Now, many of you in the audience are geniuses already. I
think that's true, but my goal is to turn you into behavior
change genius. I'm going to pick one little slice of it. It'
s different than what Gina will be talking about later. And
they're very complimentary approaches. If I can get the
visual up on the screen here? If not, I will just kind of
keep going.
Today I'm going to talk about habit. And what I want us to
do first of all is-you've got your mobile phone, right? Can
everybody pull that out and turn your ringer on? Yeah! First
time anybody's ever told you to do that, right? Get it out
and turn the ringer on. Here's what we're going to do. Every
time you hear somebody's phone ring I want you to do this-
relax, okay? So, it's a very quick relaxation exercise. So,
when you hear a phone ring, ring means relax. So, if it's
your phone going off, yeah let it ring once or twice but
then turn it off. We don't have to hear the whole Lady Gaga
ringtone or what have you.
Okay. We got that? So, habits, habits, habits. The class
that I'm teaching right now here at Stanford is about using
technology to create habits of calming, of stress reduction
and I think habits are very important. If we only have
information and we don't-I missed that one! We'll talk about
that. If we don't change our behavior information frankly
doesn't matter. In fact, rarely does information lead to
behavior change. There are some cases where it does but just
because somebody gives me a stat about I'm out of shape
doesn't mean I'm going to go and start exercising right
away. And we all know that's the case.
So, the challenge is how do you change people's lives by
changing their habits? And that's been an obsession of mine
for about 18 months in the health arena.
I came here in '93 to study this question-how to use
computers to change people's attitudes and behaviors. I
really wasn't a health person although I've always been a
health enthusiast. But in the last two years I've been
sucked into this arena because of the changes we need to
make. A lot of them have to do with health. I don't have the
exact number of how much we can save money by changing
behaviors. Somebody at a previous event said 80%. But I don'
t know what the number is.
I do believe that by using systematic methods to think about
behavior change that we can solve bigger problems. And to
this point-I'm going to offend some people, sorry-people
have been very sloppy thinkers about behavior change, okay?
So, listen to things with a critical ear, look at things
with a critical eye including what I'm going to be showing
you today.
There's a Facebook class I did here. It was on the New York
Times. Somebody asked me to talk just briefly about this. I
won't go into it deeply, but 10 weeks, they got millions of
people involved. The New York Times did do a cover story
three years later. It came out Sunday. The derivative
stories that weren't always accurate. Don't trust everything
you read. But the New York Times story was mostly on target.
But the class was all about how can we systematically have
impact with these apps and how can you do that?
In my lab's work here at Stanford we've been systematically
looking at behavior change. Now, the metaphor breaks down
pretty fast. But imagine if you were a chemist, a
pharmacist, somebody even in construction and you didn't
have the periodic table elements to work with. Imagine what
a problem that would be.
To date we have not had a periodic table of behavior change
types. And I recognized this a while ago. I tried to get
some students in Europe to do it. They didn't really pick it
up and say, "Okay, we're going to do this". And my lab and I
have been through a few iterations of this. We call it the
behavior grid. We passed out a product from my lab. You've
got a little card. Pull that out right now. For some of you
you'll have to get out your microscopes or magnifying
glasses and look at the side of the card that has that grid.
I'm going to give you a brief intro to that in the hopes
that you will then study it further, in the hopes that when
you think about a behavior change type you'll be able to put
it in the right place on the grid.
The big idea here is there's 15 types of behavior. Each one
has a different recipe strategy that works. So, if you're
trying to get a Green Dot behavior done solving with black
path strategies, that's like trying to cook a birthday cake
with chili powder, right? You've got to use the right
ingredients for the right target. You've got green
behaviors. Look at the first column. We decided to call them
green. We could have called them new. These are behaviors
that are new to people.
About a year ago I got an email here from the editor of
Playboy and he said, "Hey B.J., we're putting together a
cool professor's list. We want you to be in it in Playboy.
We're going to come to Stanford, and talk to you, and take
some shots." I was like, "Ugh". I'd never been in Playboy
before. And so, see for me that's a green behavior. It's
characterized by fear, uncertain what would happen if I said
yes. Well, I did end up saying no.
But as you look at the behavior types we're trying to get
people to do, if it's new there may be fear and uncertainty
around it and there may be lack of ability. They'd never
done it before.
Mid.com-good example of how they address this. Notice all
the things they do. I've circled it in orange to address the
issues of fear and security. Now, I'm going to use some
examples from the consumer internet space cause in many ways
they are leading the pack in changing people's behaviors.
And by adopting the techniques they use we can do a lot
better job in the health space.
Let's go to blue behaviors in the next column. Blue is
characterized by things you've done before. Virgin Airlines-
cause I fly on Virgin a lot it's no big deal for me to book
a ticket flying Virgin. There's nothing uncertain about
that. There's no barrier there. And so, when it comes to
blue behaviors it's helping people do what they already know
how to do whether it's buying a book on Amazon, showing up
to class on time, using email, using Google Docs, what have
you.
Now, I'm not going to go through all of this, but then we
have a class called Purple Behaviors. These are all about
doing stuff and then the gray and black behaviors are about
doing less or stop doing stuff. Actually, what I'd like you
to do is if you have a pen where that orange line is draw a
line down through those columns so you see really clearly, "
Here's the 'Do Stuff' side and here's the 'Do Less' or 'Stop
Doing' side of the grid."
Now that you have your pen out also, Blue Path. This is my
favorite cell in the chart. Circle that. This is where
habits live. And Blue Path means doing something you know
how to do for the rest of your life. Need a book? Go to
Amazon. My alarm rings, I wake up or I turn off the alarm. I
walk out to the kitchen, I get some water. What do you do
all the time without making decisions? So, understand some
behaviors require decisions and some don't. In fact, in some
ways that is a measure of the strength of the habit is how
much do you do it without making a decision for better or
for worse.
The Winning Technology Company-and this is a perfect list. I
grabbed it from Tech Crunch last fall. But it's a pretty
good list. They're good at creating habits, so they're very
good at getting people to this spot. Now, you don't just
start here. At least from our perspective there's a path.
There's a route to get people to that Blue Path. Certainly
people have to use your service the first time, then they
have to do it again. Maybe there's a period of time where
they're using it 30 day trial and then eventually you hope
they're always using whatever program service you're
providing and so on.
At least now with the words you can say Green Dot, Blue Dot
and then eventually you want to get people into a Blue Path
or do we want to get people into a Purple Path? That's do
more of something-exercise more, eat more vegetables, and so
on from now on. Do you really want to do a path or do you
want to do a span? A span is for a limited period of time-14
days, 21 days, six weeks, what have you for path. We want
you to buy in for the rest of your life. Spans are easier to
do than paths.
The winners are really good at creating these habits. Watch
how they do it. If you're not using the popular technologies
you should be using them. There's a reason-Twitter,
Facebook, Cora, GroupOn. There's a reason those people are
winning and you can extract the psychological recipe from
those things and use it in your work related to changing
health behaviors. That's a big, big, big part of what we're
doing in my Stanford lab-what are the recipes that work?
Focus on those behaviors. Imitate the winning formulas. Don'
t study the losers. It's a waste of time.
So, deeper on habits. I think there are three steps to new
habits and unless you've read my stuff you've not heard
these before. You have some stuff coming out. There's some
Post-It's coming out right now. So, when you get a Post-It
pass it along. Grab a Post-It and pass it along. We'll use
that in a minute.
The first step is to make it tiny. So, let's say you want
your workforce. You want people to exercise more. They're
not exercising. If you go out and say, "Hey, we're all going
to create a habit of exercising 30 minutes every day" you
all know what will happen. Very, very few people will
actually make that a habit. We've seen that over and over.
These big leaps don't work. What does work is make it really
small such as walk five minutes a day, find a spot where it
lives in somebody's routine-right after you take your coffee
break, right after you come back from lunch-and then you
train the cycle.
In other words, you don't work on getting people to walk 30
minutes a day until they have that automatic reaction, "Oh.
I'm back from my coffee break. I'm going to go walk for five
minutes." So, they're not making a decision about exercise.
They're just automatically doing it and that's it.
I think those are all the steps. I call those tiny habits.
Here are the steps here and here is the assertion we've not
yet shown scientifically, but I think it's true. Plant a
tiny habit in the right spot and it will grow out coaxing.
So, the right little behavior once you get it trained in
cycle-let's say it's walk five minutes-you don't have to
further push people to exercise more. If the context is
right they will naturally expand to the full behavior.
What I want to do is together right now let's work through a
case study. I've never done this before, but let's try this.
Okay. I'm going to have you vote on something and it might
be sensitive. So, I'm going to have you close your eyes and
don't look at how other people are voting. Got it? Okay.
Ready. It'll only be like 12 seconds. Ready? Close your
eyes.
How many people wish you had a better flossing habit? Raise
your hand.
Okay. You can go ahead and put your hands down. Hopefully
nobody peaked, but I will tell you it was at least 60%. A
bit more than I thought actually. Let's take this and apply
it to flossing. Make it tiny. Floss one tooth. Find the
right spot. Find the right spot right after you brush and
then just train the cycle. In other words, don't floss all
your teeth unless you really, really want to. What you're
focusing on is just right after I brush, I floss. You
already know how to floss all your teeth, right? That's not
what you need to drill on. What you need to drill on is the
automatic, "I brush and then I floss".
And that other piece that I didn't put here is once you
floss that one tooth what you need to do somehow-this is the
idea it's like, "Victory! I did it!" Don't floss the rest of
your teeth unless you really want to. As soon as it gets
painful like, "This is a drag" I think your brain says, "No.
I'm not making this a habit". So, it has to be something
like, "Yeah! I get to floss this one tooth. Oh and guess
what? If I do them all? Awesome! I'm even awesomer!"
Okay. So, on the Post-It that I handed to you what I want
you to do on that Post-It is write, "Floss one tooth". Got
it? Okay. We'll come back to that. Here we go. "Floss one
tooth". And again, what happens I believe where we're
showing this scientifically is once you get that little
habit going guess what? Every day I floss one tooth. In
fact, I floss twice a day cause my habit is after I brush I
floss. So, it doesn't matter when I brush I floss. So, it's
twice a day.
You can expand it to a larger behavior. "Walk five minutes-
walk 30". "Eat two vegetables-eat five". "Floss one tooth-
floss all your teeth". That expansion from blue to purple is
much, much easier than going for Green Dot. "For the first
time ever do something". And this is where as you look at
the companies that have won they're very good at this. Get a
tiny habit going. "Use us for research". "Use us for music
appreciation". "Use us to share photos". And they take that
and they expand it into other domains until you're using
Google Docs, and Google Maps, duh, duh, duh, duh. So,
understand that dynamic. Get a little thing working and
expand it.
We haven't heard any phone rings have we? Let's practice.
Wow! Either we're not very popular or people know we're in a
meeting. Let's talk about the phone in terms of
understanding how behavior works. All the 15 behaviors work
this way. Let me use this example. Imagine that your phone
rings and you don't answer it. Think of a few reasons why.
That's happened here, right? Okay. Ready? Go. Take 10
seconds.
Okay. How many people thought of, "Well, I didn't answer it
cause I didn't hear it. It was in the car and I was in the
house." How many people had an answer something like that?
Okay. So, that's the trigger which is the ring-never arrive.
The trigger is the call to action. It's like, "Do it now".
The trigger is the phone rings. "Oh. I can pick it up." The
signal turns green, "Oh. I can go now".
How many people thought of, "Oh wow! Here's a person
calling. I'm in a bad mood. I don't want to talk to them."
Okay. So, if that's you raise your left hand, okay? Just
hold your left hand up. "Oh, I don't really want to talk
right now." Okay. Keep that hand up.
How many of you put something down like, "Oh. I'm in a
meeting", "I'm in the shower", "I'm driving", and so on.
Okay. Bam! We made it. You can put your hands down. So,
right there. I wish I had known this back in 1993 when I
came here to do this work. There's only three elements that
must happen at the same moment for behavior to occur:
Motivation there has to be some level, ability, and there
has to be a trigger. And those things have to happen at the
same moment. If any one's missing the behavior won't happen.
And there's a threshold of sorts that if you're above the
threshold and the trigger hits the behavior will occur. If
you're below it, it won't. Let me show you some examples.
Here's something. Stanford Development Office called and
said, "Hey, guess what? Donate $1 million dollars." Hard to
do. But they say, "Man, if you donate $1 million we'll give
you special box seats here at the stadium, we'll name a
building in your honor", duh, duh, duh. They're going to
keep boosting the motivation. But notice how here in the
model if they keep going it never goes over the line because
for most people donating $1 million is really, really hard.
Well, should I do this? I've never done this before. Okay.
Now, I want to take the time. So, let's say the target
behavior like the photo was to sit in this position, and go
like this, and just hold it there for 10 seconds, okay? Now,
I could pull out my money and say, "Okay. Here's $100 to do
it. Here's more." And if you can't do it, you can't do it.
It doesn't matter how high the motivation. There's lots of
things I can't do that happens to be easy for me. But the
point is if it's hard to do, don't boost the motivation.
Make it easier to do.
And from a behavioral design perspective working with my
students, this is the natural reaction. If we're triggering
the behavior and it's not working we're going to make it
easier to do before we mess with motivation. Motivation's
the last of the three things you end up doing.
Here's the part of the chart I like the best. Easy to do,
doesn't matter where the motivation is. And let me show you
a video that typifies this. This is my dog, Millie. What she
wants me to do is kick the ball so she can chase it. Now,
notice how that works.
Okay. You didn't notice this at first. Now, next she puts it
in the very center of the house. She can't go anywhere
without going here. So, even without looking you'll walk
there and kick the ball. Okay . So, she makes it super easy.
So, the point here is okay, here's where Millie's at. She
wants me to kick the ball. She knows my motivation's often
low because I've done this thousands and thousands of times.
So, it's got to be easy to do and now she's even better. In
fact, she puts it outside the shower so as I step out I kick
it. Then she runs over into the bedroom and she just puts it
in all the right spots.
How can we do this well when we're designing for health
systems? Now, notice the more you do something-this isn't a
great example. Let's take the walk five minutes. Somebody
who's never really exercised before. If we can get let's say
Sara walking five minutes for five days in a row, she's a
different person at that point. And the walking for 10
minutes or 30 minutes is different on the map for her. In
other words, believe in baby steps and the more baby steps
we can get people to do the more capable they will be of
doing the harder stuff. Don't start with the hard stuff-
recipe for failure. Floss one tooth. Some of you'll be
motivated, some of you won't be very motivated but I'm
hoping that it's easy enough that you'll actually do it.
Now, I've been there. When you're not flossing regularly you
bleed, your fingers hurt, there's all these demotivators.
But the more you do it the faster you get, it doesn't hurt,
you don't bleed after about four days. In other words, the
flossing all your teeth gets easier and easier to do.
Now, a point I want to make about habits-here's where they
live and they live somewhere in here. Habits do not live
where it's hard to do. I can't think of any habit that is
hard to do that is truly a habit. So, look and see how
people trigger these behaviors. Facebook is very good as
triggering behavior mostly through email. In one case I got
a notification that one of my students had tagged me in a
photo. I was like, "Okay. I'll go check this out". Actually
I wasn't smiling. I was like, "Oh no! What could this be?"
So, I go into Facebook and look around and I update my
status. This is when I was working in theory and then I
realized, "Stupid Facebook! I'm supposed to be working!" I
got triggered. So, Facebook is very good at triggering us to
do what they want us to do which is to go into the system
and contribute content, make them a wealthier company.
But when I looked at this from a behavior design perspective
for my lab I said, "Love it or hate it Facebook is great at
this. Very important. These are probably the most important
nine words I learned at Stanford-Put hot triggers in the
path of motivated people."
A hot trigger doesn't mean it's the cool, sexy thing. The
hot trigger says, "You can do this now." "You can floss your
tooth now." The winning ventures are great at doing this.
They're great at hot triggering. And more and more of those
triggers are coming through our social network. It appears
that our friends are triggering us, not some big company.
Hot triggers aren't just in technology. They're all around
us. They've been around for a long, long time. Notice how
hot triggers work. That's one of the things I want you to do
after this talk. And I think it's part of the ingenious in
behavior change. It's like, "There's a hot trigger." "There'
s a hot trigger." "Oh! There's a hot trigger we can use in
the system." This is not a hot trigger. It's just a switch.
These are hot triggers.
On the left is a cold trigger cause I can't drink milk when
I see that bus stop. On the right I can because I can buy
it. Now, the connection here is this. Notice how people use
hot triggers to then create havoc so they can move the
explicit behavior and the trigger still happens. You still
log onto Facebook every day. You still use a certain app and
what have you.
So, these triggers need to be in the path. It needs to be
with something that people area already using-email,
Twitter, on the outside of the fridge, on your bathroom
mirror-watch for them. And technology is great at triggering
behaviors. It's going to get better and better. And mobile
phones are in some ways the Holy Grail.
Last week I ran a conference here at Stanford on Mobile
Health. We had 60 speakers who talked about what's working
with mobile and what's not. I'm hoping you put this hot
trigger in your path. It's an important part I think of
designing for behavior change to experience it and think
about it.
So, what I've tried to do in this talk is have two types of
habits we're forming. One-and it didn't happen cause our
phones didn't ring very much-is when a cue happens you
respond. Phone rings, I relax. I call that a cue habit. The
other type of habit I call that a cycle habit. Right after I
brush, I floss. "Every day at 8:00 I do this". "Every time I
go to the gym I text my sister". It happens on a cycle.
Those daily cycle happens are bulls eye of what we're doing
right now in my lab it's what we care about the most.
As you work on creating this habit with "Floss one tooth" I'
m hoping you will get a sense of how that works, how you
response, how automatic it becomes. Forget about what you've
heard-common received wisdom about habit formation. I think
a lot of it's wrong. And pay attention to your own processes
in creating habits. There's still a lot to be discovered
there.
Thanks everybody.