle down to supporting goals, like how to go about making change happen. As a general rule, people are more likely to stick with choices they’ve made themselves than with ones that have been imposed on them, especially when something is challenging.
The reason why? If someone’s working toward a behavior change goal and they hit an obstacle, they’ll need a good reason to stick it out. A personally meaningful reason for the goal will provide that. “My weight loss app told me I have to do this” will not fortify people to overcome tough temptations.
You can get people started on behavior change by imposing a goal on them. It happens all the time. How many people embark on a diet or an exercise regimen as a New Year’s resolution because that’s what they’re supposed to do? But if you want people to stick with the change, they eventually have to find their own reasons to do so.
Letting people make their own choices about what goals to tackle is a first step in long-lasting behavior change. In the example from Pacifica, a stress reduction app in Figure 3.1, new users are asked to articulate what they hope to achieve from using the program. EasyQuit, an app for smoking cessation, keeps it even simpler and invites users to generate their own list of motivations for quitting cigarettes (see Figure