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How Patient-Centered Communication Can Address Maternal Health Inequities

August 2023

This article was written by Eden Brownell, Director of Behavioral Science at mPulse Mobile, and was originally published on on August 9, 2023.

The United States is among the most dangerous wealthy nations for women to give birth.

Disturbingly, it’s even more dangerous for women of color. Black women are about three times more likely to die from pregnancy-related complications than white women, while maternal mortality rates among American Indian and Alaska Native (AIAN) women are two times higher. The COVID-19 pandemic only exacerbated these issues.

Maternal mortality rates underscore this country’s deep-rooted health inequities. Although this problem is endemic, it’s not intractable. In fact, more than 80% of pregnancy-related deaths in the U.S. are preventable.

The healthcare system must work to address all of the factors that contribute to maternal health inequalities, including barriers to care, systemic inequities, and how health plans communicate with consumers.

We can improve maternal health outcomes with digital trends by breaking down these barriers and improving communication.

How poor health communication adds to maternal health inequalities and risks

There are myriad factors that contribute to the disproportionate rates of maternal deaths among Black women and women of color.

They include

  1. structural racism and biases within the healthcare system,
  2. limited access to quality providers and facilities in marginalized communities, and
  3. socioeconomic barriers (such as lack of insurance coverage and financial constraints)

And these are only a few of the challenges.

Inadequate patient communication exacerbates many of the inequalities in maternal health problems. For example, marginalized communities often have lower rates of health literacy and higher levels of distrust of health providers, making it difficult to navigate our complex healthcare system.

Or consider someone with limited transportation options. They may be more likely to delay or miss prenatal check-ins or obtain necessary interventions, treatments, and prescriptions that providers recommend. It does little good for a health plan to send follow-up reminders or other messages that don’t consider this barrier. Instead, messages should prompt follow-up conversations that urge people to arrange other transportation options, if necessary.

Likewise, if educational materials and health content don’t provide clear, accessible, and culturally relevant information, health plans will struggle to connect, engage, and build trust with vulnerable populations. That includes addressing language barriers and offering materials in different languages, along with interpreters and translation services that are readily available. Without these supports, marginalized communities may be more susceptible to misinformation and less likely to understand all of the facets of prenatal and postpartum care, whether it’s the stages of pregnancy, warning signs of potential complications, birthing options, or more.

How to build a better patient communication strategy

The stark disparities in maternal health outcomes for marginalized populations highlight the importance of intervention.

Targeted patient health communications and engagement can help

  1. overcome the socioeconomic barriers associated with prenatal and postpartum care,
  2. reduce health risks, and
  3. empower pregnant individuals to actively participate in their healthcare decisions

Consider taking the following steps to build a patient-centered communications strategy that will address the needs of marginalized populations and improve maternal healthcare outcomes for all patients throughout your health system:

1. Promote cultural competence throughout the organization

Cultural competence that respects and understands all communities’ diverse backgrounds and experiences should be the standard for all health plans today. Health equity should be prioritized as a strategic goal and a central component of your mission. Leaders must acknowledge existing disparities and build a clear plan to address them.

It’s encouraging that many health plans have created roles specifically to focus on health equity issues. Still, these initiatives must be backed by tangible action and dedicated resources organization-wide. Developing cultural competence and addressing implicit biases through routine training and ongoing education for all employees should be part of your larger DEI goals.

These efforts are the first step toward building the right internal culture throughout your organization and ensuring all touchpoints — whether digital or in-person — will be informed by cultural competence.

2. Actively collaborate with impacted communities

The best way to ensure your digital health solution resonates with marginalized communities is to collaborate directly with impacted community members. Key community stakeholders can help identify specific needs, cultural preferences, and barriers to care that your organization may overlook or fail to understand.

For example, one client at mPulse — a digital health solutions provider where I lead behavioral science — is a medical system that serves low-income populations and individuals struggling to access care. This medical system worked directly with pregnant mothers to develop a prenatal texting care program. Members of the group came up with key phrases and terms to avoid, such as messages in an overly authoritative voice that could trigger psychological resistance to information. By actively involving community members in the planning and implementing healthcare programs, as our client did, you

can build rapport and develop tailored approaches that connect with the populations you aim to serve.

3. Incorporate behavioral science principles

Behavioral science has become a crucial component of health engagement programs. Incorporating behavioral science into maternal healthcare communications can directly impact health outcomes during your patients’ pregnancies.

For example, mPulse worked with mothers and maternal care experts to develop a prenatal engagement campaign incorporating the behavioral science principles of “social proof” and “storytelling,” with videos of mothers from various communities sharing their stories and experiences.

By highlighting the experiences and stories of pregnant individuals within the community, health plans can foster greater trust, dispelling many common concerns from mothers and increasing the likelihood that they would engage and respond to outreach materials.

4. Prioritize data-driven decisions

Health plans collect an abundance of data about their members — so it’s important to use that information. Data enables you to better understand the barriers and needs of marginalized populations so you can tailor interventions and outreach efforts to address barriers more effectively and build more personalized, relevant experiences that resonate with patients. For example, knowing that someone recently joined Medicaid can inform which educational healthcare content you send them, like how they can navigate insurance throughout their pregnancy.

Data analytics can also help in deploying behavioral science methods. For instance, cognitive overload often causes members to become overwhelmed and tune out vital information. Analyzing viewership and engagement with online videos can inform the length and substance of those videos. If you find a majority of members stop watching content about the risks of aspirin during pregnancy, you may start to develop shorter, quick-hit videos optimized for Facebook, TikTok, or other social media platforms.

5. Use multiple communication channels.

In today’s digital landscape, consumers interact with health plans through various touchpoints, such as

  • online,
  • on their phones,
  • at telehealth visits,
  • at the clinic or
  • in a provider’s office

You should leverage a variety of patient communication channels to reach marginalized populations no matter how they interact with your organization.

Beyond traditional channels like phone and email, you can broaden reach and engagement through community events, social media, and partnerships with trusted community leaders and influencers. Multiple avenues for engagement are particularly important when addressing underlying social determinants like homelessness or unstable housing—these members may not have access to a single, consistent communication channel.

Improving maternal healthcare among marginalized populations demands a multifaceted approach centered on cultural competence and active engagement with communities. And today’s advanced digital tools offer new opportunities to put these tenets into practice within your health plans.

By embracing these approaches and adopting a patient-centered mindset, health plans can begin to bridge the gaps in maternal health inequalities and achieve better outcomes for all. Together, we can work toward a future where every pregnant individual receives the care and support they need to experience a healthy pregnancy and childbirth.

Frictionless Healthcare, Part 5: The Power of Perception

Welcome, dear readers! Today, we will delve again into the captivating world of behavioral science and some of its applications in healthcare. By gaining insights into human behavior, we can effectively drive behavior change and create a seamless healthcare experience. Let’s delve into this fascinating subject!

Understanding Behavioral Science

Behavioral science is a discipline that investigates human behavior through observation and experimentation. It delves into various factors that influence our actions, including conscious thoughts, motivation, social influences, contextual effects, and habits. By comprehending these aspects, we gain a better understanding of why people behave the way they do.

To simplify the concept, behavioral change can be likened to launching a rocket. Just as a rocket requires increased fuel and reduced friction to propel forward, behavior change necessitates increased motivation and decreased barriers. By employing principles from behavioral science, we can identify the driving factors of behavior change and apply them effectively in healthcare settings.

mPulse Mobile has developed the Behavior Change Wheel, a comprehensive framework that combines best practices from behavioral science, user experience design, and instructional strategy. By utilizing behavior change techniques, mPulse Mobile engages diverse populations, promotes behavior change, and achieves positive health and business outcomes.

In today’s blog, we will focus on two significant concepts from the behavior change wheel: authority bias and reactance. Authority bias refers to the tendency of individuals to place more importance on the opinions of respected experts. Reactance, on the other hand, suggests that people are less likely to adopt a behavior when they feel coerced. Balancing these concepts is vital in effective healthcare communication.

Interested in learning more? Watch the on-demand webinar, Frictionless Healthcare: The Power of Perception »

Harnessing the Power of Authority Bias

Making decisions can be challenging, leading our minds to seek guidance from authority figures. This phenomenon is known as authority bias. Observational research demonstrates our strong inclination to comply with those in charge, as we place our trust in their expertise. The infamous Milgram Study, for example, showcased how individuals followed instructions from researchers despite witnessing distress in others.

Moreover, authority figures can influence our behavior through a simple change in attire. An experiment with New York pedestrians revealed a significant increase in the likelihood of offering financial assistance to a stranger when the requester wore a police officer’s uniform*. These examples emphasize the impact of authority bias on decision-making.

Applying Authority Bias in Healthcare

“When it comes to applying authority bias, we cannot ignore historical and structural inequities that have shifted the definition of authority in some communities. This means expanding the definition beyond healthcare providers and entities to include other leaders including community organizers, faith leaders, and other trusted leaders”

 – SriVani Ganti, MSHC – Director of Health Equity.

In the healthcare domain, where uncertainty often prevails, authority bias plays a crucial role. Patients frequently encounter various uncertainties, ranging from scheduling appointments to managing their conditions. We can provide clarity and build trust with patients by alleviating uncertainty during these critical moments. Authority bias works effectively in situations where individuals are undecided, guiding them towards preferred options and fostering trust.

However, dear readers, it is essential to approach authority bias through the lens of health equity. Different types of authority figures, including medical institutions, community leaders, and faith leaders, can influence behavior change. It is key to understand the target audience and tailor messaging to resonate with their values and beliefs. Engaging with the community, gaining their trust, and upgrading messages to establish meaningful connections are vital steps.

mPulse Mobile’s Approach

mPulse Mobile recognizes the importance of authority bias and health equity in healthcare. In developing programs such as the maternal health program, mPulse actively involves pregnant people from diverse backgrounds to share their personal journeys. By creating meaningful connections between program members and relatable individuals, behavior change becomes more achievable.

Representation holds great significance in healthcare communication. When developing solutions, it is crucial to ensure that individuals can see themselves reflected in the stories and visuals. By featuring diverse perspectives and experiences, we foster a sense of connection and enhance engagement.

In Conclusion

The power of authority bias in healthcare communication should never be underestimated. By comprehending the intricacies of human behavior, leveraging appropriate authority figures, and tailoring messaging to diverse populations, we can drive behavior change, enhance patient experiences, and ultimately improve health outcomes. Let us embrace the potential of behavioral science and work towards creating a frictionless healthcare system that genuinely meets the needs of individuals.

Key Takeaways:

  • Behavioral science is an essential tool for understanding and driving behavior change in healthcare.
  • Authority bias, when utilized effectively, can provide clarity and build trust.
  • Health equity must be considered when leveraging authority bias, tailoring messaging to diverse audiences and engaging with various authority figures.
  • Representation plays a vital role in healthcare communication, necessitating the inclusion of diverse perspectives and stories.
  • By combining behavioral science principles with a focus on health equity, we can foster positive health outcomes.

*Bickman, L. (1974). The social power of a uniform. Journal of Applied Social Psychology 4, 47-61.

Frictionless Healthcare, Part 4: Stories that Move

Dear reader, have you ever wondered why you remember a story you heard better than an article you read? Once again, it comes down to the power of behavioral science. This next installment in our Frictionless Healthcare blog series will focus on the concept of storytelling effect. Storytelling effect is around the finding that people remember stories better than facts alone.

Haven’t read part 1 – 3 of this blog series yet? Go back to the beginning with Frictionless Healthcare, Part 1: Fueling Behavior Change »

Starting with the Foundation: Good Storytelling

The desire for stories isn’t new. Researchers and scholars alike have often written about the extent to which humans rely upon stories for processing complex information, for entertaining and empowering people, and for communicating with individuals and the public more generally [1-3]. Volumes of research have been devoted to understanding what constitutes the core elements of a story, how stories affect human behavior, and why stories evoke different responses than other methods of sharing information​.

A story has five basic but important elements. These five components are: the characters, the setting, the plot, the tension, and the resolution. These essential elements keep the story running smoothly and allow the action to develop in a logical way. A place to look for a clear illustration of these elements is in fairy tales. Fairy tales are universally accessible stories with clear stakes, effective story structure, and memorable characters. Let’s take Snow White as an example. 

  • Plot: The Evil Queen has a very unhealthy level of jealousy and obsession with Snow White and wants to kill her (quite extreme) 
  • Characters: the villain is obviously the Evil Queen, our protagonist is Snow White, and we have supporting characters (the seven dwarfs, the prince, and the forest animals). 
  • Setting: a house in the forest in a faraway fairy tale land 
  • Tension: The Evil Queen spends most of her time plotting a way to kill Snow White, which understandably causes quite a bit of tension. Ultimately, she succeeds in poisoning her and sending her into a coma. 
  • Resolution: the prince wakes Snow White, and they live happily ever after. 

Neuroscience imaging has shown that facts and figures activate just two areas of the brain: those responsible for language comprehension and processing. 

But stories activate up to eight areas of the brain: those having to do with touch, movement, scent, sound, color, and shape in addition to language comprehension and processing. ​The research shows that stories “light up” more of the brain than factual reporting. ​Part of this is because storytelling connects listeners to the storyteller emotionally and motivates cooperative behavior.

According to Stanford Graduate School of Business, stories are 22 times more memorable than facts alone. This is likely because stories universally activate brain regions dealing with emotional processing and memory.

The research implies that the brain responds to the story events as if they were happening to the listener. If you’re skeptical, think about why you cry while watching a movie, even though logic tells you that the story and characters are fictional.​ The medium of video engages and allows viewers to envision a reality in a manner not captured with verbal communication.

Want to learn more behavioral science basics? We’ve got you covered! Watch the entire Frictionless Healthcare webinar series on-demand »

Storytelling for Health Engagement 

In health engagement, however, we aren’t telling stories just to entertain. While entertainment is a respectable goal and key part of the equation, our main objective is to drive a specific action, such as getting that gap closure or convincing someone to set an appointment. Because the goal is loftier for healthcare, the formula gets a little more complex. There are a few more elements to consider: your target audience, the barriers they’re facing, your key messages, and a call to action.

To illustrate the application of story bias in healthcare, we’ll stick to our own advice and use a story: 

On the eve of 2020, all through the country, Americans were partying, drinking, setting off fireworks, and celebrating the beginning of a new decade. All were blissfully unaware of the troubles on the near horizon. We had all heard of the ominous coronavirus, but that was a problem brewing in the far reaches of China, and we were safely on the other side of the world. 

Fast forward to the end of January 2020, and coronavirus had now touched our shores, news of the impending pandemic was spreading, and the first Public Health Emergency (PHE) declaration was made by the white house. This declaration gave the government powers to guide and assist the country in fighting the pandemic and included in it was a pause on redetermination for Medicaid. 

For the last two years, Medicaid members have enjoyed continuous enrollment, meaning they retained their benefits without having to reapply annually as they usually would. But the Medicaid market knows that is soon coming to an end. Plans will now have the mountainous talk of restarting the redetermination process for their entire member base and ensure nobody falls through the cracks and losses coverage. 

That’s where it becomes critical to engage and educate your members using all tools at your disposal, and we recommend storytelling be a part of that. Listen to Tom Godfrey, our Vice President of Instructional Strategy and recent webinar host, explain the use of a target audience, barriers, key messaging, and a call to action all tied into storytelling in the form of a Fotonovela (a quick bite-sized animated story). 

Interested in more? Read part five of the Frictionless Healthcare blog series.

Behavioral scientists have found that in order to make a decision, people use both the rational and emotional parts of their brain. This means the most effective marketing messages will contain elements that appeal to each. Decisions of all types are often first made emotionally, and then later justified with rational reasons. ​Fotonovelas and other storytelling devices are our way to use that to our advantage.

We’ve Now Reached the Resolution

The human brain has a strong tendency to lose focus. In fact, it is estimated to engage in up to 2,000 daydreams a day and spend up to half its waking time wandering. In the presence of a compelling story that creates tension, however, the brain snaps to attention due to the release of a stress hormone known as cortisol.​

At mPulse, we use stories because they command attention, which we need from members and patients to drive action. Fotonovelas, animations, interactive experiences—these all serve to engage the brain, motivate the person, and create healthier individuals. If you’d like to learn more about the ways in which we use storytelling to drive action, watch the companion webinar to this blog, Stories that Move: Exploring the role of storytelling in behavior change design.

Resources:  1. Gottschall J. The Storytelling Animal: How Stories Make Us Human. New York, NY: Houghton Mifflin Harcourt; 2012. [Google Scholar

2. Cron L. Wired for Story: The Writer’s Guide to Using Brain Science to Hook Readers from the Very First Sentence. Berkeley, CA: Ten Speed Press; 2012. [Google Scholar

3. Olson R, Barton D, Palermo B.. Connection: Hollywood Storytelling Meets Critical Thinking. Los Angeles, CA: Prairie Starfish Productions; 2013. [Google Scholar

Binder JR, Frost JA, Hammeke TA, Cox RW, Rao SM, Prieto T. Human brain language areas identified by functional magnetic resonance imaging. J Neurosci. 1997 Jan 1;17(1):353-62. doi: 10.1523/JNEUROSCI.17-01-00353.1997. PMID: 8987760; PMCID: PMC6793702.

Frictionless Healthcare, Part 3: The Power of Reciprocity in Healthcare

Don’t forget to catch up with Part 1 and Part 2 of this blog series first!


So, readers, let’s talk more about theory and research. Robert Cialdini has been studying the science of persuasion for over forty years. In 1984 he wrote Influence, which reveals 6 principles of persuasion. It was an instant success and sits on the desks of advertising executives, copywriters, and marketeers everywhere, and reciprocity is the first of Cialdini’s six universal principles of persuasion. Why? Because the evidence shows that it works. 

Free coffee and donuts help car salespeople close deals. A couple of unexpected candies in the check at a restaurant gets the server a bigger tip (particularly if they come back to the table and hand deliver the second candy to “you lovely, special people”). When the hotel donates to charity on your behalf, you reuse a towel that you’d normally throw on the floor.  

Reciprocity in Healthcare

You are probably thinking to yourself, Cool, but what the heck does this have to do with healthcare?” Healthcare organizations have a real need for information or action from members, and it’s not always easy to get. By using a value first design to your approach (which means you provide the member with something valuable first and ask for the return favor later), you increase the likelihood of success.

We don’t just think and talk about these concepts, though. We put it into practice, and the Health Outcomes Survey (HOS) for Medicare beneficiaries is a perfect example of a healthcare initiative in which reciprocity can play a big role.  

We innovated on the standard HOS solution by applying value first design, so instead of asking members to answer a questionnaire by telling them that it’s very important (it’s important to the health plan, not the member, by the way), we first provide them with a fun, engaging digital experience designed to be valuable, personal, and unexpected. Most importantly, it includes changes members can make easily and quickly in their own lives. It’s only after we provide this experience that we ask members to provide their feedback, allowing us to identify high risk members so the plan can act.

Useful tip: Don’t only give first (it isn’t enough). Aim to also give a gift unexpectedly. In a study, customers who were given surprise discount coupons upon entering a shop spent on average 11% more than those who were given the coupons in advance. The unexpected nature of the gift amplified customer responses. Ensure that what you give is unexpected relative to the norm of what’s expected. 

Want to learn more about using reciprocity in healthcare? Watch the on-demand webinar » 

Something Unexpected 

Enter streaming health content. It’s something unexpected from healthcare but familiar to the member because it resembles media they consume every day, such as Tik Tok and Instagram stories. In this HOS example, the unexpected and helpful gifts are Fotonovelas, which are stories told through auto-advancing images (much like the snapchat or Instagram story experience). 

One of the biggest mysteries of neuroscience is how we create meaning out of the world. Stories are deep-rooted in the core of our nature and help us create this meaning.

Information presented in a story-based format is more easily remembered than plain statistics or facts. According to Stanford Graduate School of Business’ research, stories are 22 times more memorable than facts alone. This is likely because stories universally activate brain regions dealing with emotional processing and memory.

A powerful communication tool, stories can capture attention, build trust and credibility, and deliver messages and insights with impact. In the next installment in our Frictionless Healthcare blog and webinar series, we will go more in depth into storytelling effect, the psychology behind storytelling, and how to leverage it within your organization, so stay tuned and maybe sign up for our newsletter below (nudge nudge). 

Speaking of attention, dear readers, I’m probably losing yours. So, let’s wrap things up with some key takeaways about reciprocity.   

  • It’s how relationships are built ​ 
  • It’s not a trade or negotiation​ 
  • Follow the order of events: give, then ask​ 
  • Give something unexpected, personal, and valuable to increase the impact 

To learn more about using reciprocity in healthcare outreach, watch the full webinar below.

Read part four of this blog series!

Frictionless Healthcare, Part 2: Using Reciprocity to Increase Motivation

Behavioral science describes the study of behavior through experimentation and observation. Behavioral scientists study when and why individuals engage in specific behaviors by examining the impact of factors such as conscious thoughts, motivation, social influences, contextual effects, and habits. This week, we will look at how reciprocity can be used in healthcare design and content.


Dear reader, have you ever wondered what could make you not want to drop a hotel towel on the floor after the first use? Well, a card in a hotel bathroom might do it if it were written the right way. My good friend, Robert Cialdini, and his colleagues investigated this (okay we aren’t really good friends, but a girl can dream, right?) by testing multiple different card appeals to see which would lead to the highest rate of behavior change. They found that neither the basic environmental-protection message urging us to save some no name penguin (although, feel free to name him whichever way you like) nor the message with cooperation appeal could hold a candle to a different kind of push – our need to reciprocate

 The most effective way to induce the desired response was to give the donation first then ask a guest to cooperate in this effort. The message with reciprocation appeal, giving first read: 

 “WE’RE DOING OUR PART FOR THE ENVIRONMENT. CAN WE COUNT ON YOU? Because we are committed to preserving the environment, we have made a financial contribution to a nonprofit environmental protection organization on behalf of the hotel and its guests. If you would like to help us in recovering the expense, while conserving natural resources, please reuse your towels during your stay”.

 This method reported almost a 47% success rate, which was significantly greater than the cooperation condition. Why? Because the hotel donated money first on behalf of its guests and only then asked them to join in on it. You didn’t need to reuse your towel, but you felt sort of obliged to. If you didn’t recycle (help them claim the money back), well, you would probably feel a little bad, which is reciprocity in a nutshell. 

Reciprocity in Healthcare

But what does this story have to do with healthcare? The principle of reciprocity means you are more likely to comply with a request if it comes from someone who has previously done something for you, and in healthcare, obtaining compliance is a constant goal. Whether it’s urging members to get their preventive screenings or convincing patients to diet and exercise to bring down their A1C, driving healthy action is important to plans and providers, and reciprocity is a powerful tool to get this done. Let’s review one other case study before taking a deeper look at this in healthcare setting.

Want to learn more about using reciprocity in healthcare? Watch the on-demand webinar » 

 In this next example, the British Behavioral Insights Team joined forces with the NHS Blood and Transplant, the Department of Health, Government Digital Services, and DVLA to investigate a way to increase signups to the organ donor registry. It ended up being more complex than expected and was one of the biggest trials in the history of the UK public sector.

 Given the subject of this blog, you might have already figured they used reciprocity in a clever way to reach their goal. They inserted short phrases with various behavioral science techniques embedded into an existing vehicle tax webpage, and linked it to the organ donor register, which appeared after a user had finished obtaining their vehicle tax. The best-performing behavioral science technique (surprise, surprise) was the reciprocity appeal, which outperformed the existing webpage by roughly 100,000 registrants per year. Here is how it read: 

 “If you needed an organ transplant, would you have one? If so, please help others.”

 Oftentimes, healthcare organizations can approach a lot of healthcare problems with an eye towards getting members to provide them with information (even though they have a tendency not to). The trick is to flip this process by providing the member with something valuable first and encouraging them to think about these issues on their own before we ask them to share their thoughts and feelings, which is called value first design.

 In the context of digital product experiences, users are more likely to engage with your product if you first provide value to them. They’ll be more likely to trust you and reciprocate. This concept is even more important when you’re about to ask for something big from your users, such as signing up for something or closing a healthcare gap. In part 3 of this blog series, we’ll dive into the specific architecture of outreach and how to build in reciprocity by combining behavior science and streaming health education to create a value first design.

Frictionless Healthcare: Fueling Behavior Change

Have you ever wondered why Amazon provides its recommendations or why Netflix tailors your movie menu? It’s not because they must, dear readers. It’s because they know the power of behavioral science.

They both have behavioral science and psychology marketing teams working on the user experience and are uniquely aware of the constant barrage of advertisements and marketing that their consumers are being hit with throughout the day. People, including members we are trying to reach, see between 4k and 10k ads and make about 35,000 decisions every day. To complicate things further, 87% of information is subconsciously filtered. So, most of the time it can be next to impossible to get through to members.

So, you might be asking yourself what is behavioral science? And why does it matter for health communication?

Behavioral science describes the study of behavior through experimentation and observation. Behavioral scientists’ study when and why individuals engage in specific behaviors by examining the impact of factors such as conscious thoughts, motivation, social influences, contextual effects, and habits.

Behavioral science research is diverse and expansive. There is an abundance of work showing that human reasoning does not conform to what common sense predicts. Behavioral scientists study why people sometimes behave in a way that may not maximize their own well-being, such as making choices in the present that do not maximize their happiness in the future; examining how seemingly arbitrary contextual factors influence our decisions, beliefs, and attitudes or test how different incentives affect people’s motivation and behavior.

Learn more about using behavioral science in health communications by viewing our on-demand webinar, Frictionless Healthcare: Fueling Behavior Change »

So, readers, you might be asking yourself how do you apply these ideas in healthcare or health behavior change? If we really want to drive behavior change, we need to understand how people behave. When it comes down to it, there’s a lot of human behavior that we can explain in terms of two simple forces: Friction and Fuel. A rocket ship is a helpful metaphor that Dan Ariely uses to describe behavior change. To get a rocket ship moving, you need to increase fuel and decrease friction. To change behavior, you need to increase fuel (increasing motivation) and decrease friction (removing barriers). And it turns out, these concepts play out quite well in healthcare, so let’s examine that.

The Friction

In healthcare, frictions are anything that get in the way of your member performing a positive health behavior. Friction is typically caused by uncertainty on the part of your member. They could be uncertain about how hard an action will be, how long it will take, or how much it will cost.

Technology can go a long way to uncover and decrease friction.

One way is to employ barrier messages to uncover challenges (the friction) a member may be facing. Barrier messages are specific questions posed based on research of top barriers for specific audiences with specific health actions. Barriers happen. Why not proactively create opportunities to uncover and address them?

Once the barrier is discovered, we can work to solve it then drive motivation using proven behavior science techniques. You can see examples of those barrier messages below and observe how in a short phone screen you can do a lot to try to reduce barriers and increase motivation.


The Fuel

Speaking of motivation, fuel is anything that makes a positive health behavior more appealing. This could be member testimonials that utilize people copy the actions of others in an attempt to undertake behavior in a given situation) or an offering using incentives to activate the concept of reciprocity. Or you could utilize the endowment effect in messaging (an emotional bias that causes individuals to value an owned object higher, often irrationally, than its market value) like The Behavior Change for Good Initiative (BCFG) did to boost flu vaccine rates by up to 11%. The most powerful of these vaccination texts simply used ‘reserved for you’ messaging.

One of the ways we use these concepts is in stories or fotonovelas. This format is something members are used to seeing on social media, are they are quick and viewable on-the-go.

The Big Picture

Behavioral science can be tricky, but you can use the concept of friction and fuel to make a big difference in behavior change. This post was just an introduction to friction and fuel in healthcare, but we’ll be following up with a lot more information around the specific concepts and examples of each, so stay tuned for part 2!