By Matt Miller, Ph.D., StayWell
Medical care is being revolutionized by precision medicine and personalized treatments that address each patient’s unique needs. However, these advancements alone are not nearly enough to improve outcomes. Individual behavior also plays an important role in tackling chronic conditions, reducing risk of diseases, and improving overall population health.
According to the CDC, 90 percent of the nation's $3.3 trillion in annual healthcare expenditures are for those with chronic and mental health conditions, including diabetes, obesity, heart disease, and tooth decay. Making positive changes in behavior—including increasing physical activity, implementing a healthier diet, curbing use of alcohol and tobacco—can make a significant impact on these statistics.
Research also indicates that many patients do not adhere to prescribed medication regimens. This ultimately costs the U.S $100 billion to $290 billion annually, according to the New England Journal of Medicine. In addition, only about half of the medications for chronic disease are taken as prescribed and an estimated 20-30 percent of prescriptions are never filled.
Knowledge Alone Is Not Power
There’s a common misconception in the healthcare industry that knowledge equals power. The assumption is patients will change their behavior if they’re aware of how it’s impacting their health. Unfortunately, this is often not the case.
Doctors can provide patients with adequate and compelling information, but that information alone won’t produce the ideal results, even if it’s fully absorbed. Consider smokers as a simple example. Most smokers know the health risks associated with smoking, but they still smoke. The bottom line: Human behavior—and the factors impacting it—are more complicated.
Determinants Drive Outcomes
To more effectively address the impact of individual health behavior, a scientific discipline has evolved to help understand why people behave the way they do, with the goal of leveraging insights to improve outcomes. Examining the determinants for how we engage in specific behaviors includes three primary categories:
These determinants encompass an individual’s perceived benefits and barriers, self-efficacy, attitude, access to resources, social support, and many other factors.
In our world, there are two main types of behaviors to analyze: Consumer behaviors and health behaviors. Consumer behaviors are something individuals want to do because they are enjoyable and provide instant gratification. In contrast, health behaviors are activities individuals need to do—such as waking up early and going to the gym or cutting back on a favorite fried food or dessert. Pursuit of health behaviors often requires individuals to give up something now for a future reward, without a guaranteed return on their investment. This makes health behavior change much more difficult to sustain.
Behavior Science Best Practices
New technology that enables individuals to monitor progress is not enough to ensure healthy behaviors become long-term habits. Health care professionals need to apply behavior science best practices that inspire individuals to make positive, permanent changes to behaviors subverting their health.
Self-determination theory shows autonomy is crucial for supporting sustainable changes to behavior. Individuals will respond better if they can be guided to recommendations while also given a choice in the path they take to achieve health goals.
Too much information at once can cause confusion and make people feel overwhelmed. Think of new ways to provide content in smaller doses to keep interest and enable them to absorb the information. It should also be easy to access additional resources or go back and find content that was useful for them in the past.
Programs should be flexible in accommodating each individual’s needs over time, providing different interactions, updated content, and new recommendations. For example, this could include increasing the difficulty of exercises as skill levels advance (e.g., “graded tasks).
People typically respond better if they can set their own goals, then be directed on the behavior(s) needed to achieve those milestones. Programs should assist in measuring progress over time so individuals develop a sense of mastery. They should also help identify potential roadblocks and help with strategies to overcome barriers.
Long-term behavior change is more likely when we simultaneously address an individual’s level of motivation, capability, and opportunity to engage in healthy behaviors that are unique to them and their desired outcome. The key is to apply behavior science principles that activate and drive patients to healthy living in order to reduce healthcare costs, minimize chronic disease, and improve population health.
About The Author
Matt Miller knows that health empowerment begins with behavior change—and behavior change isn’t just a catchy motivational phrase, it’s a science. As Vice President of Behavioral Science, Matt is responsible for ensuring the use of evidence-based, best practices in all well-being products and services StayWell offers a company’s workforce. Matt has over ten years of experience in health empowerment and research. Matt has a Ph.D. in social and behavioral science and is a licensed mental health professional. When he’s not working on guiding others to better health, Matt is busy improving his own with trail runs, hikes, and travel.