I find behavior change and self-improvement a fascinating subject; it’s a unique aspect of our human nature. Interestingly, I find that few lay people can tell me how behavior change actually works. Many people feel that change is simply a matter of “willpower.” But, in our research we’ve never been able to find this thing called willpower. We do know that smokers who say that quitting is a matter of willpower actually have lower rates of success in quitting.
Based on years of research, two major factors relate to success in changing behavior. One is motivation— how motivated are you to lose weight, to quit smoking, to exercise, to manage your diabetes? Motivation comes from motives: I’m losing weight to look better, to feel better, to be healthier, etc. Motives come from our values— I value my appearance, I value being a good parent, I value being in control of my life. Exploring motivation to change a behavior and the roots of this motivation helps us understand the causes and therefore some of the targets of our behavior change efforts.
Another factor of change is called self-efficacy— how confident are you that you can lose weight? What influences our self-efficacy? Our previous successes and failures and how we’ve interpreted them. Watching other people we think are similar to us succeed or fail. Having others tell us that we can or can’t do it. Our ability to control our emotions while we try to change.
Combined motivation and self-efficacy help determine whether we’ll succeed or fail in making health-related behavior changes in our lives. When it comes to most health-related behaviors such as weight loss, quitting smoking, or physical activity, most people have strong motivation to change but low self-efficacy. This is a sweet spot for our behavior change programs, which help capitalize on motivation while helping address barriers to high self-efficacy.
The vast majority of programming on the web continues to be static “pamphletware.” We’ve known for 30 years that pamphlets don’t change health behaviors. So why should we expect them to do so on the web?
The web allows us to mimic some of the ways we normally seek advice and make decisions. We seek the advice of experts who ask us questions, process this information, and provide feedback tailored to our specific needs and interests. We go to a library to find out more about a subject. We talk to others similar to us who have similar issues and have successfully resolved them.
The web can do all of these things and more. The web can apply a group of experts to your problem. The web can give you a vast library of information to find just what you need, just when you need it— even at 3:00am. The web can identify hundreds of people similar to you who’ve gone through the same issues you’re going through.
The easy part of this question is that we know that baby boomers are aging and will start getting sick. We also know that baby boomers have historically been interested in self-help and self-improvement— they’re information seekers. Their physicians are partners and consultants, not gods. Unlike their parents, when boomers are not satisfied with their physicians, they don’t comply. In 1963, an investment in Levi’s was a good bet. Now, an investment in health programming that allows aging boomers to improve their health and wellness seems like a good bet. In another few years I’d invest in Depends.
Another easy thing to predict is that health care technologies will increasingly work together to create increasingly useful solutions. HealthMedia® Digital Coaching™ programs will increasingly be linked with electronic medical records (EMRs), biometric devices objectively measuring physiological and physical functioning (pedometry is a good early example), devices measuring psychosocial responses throughout the day (for example, measuring stress through your cell phone), iPods, phone-based text messaging— just to name a few technologies.
More difficult to predict will be the pace of change. Although it’s relatively straightforward to develop these linkages right now, many of us have learned the hard way that adoption of innovation can be slow, particularly in the health field. I think it’s still safe to say that, with respect to most content on the web, you can still find better websites to buy a book than to quit smoking.