Amy Bucher ‘Understanding Behaviour Change Design and how it co-exists and compliments other design disciplines’

Gerry Scullion  00:27

Hello, and welcome to another episode of Bringing Design Closer. My name is Gerry Scullion, and I’m a service designer, trainer, educator, and also the founder of This is HCD, based in Dublin City, Ireland. Bringing Design Closer is a podcast dedicated on shining the light on the complexities of embedding the designer’s mindset within organizations. In this episode, I chat with the wonderful Amy Bucher, VP of Behavior Change from Mad*Pow in Boston in the United States. We chat about the emerging role of behavior change design and how it intersects with other disciplines like service design and user experience. I’ll also cover off my personal unease with behavior change design, and unpack its ethical use – and sometimes its misuse – across industries. Amy gives fascinating examples of her work in healthcare and how she has used behavior change design to help improve the lives of people using those services. And we discuss how behavior change design practitioners sit within a more traditional design process and discuss the origins of her new book Engaged: Designing for Behavior Change on Rosenfeld Media. Now the folks over at Rosenfeld Media are amazing supporters of This is HCD and have given our listeners an exclusive 15% discount. So all you have to do is go over to Rosenfeld Media and use the code HCDENGAGED to get the discount. Of course, the code and the link are in the show notes to make it extra easy for you to check it out. Anyway, I’ve rambled on too much. Let’s get straight into this episode.

Amy Bucher, a very warm welcome to Bringing Design Closer. How are you?

Amy Bucher  02:00

I’m good. Thank you so much for having me.

Gerry  02:03

I’m super excited to have you here today because, as we were just chatting before we started to record, Amy was actually the very first winner of a book on This is HCD when it started right back at the start. So it’s really funny to finally get to speak to not only a book winner but also now an author.

Amy  02:24

Yeah, and I was saying, too, I really have enjoyed that book. It’s something I use a lot in my work, so it was a great sweepstakes to win.

Gerry  02:32

It was This is Service Design Doing, was that the book?

Amy  02:35

It was.

Gerry  02:36

It was. I do remember it cost me about $60 to post it from Sydney to Boston. I remember looking at Book Depository afterwards, and it was $35. I was like, ‘Oh, that wasn’t good.’

Amy  02:49

I didn’t realize that you were overseas. I remember when I received the package having that twinge of guilt.

Gerry  02:55

Think of the carbon footprint of shipping a book that came from Europe to Australia to then Boston. I was like, ‘Oh, that wasn’t good. I won’t be doing that one again.’ But let’s chat. The book is Engaged: Psychology for Digital Product Design. First question: how and why this book?

Amy  03:16

First of all, I’ve always wanted to write a book. I love writing. I love taking difficult scientific concepts and translating them into something that’s understandable for people who don’t have a lot of background. That’s been a common thread through my career. But this specific book was because I kind of cobbled together my own career path, which is pretty typical of the people you see doing behavior change design, because it wasn’t until a few years ago that it really became a little bit more of a cohesive professional community. I would get people who would reach out to me after I spoke at an event or sometimes in response to something I posted on a blog or even tweets, things like that, and they would be interested in ‘How do I become a behavior change designer? How do I evolve my career into this new area?’ And I would do a lot of one-on-one conversations and coffees, but that’s really difficult to sustain. I tried to write a few blog posts that spoke to what behavior change design is and how one might do it. And again, that wasn’t quite enough to really answer the questions people had. I just kept wishing that there was a book I could hand people or give people the URL to buy and say, ‘Listen, this will tell you about the field and how to do it.’ I always thought really highly of Rosenfeld Media – I’ve enjoyed reading their books – and when I saw that they had a form on their website where you could submit a proposal my trigger finger just hit submit. It did take a few years of going back and forth with them and refining the proposal and really honing in on exactly what the message was, but it all came out of this desire to help other people understand what behavior change design is and how they might make it a career for themselves if they wanted to.

Gerry  05:02

So, behavior change design. I’ve worked with lots of psychologists and I noticed in your book – you know, obviously you’re a psychologist, you’re qualified. How does this behavior change design as a discipline differ from, say, psychology, but also what you bring to the design process? How does that differ that’s different from, say, the existing user experience world?

Amy  05:29

So first, on the psychology side, one thing that I like about behavior change design is that you don’t have to be a psychologist to be a behavior change designer. I’ve had colleagues who come from other areas of social science. So for example, public health is one area where I’ve had quite a few colleagues who are thinking a little differently from me about behavior and how behavior is influenced but they still are bringing a really robust training and skillset to the field. And I’ve also had colleagues who have no formal training in social science, but have over the years through their reading and attending events and kind of that self-education really developed a sophisticated understanding of social science theories and frameworks. So that’s thing 1: you really don’t have to be a psychologist to be a behavior change designer.

Gerry  06:17

Okay.

Amy  06:18

And then thing 2: how is it different from user experience today? I think one of the primary differences is right in the name, which is that we’re always focused on a behavior as the centerpiece of our design process. So we will identify very early on in any design project the specific behaviors that we are trying to get people to change. And we try to be very crisp about defining those, making sure they really are behaviors. So when you read my bio, you mentioned I care a lot about happiness and facilitating people’s ability to do whatever it is that makes them happy. But happiness in and of itself is not a behavior and so I never design directly for happiness. I might design for a specific behavior that leads people to feel happier, but it’s really about having that discipline of understanding what is the behavior we’re designing for and then making sure that all of our research, all of our design, all of our measurement anchors back to that target behavior.

Gerry  07:15

Yeah. So one of the things that when I was reading it I said to myself, ‘Well, behavior change design’. For some reason, it kind of makes me feel somewhat uneasy as a discipline. And I was explaining to you beforehand, that, years ago, the whole nudging theory was very popular amongst marketeers and it starts to encroach in the world of design – you know, that this thing could change behaviors. It tends to be coming from the business’s perspective of, ‘This is the behavior we want to see. This is the outcome we want to get.’ So in your world as a behavioral change design expert, who decides the right behavior, and how do you get to that point?

Amy  08:00

I think that that’s a great question. And it’s an unease that I share. I think you noticed in looking at the book that I tried at every opportunity to speak to ethics. I interviewed people in each chapter and I actually chose a few people because I really admire the ethical approach they bring.

Gerry  08:17

I saw that, yes.

Amy  08:18

Yeah, I really wanted to make sure that comes through. Because the unease you’re talking about, that’s grounded in reality. There have been a lot of high-profile cases of companies that abuse people’s trust, that do things that, maybe even if they’re not outright unethical, still walk that line where ultimately they end up harming people rather than helping people. So I do think it’s really important to pay attention to that. And there is no one right now enforcing a set of ethical standards in the design field or in the new behavior change design field. But one of the dynamics that is happening that I’m really happy to see is you have a strong ethical grounding in the academic tradition, so any human subjects research you do has to go through an institutional review board review, which really is looking for those sorts of ethical issues. That whole tradition comes straight out of the Nuremberg trials and the Belmont paper. So there’s this long historical consideration of the harms that could be done if these professional skillsets were misapplied. What I’m seeing now that I’m really pleased about is more and more cross pollination of the academic behavior change tradition and this new behavior change design field, which tends to live outside of university contexts and more in a commercial space. And as you see more of those professionals collaborating and talking to each other, I think you’re going to start to see more of that strong ethical consideration from the academic tradition coming into the corporate tradition. That’s hopeful on my part – it’s not quite there yet, but I think that there’s just a lot of interest in those collaborations and everything they bring, and one of the things they will bring is that training, that consideration.

Gerry  09:59

Yeah, I mean, with the behavioral change piece, just to the question of, you know, who decides? If you’re in a typical client engagement and the client says, ‘We want to change this behavior’, who or how is that managed to ensure that the behavior that gets worked on to change adheres to the human centered design principles? Is that something the behavioral change design consultant will look after or is there a piece that you’ve had experience in?

Amy  10:35

It’s a piece that I wrestle with often. One of the reasons that I like working at Mad*Power, where I am today, is that as an agency years ago they decided that we have principles that we live into, and one of our tag lines is ‘good for people, good for business’. So there have been times where we have actually known ahead of time that a potential client is seeking to change behaviors that are really just good for business and not necessarily good for people. So for example, they just want to sell more of their product, whether or not it’s the best product for people. And what I’ve seen happen is we will not pursue those projects. So that right away clears off some level of those icky discussions, because we just won’t get involved with those projects that aren’t doing the ‘good for people’ bit that’s so important to who we are as a company, and to who I am as a person. So that alignment is really crucial to me. But then, even beyond that, even clients who say the right thing, who have their patients’ or their customers’ benefits at top of mind, of course they do still have their business goals. And I think almost always there’s a little bit of negotiation during the project where you outline what their long-term goals are – and those are typically going to be things that are related to money somehow, they want a return on their investment, that is fine – and then you work backwards from there. Well, what behaviors do people need to change in order for that return on investment to come true for you? It really is a discussion where, okay, the behavior can’t be just buying more of your product. It has to be something that is beneficial to them. And that ties back to the psychology piece. We have self-determination theory throughout the book – that’s really the behavior change framework I rely on most. It’s this idea that in order for something to be motivating over the long term, for you to keep engaging with something, it has to relate to your personal values, to your identity, or to something you really care about. And the way that you design experiences that do that, in part, is by supporting people’s autonomy, giving them this free choice.

Gerry  12:37

The control.

Amy  12:39

Yes. So when I’m talking to a potential client or to an actual client, and having this conversation, part of the point I’m trying to make is, if you’re imposing your goals on somebody, you are not giving them that autonomy, you’re not giving them that sense of choice. And ultimately, if you want to have a long-term relationship with this person, if you want them to be your customer forever, for the long term, you really have to give them that feeling of autonomy for them to be interested in that. So you need to play a longer game here. You can’t just go for the quick win, because you won’t get the long-term win that way.

Gerry  13:12

So that goes into the whole kind of interconnectedness of the relationship, with trust, Amy, and I know it’s something that you really care about. We were emailing last night. And you’ve got a great chapter in the book all about trust and how to build trust with the user – the person using the product or service. So talk to me about the tactics that you’ve seen and used that help build that trust with the people using the product or service.

Amy  13:38

So a first step is really just establishing your credibility as the person or company who’s built a product. So one thing I didn’t mention before, in terms of defining the behavior to be changed early in the process, and is another thing that I think sets behavior change design apart from design more broadly is that we tend to work with behaviors that are a little meatier, a little bit more complicated. So a project that is about getting more clicks on a web page, that feels to me like an arena where a digital marketer can do a totally wonderful job without the help of psychology. But if it’s something like managing high blood pressure by being adherent to medication for the rest of your life, changing the way you eat for the rest of your life, changing the way you exercise for the rest of your life, those are the sorts of complicated behaviors where behavior change design gets involved. And typically, when we work with those sorts of behaviors, there’s some kind of clinical protocol or background associated with it. There’s usually an evidence base that we’re drawing on in order to say these are the behaviors that are the right behaviors for your outcomes. And making that very clear to users is an important way to start to establish trust. So anytime there is a science background to the things that we’re recommending, talking about that, talking about our own credentials, our own experience. There are products that have done scientific studies that have shown that they work for a certain health problem. And I’m using health a lot, because that’s where a lot of my work is, but this holds true across other fields as well. But you know, if a product has been shown to help people lose weight and keep that weight off, or, you know, quit smoking and stay quit for six months, sharing that data is a really important way to establish that credibility. Now, the art is in doing that in a way that most people can understand and are interested to understand, because we also know that your average user is not going to sit there and read an academic paper about your product. But at least distilling that into a tagline or a show of credibility is really important.

Gerry  15:36

Yeah, it’s the intent. I know there were quite a lot of pieces around showing the information and improving the transparency and the rationale behind the decisions and why we’re doing certain things. And that echoes a lot of the stuff that I’ve heard from Leisa Reichelt, ex-GDS and now in Australia as Head of Insights and Research for Atlassian: ‘Show the thing.’ It goes towards not just only building your stakeholders’ trust, but also with the people using the products and services. So I really liked that bit in the book. Going back, you gave an example there of a project that you might be working on. Can you give us an example of say, a typical project that a behavioral change design consultant might be involved in, and how that interconnects with say ‘traditional’ design research in a service design type project?

Amy  16:34

I like to say that a lot of the activities a behavior change designer does are the same as other designers. It’s just the lenses and frameworks we bring to those processes are a little bit different.

Gerry  16:45

Yeah.

Amy  16:45

So almost all of my projects begin with a research phase and we–

Gerry  16:49

And you conduct the research?

Amy  16:52

I do. For example, I just wrapped up the research phase for a project with people who have a rare genetic condition and they have different health management behaviors they need to engage in to help control their symptoms. It’s not curable, because it’s genetic, although there’s hope with new technology that there may come a cure. And so I developed interview protocols and actually conducted one-on-one interviews with people who have this condition. The company that we’re working with actually wants to try to provide motivating feedback that will help people engage in these behaviors, knowing that it won’t cure them, but just that it will keep their symptoms from progressing. It’s a really thorny sort of problem that I’ve dealt with a number of times in my career, where you have a health condition or a situation where you’re just mitigating decline as opposed to improving things. It’s a really interesting perspective to think through when you think about something even like a progress meter or a visualization of progress, because it’s very different. You’re not showing progress toward a resolution; ideally, you’re just showing a flat line, and that hits people differently. So, we wrestle with that kind of question a lot.

Gerry  18:03

Okay, so in Mad*Pow’s world, behavior change design practitioners, do they work alongside user experience or design researchers? Or are you the new breed of design researchers, so to speak?

Amy  18:17

No, we’re actually fully integrated into our other team. So for any given project, we pull together a project team based on the skillsets that are needed for that job. And I do work alongside our other researchers. So for the project I just mentioned, I was working alongside one of our design transformation researchers who thinks very deeply about context in terms of the organizations that people are embedded in. And like I said, we do a lot of the same activities, but we’re bringing sort of different interpretive lenses to the way that we do them, so it’s nice to have that complementary viewpoint alongside mine. I like that I’m always learning and being challenged a little bit. I think my ability to be a behavior change designer is enhanced by working alongside people who have different training and backgrounds.

Gerry  19:04

So what I’m trying to understand from asking more about a traditional project for the likes of a behavioral change design consultant – it rolls off the tongue, that new title – is how does it interconnect with the other design processes, like user experience and service design? Is the thing that you’re tasked to do just change the behavior, or is it part of a broader project ecosystem?

Amy  19:29

It’s usually part of a broader project ecosystem. So one example – this is actually a series of projects that we’ve worked with, and I apologize because this is a very American example. But there’s a health plan here in the United States that we’ve done some work with. Health plans here oftentimes will have large employer organizations who are their clients. So you’ll get – I’ll just use Google as an example; I have no idea if Google is a client of this health plan or not.

Gerry  19:58

Okay, as an example.

Amy  19:59

Google will say, ‘Health plan, I’m going to offer your insurance to all of my employees.’ And then the health plan will make additional tools and services available to all of Google’s employees because they’re now customers.

Gerry  20:10

Okay.

Amy  20:10

So we’ve worked with this health plan a few times now. One of the things that health plans will typically offer to these employees of their employer customers is a wellness app or wellness services, because there’s a lot of data now that shows that I think it’s 80% of health care costs are influenced by seven modifiable behaviors. So it’s the way you eat, the way you move, your sleep, stress management, smoking, and there’s two more. But so what health plans will do is they’ll develop interventions or programs that target those seven behaviors. They give them to everybody. And their hope is that if enough people do them, they will ultimately spend less money in the healthcare system, they’ll be healthier, they won’t need as much care. So it’s really a cost control measure.

Gerry  20:52

Yeah.

Amy  20:53

But in terms of the individual user experience, what you hope is that they are finding activities that they enjoy, that are improving their quality of life, they’re helping them achieve goals that they want to do. Because most people also don’t want to be sick. They don’t want to incur those healthcare costs. So we did a number of projects now with this one health plan where they actually had us go out into their community and talk to people who might be their customers, individual people, and really understand their needs and interests around health and wellness so that they could completely redesign those wellness programs that they’re offering. And so with the first study that we did with them, one of the things we learned is that most people feel really frustrated with wellness apps that give them a lot of negative feedback. And that does tend to be the norm. You know, you didn’t get enough steps today, or you ate too many calories, but you very rarely get a congratulations. I guess with steps you sometimes do, because that’s so easily quantifiable, but people specifically kept saying, ‘I tried really hard and ate a good lunch today’ or ‘I made this sacrifice but nobody noticed. Nobody patted me on the back for it.’ And so that was the sort of insight we were able to give to our client. And they actually went and developed a whole totally new wellness experience based on that, which is really performing well and getting really positive feedback from its users. And then from there, they’ve hired us to do some additional investigations to help extend that to additional audiences in some cases, or into other areas of health. And so we’re coming back to them with these sorts of broad insights, but then we’re also working with them to distill them to really specific recommendations for how their development teams might implement them into – it’s a digital app. So I hope that helps to explain a little bit.

Gerry  22:34

Absolutely. Now that I know that it’s part of a broader project ecosystem, as opposed to replacing a ‘traditional’ – I’m doing a lot of air quotes here; I’m like Joey on Friends doing the air quotes – and it complements the research process of user experience and all the other qual and quant methods we use all the time in our disciplines. So it’s important to understand that because I know a lot of my peers when I mentioned that I was excited about, you know, speaking to Amy Bucher today, and they were like, ‘Ask her: what’s the story with this? How’s that gonna work? Is it going to try and replace user experience? Or how does it work with that?’ So it’s important to address that – that the book is really around this role of behavioral change and how it sits to complement the design research phase. Do you do typically extend beyond the research phase into ideation and prototyping and so forth?

Amy  23:37

I do. And that relates to a point I wanted to make, which is I really think that behavior change design can exist separate from other design skillsets, in a sense; it’s like an overlay. So I think you could be an interaction designer who’s also a behavior change designer, or a content developer who’s a behavior change designer. I happen to come in with a research and strategy skillset, but I’ve known other behavior change designers who can create beautiful visuals that then implemented as part of the experience. So I really think of it as almost a pair of sunglasses that you can put over your existing viewpoint or existing skillset. And it’s bringing in, first of all, that focus on the behavior and secondly, the frameworks, the empirical evidence that comes from social science. But to answer the question that you asked: yes, I do get involved into the ideation phase, almost always. I don’t have a skillset where I’m actually coding or creating visuals. I do sometimes get a little bit involved in content development, but I recognize that at some point it’s always best to hand that off to a specialist. I can do just enough to be dangerous there.

Gerry  24:45

Absolutely.

Amy  24:46

And then I typically get involved in the end again, because if we are deploying something, first of all, we really want to consider the process through which it gets deployed. We’re not just creating a digital product; we’re also creating an experience through which it’s set off in the world. Perhaps people need to be trained in it – that happens, especially sometimes if we design something that’s for, say, physicians or more of a professional group and it’s part of an existing workflow. And we want to measure it; we want to make sure that there’s an evaluation plan in place so that we can see if this thing is actually working–

Gerry  25:17

Which is my next question.

Amy  25:18

–and go back and make updates if not.

Gerry  25:19

It’s like you’re reading my mind and my notes at the same time. You’re not reading my mind and you’re definitely not reading my notes. But I’m really keen to see how you measure this. So if you’re trying to change – obviously, you could say, you know, clicks and so forth. How do you measure that the behavior has been changed, because behavior is such a complex thing.

Amy  25:24

It is. So in the book, in one of my early chapters, I talk about measurement and one of the activities that we do very early in the project. We identify those target behaviors, as I mentioned, but we also identify what the success metrics for the project will be and we work backwards from there. It’s almost like a time based map. We have leading indicators; these are the things that happen first that you can identify pretty quickly, and those tend to be your clicks. Are people actually using this intervention? And if it’s not digital, it might be things like signups or attendance at an event. Whatever your thing you’re building is, there usually is some way that you can tell early on if people are interacting with it, if they’re experiencing it, and we want to measure that because if they’re not, then it won’t work.

Gerry  26:24

So with that kind of approach to research, is there qualitative and observational research going on at the same time? If you’re just focusing on clicks, it tends to be very quantitative focused.

Amy  26:37

So one thing we do a lot during our development process – and we haven’t settled on a good name for this; we sometimes call it desirability research or usefulness research – is when we have a prototype of a product, kind of the early design stages where you can start to see what something might be, we’ll often bring people back in to look at it and interact with it. What we’re trying to understand is not usability – that comes a little bit later when you have the design a little bit more solidified – but ‘Is this something that you’re interested in, that you might use? What role would it fill in your life? How could we talk about it to you that would get you to be interested in it?’ And that research goes toward that initial point: how can we make sure that people are interacting with whatever it is we’re building so that their behavior ultimately is affected by it?

Gerry  27:22

So then are you looking for the likelihood that this is more desirable than the previous piece? So this has got to show these signs of more interest from X amount of people? Is it that kind of approach?

Amy  27:36

Yeah, that’s one of the things we’re looking at. Another thing that I’m particularly paying attention to is whether it fits a need or a perceived need the person has, because one of the things that we know is that if a product – even if it’s really cool- doesn’t do something for a person, if it doesn’t deliver a benefit to them, and if it doesn’t fit with their existing habits and routines, it’s far less likely that they’ll use it regularly. So we want to make sure that there’s this nice integration with what they’re already doing, or it provides enough value that they’re willing to change what they’re already doing.

Gerry  28:10

Sure. So like an anthropological kind of consideration of how they’re currently doing these things – that’s being considered, so when you’ve got a new potential prototype, that it’s actually not just of interest, but it’s also meeting the need.

Amy  28:25

Right. Absolutely. That’s perfectly said.

Gerry  28:26

I think we’re on the same page. So Amy, I thought the book was out, but the book is out next week.

Amy  28:35

March 3, so I think it’s two weeks.

Gerry  28:36

What are you doing when the book goes out? You must be celebrating?

Amy  28:40

Well, I’m actually going to be on site with a client delivering a workshop that day. The release date moved. We had some other considerations going on in terms of the marketing and the design, and so it moved from when it was originally going to be, and I had already booked this client trip. So I’ve told my co-workers they’re taking me out for a cocktail, and they’ve agreed. And then when I come home, I think we’ll just get together with some friends. I saw Andy Welfle, who just had a Rosenfeld book come out last month.

Gerry  29:09

That’s right, he was on the podcast last month.

Amy  29:12

So I was looking at his tweets from when his book came out. He had a cake made with the cover of the book, and that has really caught my fancy, so I might do that too.

Gerry  29:21

Now that you’ve said that you’re doing a workshop, you know you cannot ring in sick on those days, because it would be just too obvious.

Amy  29:29

Well, I’m going to be in another state is the thing. We travel a lot for our client work, so we’ll be out of town – new city for me, a place I’ve never been before. So I’m trying to have a spirit of adventure about it. And hopefully the workshop goes well, and we have really great drinks.

Gerry  29:44

That’s great. Amy, I’ll put a link to the book in the show notes. And if people want to reach out to you and ask some questions, how might they go about doing that?

Amy  29:52

So my Twitter handle is @amybphd, and I am on there all the time, so I check that. And then I also have a website, which I neglected really badly while I was writing the book, but I’m trying to get better about it again. So that’s amybucherphd.com and I will be blogging and things on there more frequently.

Gerry  30:13

Okay, very good. Amy, it was great chatting to you and I’ll chat to you soon.

Amy  30:17

Sounds great, good talking to you.

Gerry  30:19

I hope you enjoyed this episode. And if you’d like to be part of the conversation or community, hop on over to ThisIsHCD.com, where you can join the Slack community and help shape future episodes and connect with other designers around the world, or join the HCD newsletter where you can win books and get updates. Subscribe to our content on Apple Podcasts or Spotify, and listen to any of our other podcasts, such as Getting Started in Design, Bringing Design Closer with myself, Gerry Scullion; or Power of 10 with Andy Polaine; or Decoding Culture with Dr. John Curran; ProdPod with Adrienne Tan; and EthnoPod with Jay Hasbrouck. Thanks for listening and see you next time.