Healthcare Applications
Healthcare outcomes depend fundamentally on human behavior - from medication adherence to lifestyle changes. Behavioral Strategy provides healthcare organizations with systematic approaches to identify, understand, and influence the behaviors that drive health outcomes.
Core Applications in Healthcare
1. Medication Adherence
Challenge: Many patients with chronic diseases struggle with medication adherence, leading to significant preventable health complications.
Behavioral Strategy Approach:
- Behavioral mapping: Identify specific barriers to adherence (forgetting, side effects, cost concerns)
- Habit integration: Link medication-taking to existing daily behaviors
- Feedback systems: Provide timely, actionable information about adherence impact
Example: A diabetes management app achieved significantly improved adherence by:
- Linking medication reminders to meal times (existing behavior)
- Showing real-time glucose impacts (immediate feedback)
- Creating “adherence streaks” with family visibility (social accountability)
2. Preventive Care Engagement
Challenge: Most eligible patients do not complete recommended cancer screenings on schedule.
Behavioral Strategy Approach:
- Friction reduction: Simplify scheduling and preparation processes
- Loss framing: When validated for the specific context and audience, emphasize what patients might lose by not screening, as opposed to solely focusing on gains.
- Default options: After careful ethical consideration and validation of patient acceptance and impact, consider systems like auto-scheduling appointments with clear opt-out mechanisms rather than opt-in. Defaults are configuration; on their own they rarely drive sustained behavior. See Why Nudges Fail.
It’s critical that such approaches are not applied generically but are rigorously tested and validated within the specific healthcare context to ensure efficacy and ethical application, aligning with core Behavioral Strategy principles.
Example: A health system substantially increased colonoscopy rates through:
- Pre-scheduling appointments during primary care visits
- Mailing prep kits before appointments
- SMS reminders focusing on “maintaining your health” vs. “preventing disease”
3. Chronic Disease Management
Challenge: Many chronic diseases are preventable through lifestyle changes, yet sustainable behavior change remains challenging for most patients.
Behavioral Strategy Approach:
- Micro-behaviors: Break large changes into specific, measurable actions
- Environmental design: Modify contexts to make healthy behaviors easier
- Social support: Leverage peer behaviors and community dynamics
Example: A cardiac rehabilitation program improved outcomes by:
- Focusing on “walk to your mailbox daily” vs. “exercise 30 minutes”
- Providing pre-portioned meal containers (environmental design)
- Creating walking groups with other cardiac patients
4. Digital Health Engagement
Challenge: Most health apps experience high abandonment rates shortly after download.
Behavioral Strategy Approach:
- Behavioral onboarding: Guide users to early wins within first session
- Personalized triggers: Send prompts based on individual behavior patterns
- Value demonstration: Show health improvements tied to specific behaviors
Example: A mental health app achieved high long-term retention by:
- Starting with 2-minute daily check-ins (low barrier behavior)
- Sending prompts at user-selected “vulnerable times”
- Showing mood trends correlated with completed exercises
Implementation Framework for Healthcare
Step 1: Behavioral Diagnosis
- Map patient journey with focus on decision points
- Identify where intended behaviors break down
- Understand contextual factors influencing health behaviors
Step 2: Intervention Design
- Design interventions targeting specific behavioral barriers
- Test multiple approaches with small patient cohorts
- Measure both behavior change and health outcomes
Step 3: Scalable Implementation
- Integrate successful interventions into clinical workflows
- Train staff on behavioral principles and techniques
- Build technology systems that support behavior change
Step 4: Continuous Optimization
- Track behavioral metrics alongside clinical outcomes
- Identify patient segments with different behavioral needs
- Iterate interventions based on real-world data
Key Metrics for Healthcare Applications
- Behavior Activation: % of patients initiating target health behavior
- Behavior Persistence: Duration of sustained behavior change
- Clinical Correlation: Health outcomes tied to specific behaviors
- Cost Per Behavior Change: Economic efficiency of interventions
- Population Health Impact: Aggregate outcomes from behavior change
Evidence-Based Behavioral Interventions for Healthcare
1. Rigorously Validated Commitment Devices
- Public pledges validated through behavioral research for specific patient populations
- Deposit contracts with measured effectiveness for targeted health behaviors
- Automated accountability systems designed based on patient-specific behavioral patterns
2. Evidence-Based Social Proof
- Peer behavior data validated for specific patient demographics and conditions
- Support groups designed around verified behavioral change mechanisms
- Family involvement strategies based on measured effectiveness, not assumptions
3. Behavioral Temporal Interventions
- Immediate benefit messaging validated through rigorous testing, not generic time preferences
- Achievement frameworks designed for sustained behavior change, not superficial gamification
- Incentive timing based on patient behavioral research and validated motivation patterns
4. Validated Choice Architecture
- Default options tested for specific patient populations and health behaviors
- Decision simplification based on behavioral research, not intuitive design
- Environmental modifications validated through measured behavior change outcomes
This contrasts with merely applying common choice architecture heuristics without dedicated validation, as Behavioral Strategy demands proof of effectiveness in each unique situation.
Common Healthcare Pitfalls
- Afterthought Behavioral Integration: Adding behavioral insights after clinical protocol design rather than integrating from the inception of treatment planning
- Superficial Nudging: Applying generic behavioral techniques without rigorous validation for specific patient populations and health conditions
- Information Overload: Assuming education alone changes behavior without addressing underlying behavioral barriers
- One-Size-Fits-All: Ignoring behavioral segmentation and individual differences in motivation and capability
- Complexity Bias: Making healthy behaviors harder than unhealthy ones through poor behavioral design
- Provider-Centric Design: Focusing on clinical efficiency over validated patient behavior change
Getting Started in Healthcare
For healthcare organizations beginning with Behavioral Strategy:
- Select a specific health behavior: Start with one measurable action (e.g., daily glucose testing)
- Study current patient behaviors: Observe and document actual vs. desired behaviors
- Identify behavioral barriers: Understand why patients don’t perform the behavior
- Design targeted interventions: Create solutions addressing specific barriers
- Measure and iterate: Track both behavior change and health outcomes
Ethical Considerations
Healthcare applications of Behavioral Strategy must prioritize:
- Patient autonomy: Influence without coercion
- Informed consent: Transparency about behavioral interventions
- Equity: Ensure interventions work across diverse populations
- Privacy: Protect behavioral data with same rigor as clinical data
By applying Behavioral Strategy, healthcare organizations can move beyond simply treating disease to actively shaping the behaviors that prevent it - creating sustainable improvements in population health.
Note: Numeric examples herein are illustrative only. Link any published claims to the Evidence Ledger.
Recent Cases (Evidence)
- Spain’s ONT: system enablement via coordinators, training, ICU workflows; defaults alone insufficient. See case: /cases/spain-ont/
- Digital Health Onboarding: systemic redesign beats reminders; reduced churn and improved adoption. See case: /cases/digital-health-onboarding/
Licensing: Core Behavioral Strategy concepts in this content are shared under Creative Commons BY-NC-SA 4.0. DRIVE Framework references require attribution to Jason Hreha.
Behavioral KPI pack
- Behavior Activation - percent of patients initiating the target behavior.
- Behavior Persistence - days performing the behavior continuously.
- Clinical Correlation - outcome change tied to behavior completion.
- Cost per Behavior Change - cost divided by behavior completions.
Evidence
- Healthcare exemplar A - Δ‑B for screening completion and outcome impact.
- PMF ≥ 0.75 confirmed
- BMF_min ≥ 6 confirmed
- Prototype defined and instrumented
- SMF target pre‑registered