Triggering Successful Patient Behavior Changes

By Karolyn A. Gazella

Healthcare practitioners continually work to crack the code when it comes to positively and sustainably changing patient behavior. While the true secret to success is likely highly individual and based on many nuances unique to each patient, there are some tenants to follow that may impact sustainable behavior change.

For years we were led to believe that all it takes to change behavior is motivation. Without motivation, patients were doomed to fail and with the right level of motivation, success was surely theirs. For example, if a patient really wants to quit smoking, then they will be successful. Alas, nothing could be further from the truth. Failure among motivated individuals led to numerous pundits writing about the “motivation myth.”

It was then thought that all we need to do to change behavior is to ensure the person has the ability to change. From a practical standpoint, this merely meant reducing physical barriers to change. For example, if the patient needs to exercise more, is she/he physically able to exercise more? Does the patient have the right tools to eat healthier? Once again, just as with motivation, we learned that ability is just one small piece of the puzzle.

What if we combine motivation and ability? Then we are sure to be successful! Not so, says Stanford researcher BJ Fogg, PhD. According to Fogg, there’s still one significant component missing that we need to help ensure lasting, successful behavior change. And that’s a trigger. Without that trigger, motivation and ability just aren’t enough. Fogg also believes that any two will not succeed without the third.1 It’s the trifecta that dictates successful behavior change.

In Fogg’s research, he has found that there are three steps that need to take place in order to change behavior:2

  1. be as specific as possible
  2. make it easy to do
  3. make sure there is something that will prompt the new behavior (the trigger)

“Behavior change happens when motivation, ability, and trigger all come together at the same moment,” says Fogg. “If any one of those things is missing, the behavior won’t happen.”

It seems as though the trigger is often a missing link. The trigger is a prompt that reminds the patient to do the behavior. This may require some creativity. Fogg tells a story about how he wanted to do more pushups throughout his day. He decided his trigger would be going to the bathroom. So, every time he went to the bathroom, he was reminded to do five pushups. He jokes that the number of pushups he would do throughout any given day was dependent on his water intake for that day.

Effective triggers, says Fogg, are often associated with an existing routine or something that you can consistently count on, like going to the bathroom. Perhaps the trigger is morning coffee or before the evening news or a part of the bedtime ritual. “Find a routine or habit that you already have and have that be the prompt for the new behavior that you want,” says Fogg. Fogg says that post-it notes, alarms, digital notifications, and other technology prompts can actually become irritating and ineffective. Identifying an existing habit or daily task to tie into will likely encourage a higher rate of sustainability.

I had the opportunity, along with my good friend Dr. Lise Alschuler, to interview Fogg about his research, which actually inspired this blog post. If you’d like to listen to the entire interview (approximate listening time is 50 minutes), click here.

Healthcare practitioners—especially integrative medical professionals—work in concert with their patients to facilitate positive lifestyle behavioral changes. The key is to utilize a technique that will help ensure that the new behavior sticks. Fogg’s focus on motivation, ability, and triggers, just may be the answer to this continual conundrum.

About the Author

Karolyn A. Gazella has been writing and publishing integrative health information since 1992. She is the publisher of the Natural Medicine Journal and the author or coauthor of hundreds of articles and several booklets and books including her latest book The Definitive Guide to Thriving After Cancer that she wrote with Lise Alschuler, ND, FABNO. Gazella is the co-creator and Chief Executive Officer of the iTHRIVE Plan, an innovative online wellness program specifically for cancer survivors.

References

  1. Fogg BJ. A behavior model for persuasive design. Proceedings of the 4th International Conference on Persuasive Technology. 2009;April 26-29.
  2. Fogg BJ. What causes behavior change? Accessed online 3/15/17. http://www.behaviormodel.org/index.html