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A Guide to Behaviour Centred Design Robert Aunger and Valerie Curtis Hygiene Ce

A Guide to Behaviour Centred Design Robert Aunger and Valerie Curtis Hygiene Centre London School of Hygiene and Tropical Medicine ! ! ! DRAFT April 2015 2 Table of Contents Introduction ...................................................................................................................... 3 What is BCD? ............................................................................................................................................................................... 4 Part 1: Understanding Behaviour ..................................................................................... 7 Behaviour settings ........................................................................................................................................................................ 7 The predictive brain ..................................................................................................................................................................... 9 Three levels of control .................................................................................................................................................................. 9 Reactive behaviour ................................................................................................................................................................. 9 Motivated behaviour ............................................................................................................................................................. 10 Planning and executive control ............................................................................................................................................. 13 Part 2: Changing Behaviour ............................................................................................ 14 Surprise ...................................................................................................................................................................................... 15 Getting exposure .................................................................................................................................................................. 15 Grabbing attention ............................................................................................................................................................... 15 Revaluation ................................................................................................................................................................................. 16 Alter rewards ......................................................................................................................................................................... 16 Modify value ......................................................................................................................................................................... 17 Facilitate processing ............................................................................................................................................................. 17 Performance ............................................................................................................................................................................... 19 Opportunity creation ............................................................................................................................................................ 19 Action selection .................................................................................................................................................................... 20 Part 3: Designing a Behaviour Change Intervention ....................................................... 22 Assess ......................................................................................................................................................................................... 24 Background review ............................................................................................................................................................... 24 Framing Process .................................................................................................................................................................... 24 Build ........................................................................................................................................................................................... 33 Formative Research .............................................................................................................................................................. 33 Design Process ...................................................................................................................................................................... 37 Create ........................................................................................................................................................................................ 48 Creative Process ................................................................................................................................................................... 48 Field Testing ......................................................................................................................................................................... 51 Deliver ........................................................................................................................................................................................ 54 Delivery strategies ................................................................................................................................................................ 54 Monitoring ............................................................................................................................................................................ 55 Evaluate ...................................................................................................................................................................................... 58 Impact Evaluation ................................................................................................................................................................. 58 Process Evaluation ................................................................................................................................................................ 59 Dissemination ....................................................................................................................................................................... 62 Conclusion ....................................................................................................................... 63 Acknowledgements ........................................................................................................ 65 Appendix 1: The Predictive Brain ................................................................................... 66 Reinforcement learning .............................................................................................................................................................. 66 BCD Behaviour Change Models ................................................................................................................................................ 68 Appendix 2: BCD Behaviour Determination Theory ....................................................... 72 Levels of control ......................................................................................................................................................................... 73 The ‘Extended’ Model ............................................................................................................................................................... 74 Appendix 3: Variant uses of the BCD approach ............................................................. 78 Policy-based change .................................................................................................................................................................. 78 Marketing/re-branding ............................................................................................................................................................... 79 Business development (incorporating product innovation) ....................................................................................................... 79 Self-help ..................................................................................................................................................................................... 80 References ...................................................................................................................... 81 3 Introduction! Behaviour Centred Design (BCD) is a new and radically different approach to the problem of changing behaviour. Using an evolutionary framework, it unites the latest findings about how brains learn with a practical set of steps and tools to design successful behaviour change programs. This approach mixes both science and creativity because behaviour will only change in response to something new and challenging. [1-3] The approach has been employed successfully on a range of public health behaviours as well as in commercial product design and marketing. Why is BCD necessary? First, because we fail to solve the world’s most pressing health problems – not because we don’t have solutions, but often because they are not used enough. We know that not smoking, vaccination, using toilets, oral rehydration, appropriate eating, safe sex and exercise could solve the majority of the world’s health problems, but they are simply not taken up sufficiently. [4] Similarly, marketers seek to make products more appealing to consumers, but often don’t know which insight would work best to get them to change their buying habits. Their frustration is expressed in the famous quote (attributed to Henry Ford): ‘I know half of our marketing efforts work; the problem is I don’t know which half’. People also form intentions to change their own behaviour (e.g., New Year’s resolutions, dieting plans), but often fail to follow through. We know the benefits of recycling and paying our taxes, and we know not to bite our nails, but we still fail to do these things. All of these situations require a better understanding of how to change human behaviour. While many approaches to behaviour change are being used today, most are based in trying to change cognition in one way or another: either through cognitive appraisals, [5-7] or modifying cognitive heuristics -- techniques used by behavioural economists. [8, 9] OAM approaches (for opportunity, ability and motivation) are also popular, but are based on information processing models of persuasive communication (that is, attitudinal, rather than behaviour, change). [10-13] None, as yet, is firmly based on the latest thinking about human behaviour itself, the purposes that it evolved to serve, or the way in which it changes in response to changing circumstances. With the recent revolutions in the understanding of situations, [14-16], environments [17] and brains, [18] it is time to update our approach to behaviour change. People largely know what they should be doing to influence (their own) behaviour, but just don’t do it. So behaviour change programs need to focus on behaviour, not cognition or communication. Behaviour Centred Design is a new approach which, as the name implies, is centred on behaviour. It differs from existing approaches in that it is a complete process for behaviour change, aimed at both individuals and societies. It provides a coherent behavioural model derived from reinforcement learning theory, develops a fundamental taxonomy of needs based in evolutionary biology, shows how the disruption of ‘behaviour settings’ (a key concept derived from ecological psychology that we explain below) is key, and sets out the steps involved in programming for behaviour change. So as well as providing a means of identifying the levers that can change behaviour, it also provides a design process, with steps and tools to use in conceiving, creating, implementing and evaluating a behaviour change program. 4 This document is designed to encourage behaviour change practitioners to think differently about behaviour – both in understanding how and why it is produced and in how to design programs to change it. Part 1 covers some basic theory which explains the processes that govern human behaviour, including habit, rational planning and motives, as well as the role of the environment and of behaviour settings. Part 2 discusses BCD’s theoretical proposition about how to change behaviour, which is unlike traditional approaches that start and end with changing cognitions. Rather, we emphasize other psychological processes and environmental factors – and include the key principles of surprise, revaluation and performance. Part 3 describes the process of developing, creating and testing a behaviour change intervention, with five key steps – the ABCDE of behaviour change. We provide many examples along the way, as well as further material which we encourage you to consult via the links and suggested literature. What!is!BCD?!! One diagram will be used to describe the whole approach (see Figure 1). This is the BCD Process Model, which will figure throughout this monograph. Across the middle of the diagram is the chain of events that has to occur for behaviour to change. In a nutshell, an intervention has to change something in the environment, which has to change something in the brain and/or body of the target individual, which then has to impact on behaviour. The aggregate of these individual behaviours then has some impact on the state-of-the-world. This causal chain represents the BCD approach to defining what is known as a ‘Theory of Change’. (For more background on Theories of Change see the Theory Box below.) Figure 1: The BCD Process Model 5 BCD THEORY: Theory of Change Theory of Change is an emerging approach to guiding program development, execution and analysis [19]. Having an explicit Theory of Change helps one to think clearly about the pathways by which change occurs, to design interventions that are more likely to affect those pathways, and to better evaluate how program inputs have led to the desired outcomes and impacts. [19] It requires that program managers make explicit assumptions about the cause-effect relationships between program activities and behaviour change, about the operational/logistical expectations for delivery of those activities, and about the macro-environmental context within which the program is taking place. This allows program stakeholders to attribute results to program activities when both the program and the context within which it has been executed are complex (a useful ability in the era of ‘evidence-based’ policy). [20] A Theory of Change can be used in several ways: as a process description that makes explicit the causal connections between program inputs and outputs, as a strategic planning tool to guide action, and as a conceptual or thinking tool from which to learn from experience. [21] A particular view of how a Theory of Change should be organized forms part of the BCD approach. But the key question remains: how to design the intervention such that it has the desired behavioural outcomes and impact? And then, how to learn if it has worked? Along the top and bottom of the diagram are depicted the five steps of the BCD program development process. We have dubbed these the ABCDE steps, as follows: A: Assess – here program designers start by gathering what is known about the target behaviours, the target audience, the context and the parameters of the intervention. A framing statement sets out what is known already about how change can be achieved and sets out hypotheses about change mechanisms for further exploration. B: Build – involves carrying out carefully targeted formative research with a sample of the target audience to find out the things that are unknown and explore hypotheses about the likely drivers of change. Unlike typical formative research, which typically involves key informant interviews and focus groups, BCD employs a variety of innovative methods such as motivational mapping, product attribute ranking, scripting and video ethnography in a rapid ‘deep dive’ with target audiences. The insights from this formative research are then ordered into a Theory of Change and distilled into a brief for the next phase. C: Create uploads/Management/ bcd-guide.pdf