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26.04.2014
We all seem to be talking about changing behaviour through good design…but changing behaviour is actually really hard. Can you recall when you last changed your behaviour and maintained that change for an extended period of time?
When I first opened the envelope I promptly put it next to our bathroom sink in the hope it would make my young children brush their teeth longer than their current ten second swill. What’s fascinating is that while it took a while for the device to find its way to the intended context, once it was there the initiative to change was almost immediate, and the result easy to maintain.
Design has always facilitated change in behaviour, especially in the area of technology, but it seems lately that design for behaviour change is in the forefront of people’s awareness.
As experience design researchers we quite often focus on what people do, and why they do it, so we can incrementally design better products, services and systems to ultimately improve the customer perception of a client’s brand.  However, one of the most important things we need to be mindful of when designing for behaviour change is that we must also focus on the ‘future’ view of how we want people to behave with what we create. As Henry Ford says, “if I had have asked my customers what they wanted, they would have said a faster horse”: people can’t project beyond their current experience to meet a future need.
What this model shows us is we can shape behaviour, and generally the easiest way to do this is through some form of positive reinforcement or removal of a negative. As designers, the important part of this basic model when applied to behavioural observations is that your design is the positive reinforcer, or the negative affect; meaning the behaviour you are observing is quite often a direct result of your design.
This shows us through good design we have the ability to shape and influence someone’s behaviour. We can’t change a person, but we can influence the way they behave by shaping the environment they function within … through good design we have the ability to shape and influence someone’s behaviour. The model highlights what influences a persons decisions, and attempts to reveal why we might make certain choices. Whether the person feels in control of the action in question (perceived behavioural control). Without going too deeply into the cognitive side of things, it’s important to keep in mind that behaviour is often not intentional or controlled at all.
Nevertheless, we need to keep this model in mind, because if we can understand the attitudes of customers and what influences the choices they make, we are better able to use this information to design solutions that will resonate with their belief system, and ultimately, have a greater chance of influencing them to change their behaviours.
Another useful model is the Stages of Change Model proposed by Prochaska & DiClemente, which is arguably one of the most dominant models of health behaviour change.
The model broadly suggests that people can cycle in and out, and around several times before sustained change is realised, then maintained for the long term.
Taken together, the models can help us as designers understand how people might make certain choices (Theory of Planned Behaviour), and consider ‘where’ in the cycle of change an individual may be (Stages of Change Model), in order to assist them move through these stages toward a new behaviour. So looking at basic behavioural analysis – or the ABC of my behaviour – the tool was the Antecedent, and the Consequence was that I felt better about having a shorter shower and saving water…less guilt if you like. One example comes from Melbourne’s new bike share service – and the problems caused by the government’s laws requiring users to have and wear a helmet while using it. Graphs of cyclist hospital injuries in Victoria with and without head injuries (1995) show that while head injuries were reduced, so were non-head injuries – so perhaps all they did is reduce the number of cyclists? Today we want to design services and provide infrastructure that encourages use of bikes, and unfortunately, when we reflect on it from a behaviour change perspective, having to wear helmets appears to have caused a decline in the number of cyclists.
The assumption that all cyclists would adopt helmets because it was the law appears to have caused behaviours within the wider population that were very different from those initially expected. Ralph Koster’s book A Theory of Fun for Game Design (2004) looks into the meaning and significance of fun. The explosion of games and apps on mobile phones show that games present a real opportunity to change people’s behaviours and habits.
So, we can change behaviour through design of products, services and systems, and the best way to do this is to first consider the customers culture and context, before we even start on ideas. However, if we hope to design behavioural change, we’ll need to focus beyond what is happening right now.  One way to ensure we are looking ahead is to be mindful of the behaviour we want to observe in the future. Here are a few takeaways to consider when you are designing solutions that need to drive behaviour change.
Monitor, measure and modify.  Remember, changing a behaviour can take time, so let’s be patient!
Jodie Moule is Co-founder & Director of Symplicit, an experience design consultancy based in Australia, that focuses on research, strategy and design services. Her background as a Psychologist means understanding human behaviour is a core philosophy; and she has a passion for helping clients to see their brands through the eyes of their customers. Featured, Methods & theory, Psychology and tagged behaviour change, design thinking, experience design, Psychology.
Your final part on games promoting behavioral change made me think of cognitive artifacts and how successful they are at changing behaviors.
Firstly, thank you all for reading and contributing to some great discussions around this topic, it was nice to see that the topic struck such a chord. I guess we already know that games have the ability to engage players with immense strength, so translating this focus into the real-world for the greater good is not only logical, it’s a great idea. This has probably been looked at in detail by somebody, but I don’t know why you would infer that wearing helmets reduced the number of cyclists. I personally believe that the need to wear a helmet for casual biking has turned people off riding a bike. My thoughts are that the need to use helmets for casual biking is turning many people off using the bike-share system in Melbourne – one of the main issues is that no one carries a helmet around, so it is a real barrier to use.
I look to several places in Europe that don’t have these type of laws around helmets, yet have high use of bikes in urban spaces, and low incidence of injury. The case for reconsideration of helmet laws in Australia for specific types of bike use is a a strong one I believe. Also related books that seem to complement the ideas here are Nudge, Sway, Tell to Win (on purposeful narrative) and Paradox of Choice.
So pleased you enjoyed the article, have to say, I am thrilled that it is still getting people thinking and encouraging discussion.
I will look for the Quantified Self Group you mention, it sounds interesting; any links are most welcome too. Scarcity is more than an economic idea of there being limited resources to meet everyone’s every need.
They illustrate the scarcity and tunneling problems through reference to several studies in both the laboratory and in the field of how poverty is a major contributor to reducing bandwidth.
Scarcity, and the cognitive load it puts on people who dwell on immediate concerns to the detriment of other issues, literally makes us dumber and more impulsive. A related paper by Datta and Mullainathan (2012) also discusses ideas of scarcity in a policy development context. Scarcity of cognitive capacity - Cognitive resources available to people at any moment are limited and can be depleted by their being used for other activities.
Scarcity of self-control - Think of our self-control as a psychic “commodity” of which we have a limited stock, so that using up some for one task (continuing to exercise when you really want to stop) depletes the amount available for other tasks (resisting the dessert at dinner after your workout).
Scarcity of attention - Think of attention as another precious commodity – people do not have unlimited attention and might not pay attention to the ‘right’ things – they are busy paying attention to others. Scarcity of understanding – People’s mental models of how the world works may be incomplete; not all underlying causal relationships are correctly or accurately understood.
Behaviour is generally easier to change when habits are already disrupted, such as around major life events. That was the challenge given me by the Society of Nutrition Education and Behavior for a webinar I did this week. I start with Duncan Watts, a physicist and sociologist, who presents two problems that bedevil people faced with the challenges of large and complex puzzles. The second problem Watts (2011) discusses is the micro-macro problem: one that goes at the heart of the social marketing dilemma. To bring this problem back into the social marketing world, believing that social change will happen “one person at a time” does not conform to what we know about emergence in many other disciplines. These words sum up how important it is for us to have ways to explain facts and make sense out of them. All social change efforts involve different actors known by various labels such as audiences, influencers, stakeholders, consumers, suppliers, partners and policymakers. Everyone has assumptions and explanations for how and why people think and behave the way they do; these are often referred to as naive theory or folk psychology. Many social change agents are familiar with the challenges of addressing other people’s cultural beliefs as they relate to health and social behaviors. This is why many social marketers stress the need to base programs to improve health, social welfare and the environment on empirically-validated models and theories. Many social marketing programs, and most public health ones, have shied away from working with their customers or members of their priority groups.
We would view the launch of our smoking cessation effort as the continuation of a conversation with them.
Is it time for more of us to loosen our grip on the 4Ps of the marketing mix as a necessary ingredient or benchmark for social marketing programs?
The internal orientation of the marketing mix in which the four elements are controlled by the producer of goods, services and behavioral offerings and has little involvement or interaction with customers. The rise in services as primary drivers of economic activity that have their own unique character not addressed by the traditional 4Ps - for example, People or Participants, Physical Evidence (of their value), Processes (of service delivery), the intangible nature of their offering and demonstrated value to customers, as well as unique legal and professional restrictions on providers of many services (licensure of health providers, lawyers and general building contractors being just a few examples). Most of these debates have been on theoretical grounds rather than based on empirical studies; it is also true that most marketers continue to practice as they were taught in college marketing classes (Constantinides, 2006).
What S-D Logic shows us is that a tangible (product) or intangible offering (service, behavior) has value only when a customer ‘uses’ it. The premises of S-D Logic (see below) guide us away from trying to create what we believe will be of value to people to a customer perspective that reminds us that it is how people utilize our offerings and experience rewards or value for adopting behaviors that should be our critical concern. Many of the biggest policy challenges we are now facing – such as the increase in people with chronic health conditions – will only be resolved if we are successful in persuading people to change their behaviour, their lifestyles or their existing habits.
That statement appears in the Foreword of a new joint publication by the Cabinet Office and the Institute for Government MINDSPACE: Influencing behaviour through public policy.
The contrasting model of shaping behaviour focuses on the more automatic processes of judgment and influence. So MINDSPACE becomes a methodology for, as they put it, changing behavior without changing minds. The differences in the social marketing approach became even more pronounced in the international community where social marketing became synonymous with the marketing of products for family planning, HIV prevention and malaria control while various other groups organized themselves around concepts such as behavior change communication, health communication, development communication and community mobilization to name a few. A hybrid approach developed independently in North America to reunite community with social marketing was coined as community-based social marketing (CBSM; McKenzie-Mohr, 2000). SynopsisThis article introduces META-Kinetics, an exciting new development in mind-body medicine. Part 1: META-Medicine - A New Model of Health Understanding The first piece of the jigsaw was META-Medicine.
Principle 1: Symptoms are Bio-logically Meaningful ReactionsRather than random errors, META-Medicine shows how all symptoms are meaningful responses to specific emotional stimuli. When we experience a stressful event or trigger (for example, being shouted at), we enter into Phase 1. The META-Medicine Enquiry ProcessThe META-Medicine questioning process, along with an understanding of the Two Phases, enables META-Medicine practitioners to uncover why a client is experiencing a particular symptom, and track back to the specific bio-logical and emotional cause in the client's life. Research has revealed that our bodies have their own energy and information fields which direct and control the processes within the physical body. META-Kinetics has given us an invaluable tool for exploration and revolutionized the way we work with clients. Joanne Ross, Robert Waghmare and Tremayne Reiss are META-Kinetics Trainers, META-Medicine Master Trainers and Master Health Coaches. Campaigns aiming at behaviour change tend to require more complex theories of change, as human attitudes and behaviour are influenced by multiple, complex factors that resist being subsumed under simple rules or linear cause-to-effect chains. However, to ensure that survivors actually use the number advertised, multiple factors that encourage or prevent them from calling the line need to also be taken into account.
Nevertheless, the fact that a theory of change is not easily expressed in a few words does not mean it won’t be effective.
Soul City understands that theories and models are developed in the context of specific behaviour and that a single generic theory will not explain all behaviours in all contexts equally well. Behavioural patterns and trends more often than not seem to be resistant to change and are sustained through various mechanisms, such as habits, routines, social norms and expectations, dominant cultural values, incentive structures, institutional barriers, inequalities in access, restricted choice etc.. Theories of Social Learning tie in with this perspective insofar as they place the individual within a social or cultural context and elucidate how people influence their environment and visa versa in a process of reciprocal determinism. Lewin’s Theory of Change adds the role of emotion, dialogue and debate to an understanding of how behaviour change takes place: behaviour (often resistant to change) is lifted up for scrutiny (sometimes through an “emotional stir-up”) and reconfigured through a process of discursive elaboration (dialogue and debate) of new and preferable alternatives.
Many  behaviours are strongly influenced by perception of group membership and consequent group dynamics and norms.
The Theory of Interpersonal Behaviour is an expansion of the Theory of Reasoned Action but is less deliberative in that it includes the notion of habitual behaviour in the model.
Soul Beat AfricaA collaboration between the Soul City Institute for Health and Development Communication and The Communication Initiative. 88,000 people engaged or with an interest in media and communication for development, social and behavioural change - growing on a daily basis. Submit and share your media, communication and development policy thoughts, observations and analysis with The CI network. An environmental trigger (the water crisis) was accompanied by social norms of the time around saving water in Melbourne, so my senses were highly attuned to this and my motivation to comply was high. From a behavioural perspective, how about considering the behaviour the government were hoping to change with the introduction of helmet laws in the 1990’s, and how it’s fared?


He suggests that fun is the element of life that is enjoyable and frees us from the normal stresses of the everyday – and also the means by which we retrain our brain to learn new patterns of behaviour. Set behavioural goals, just as you would set design goals, and let this guide your strategy and design process. Games can change the nature of the task, allowing you to complete your goal as a consequence of another behavior.
This presents people with the much simpler task of writing down items to buy and bringing the list to the store.
Instead of timing yourself each time you went into the shower, you simply stayed in until the timer ran out. I also think his model fits very well to Azjen’s model (Theory of Planned Behaviour).
Having less than what we perceive we need – whether it is food, money, friends or time – is having less than we feel we need. It extends the insights from behavioral economics beyond the nudges and defaults we are now so familiar with to how we think and feel when we have too little; it changes our thoughts, choices and behaviors. Consider some unsuspecting shoppers in a mall who were asked to imagine a scenario in which they either had (a) a $300 estimate, or (b) a $3,000 estimate to repair their damaged car of which their insurance would pay half the cost.
Think about that the next time you wonder why people who are poor do some of the things they do – to your utter exasperation.
They talk more about the limited resources imposed by perceptions of scarcity and suggest some ideas about how to address each of them in program design. So increasing the cognitive demands of social change programs (cover more material, require more time spent in classes) may in fact be designing them to be less likely to succeed. Good points to be reminding ourselves of as we talk with people among our priority groups and set out to design programs that will help them solve their real problems. This is the reason I spend time talking about different theories and models of behavior change. What dramatically illustrates the power of a theory, and its drawbacks, is to break the workshop (or class) into five smaller groups.
We have a strong tendency to go with the default or pre-set option, since it is easy to do so. Making the message clear often results in a significant increase in response rates to communications.
Financial incentives are often highly effective, but alternative incentive designs — such as lotteries — also work well and often cost less. We are embedded in a network of social relationships, and those we come into contact with shape our actions. We often use commitment devices to voluntarily ‘lock ourselves’ into doing something in advance.
We are more influenced by costs and benefits that take effect immediately than those delivered later. You might also note that none of these methods have direct counterparts to any of the variables in the theories I presented above. Some of the countries outside the US that were there included Canada, Columbia, Czech Republic, Spain, Indonesia, Israel, Italy, Malta, Mexico, Pakistan, Romania, Somalia, Turkey and Uganda. This theory has guided many marketers’ approach to discovering what the desired behavior might be, its possible determinants, the context in which it occurs - or not, and the consequences that people and society incur. This dilemma emanates from our desire to achieve macro outcomes, ones that involve changes among large numbers of people, among population segments, or in society as a whole.
It is analogous to believing that consciousness can be explained by the action of a neuron or even many neurons; it may be convenient to think like this, but throughout his book, Watts (2011) takes on these logical fictions with data. But even more so, the lyric reiminds us of why it so important to have facts to back up one's theory. Depending on the actor and the objective of the program, social marketers and change agents may be trying to increase some behaviors (healthy eating, physical activity, recycling), decrease others (tobacco use, risky sexual behaviors, energy use), encourage participation in social change activities (citizen engagement, social mobilization) or gain support for environmental change (adopt policies, redesign physical entities such as automobile safety features or entertainment content).
Stories and case studies have a limited place in moving us closer to understanding and solutions. Yet, agreeing on a common approach to thinking about and addressing wicked social and public health problems is a major point of contention when working with partners. Our role is to facilitate value creation as they quit smoking: they must integrate what we (and perhaps others) are giving to them as an active creator of value, not a passive recipient of benefits (Gronroos, 2011).
Rather, we should view exchanges as mutual sharing of knowledge and resources among the social marketing agency, the priority group or customers and other actors or stakeholders (co-creation of value-in-use).
This shift requires marketers to understand customer constructions and evaluations of value, be more flexible in their approach, engage with customers over longer periods of time, and innovate and adapt to changing market conditions - especially those related to technology and communication. People bring skills and competencies to encounters they have with us, and thus are always a co-creators of value, not passive recipients of what we judge they need or want. Fortunately, over the last decade, our understanding of influences on behaviour has increased significantly and this points the way to new approaches and new solutions.
This shifts the focus of attention away from facts and information, and towards altering the context within which people act. It certainly provides something for us to think about when we try and use policy-making as a way of changing behaviors. Lefebvre & Flora (1988) laid out the defining features of the social marketing approach based on experiences they shared directing community interventions for cardiovascular disease reduction. Responding to this fracturing of resources and talent, McKee (1991) wrote a book that he hoped would enhance the understanding of social mobilization, social marketing and community participation amongst communicators who sometimes set up unnecessary barriers between their various fields.
Interventions to Change Health Behavior Health behaviors are shaped through a complex interplay of determinants at different levels. It is a fusion of two powerful disciplines: Cyberkinetics, a form of advanced kinesiology, and META-Medicine, an advanced system of health understanding. Robert and I were working as life coaches and looking for a scientifically-based approach to mind-body healing that would give us a deeper understanding of clients' issues. This is characterized by obsessive thinking about the stressful situation, nervousness, tension, sleeplessness and other fight-flight symptoms. For Robert, this was the convincer: he finally found out why he had developed kidney disease, and why it remained a chronic process for sixteen years.
Practitioners now have a way of calibrating the information clients present, removing much of the ambiguity of conversational analysis.
For students of META-Medicine, the interaction and kinaesthetic dimension META-Kinetics provides brings mind-body-social analysis to life. They are members of the Advisory Board for the International META-Medicine Association (IMMA), and are actively involved in the ongoing evolution of META-Medicine, including the development of META-Kinetics, an advanced system synthesising Kinesiology with META-Medicine. For example, where domestic violence (DV) is widely considered to be a normal part of married life, women may feel they may be rebuked if they call the hotline.
Examples or visualization, such as the map by Raising Voices shown below, help to identify the main drivers of change.
Violence against women is unacceptable”) with at least ten more persons, thus triggering a chain reaction of attitude change across society (Raab, 2009. Thus in the context of broader health promotion- and societal-level frameworks (where macro-societal factors are understood to shape individual behaviour from higher levels of scale), the main components of Soul City’s theory of social and behaviour change comprise the dynamic integration of a number of models of behaviour and theories of change.
Empirical evidence supports the assertion that Social Learning is a powerful avenue for behaviour change (Jackson, 2005).
It states that the three most important factors determining the probability of behaviour are habit, intention and facilitating conditions. Offers a space to access and share knowledge (currently over 6500 knowledge items), as well as network around a wide range of development issues with a focus on media and communication for social change in Africa. Combine this with the fact that most human behaviour is not considered to be overly planned, with ‘conscious thought’ playing, at best, a small role in shaping our choices…things start to become a little tricky for us as designers.
For example, getting fit is difficult and cognitively intense – the stress, the guilt, the effort.
It is a fast-growing movement that might interest you… was covered in On the Media on NPR this past weekend. What makes scarcity an important idea for social marketers and other change agents is that it captures the mind; scarcity changes the way we think. While we recognize how scarcity can make us more attentive and efficient in managing immediate needs – think of the last deadline that was looming over you – it also reduces what the authors refer to as ‘bandwidth.’ They consider bandwidth as a short-hand for our cognitive capacity and executive control that are currently available for use. Do they get the car fixed, or take the chance that it will continue to run a little longer? Scarcity forces people to engage in trade-offs; having slack in money and time (disposable income and free time) makes decision-making (and life!) so much easier. The prescription: simplify choices people have to make and encourage rules-of-thumb (heuristics) for decision-making.
In workshops that I facilitate, I use this slide to illustrate some of the main ideas from some usual, and not so typical, theories that I find are employed by many social change agents. All of the groups are given the same behavior change challenge and asked to come up with one or more priority groups to focus on, what research questions they would want to ask of them to learn more about the problem, and what potential solutions can they quickly generate (brainstorm).
In particular, it’s useful to identify how a complex goal can be broken down into simpler, easier actions.
Similarly, policy makers should be wary of inadvertently reinforcing a problematic behaviour by emphasising its high prevalence. Governments can foster networks to enable collective action, provide mutual support, and encourage behaviours to spread peer-to-peer.
Policy makers should consider whether the immediate costs or benefits can be adjusted (even slightly), given that they are so influential. A proven solution is to prompt people to identify the barriers to action, and develop a specific plan to address them. The ideas and tools are designed to stimulate innovative approaches to nutrition education.
I offer that to fully develop the discipline of social marketing and its promise to be a positive force for social change, we must think about change as it occurs among groups of people (segments, social networks) and at different levels of society (organizations, communities, physical environments, markets, and public policies)…[Ed Note: See Transformative Social Marketing (pdf)]. Both of these problems highlight the need for social change programs to adopt theoretical perspectives that are broader than individual determinants. Yet these outcomes are driven by the micro actions of individuals (for example, it is individuals whose voting behavior determines the outcome of policy options, individuals’ behavior that sets the tone for an organizational culture, and individuals who connect through social network sites to organize and plan social action). Changes in complex social systems involve interactions between people and systems, just as neurons must be connected and interact with each other in systematic ways to create what we refer to as consciousness.
For social marketers, social innovators and people who are working with social and mobile technologies for health and social change, the song should become a chant. Who is the focus of these activities, and what they are asked to do is largely a function of the framework (or theory of change) that we bring to the task.
Because people often only have only one or two frameworks or theories they use for problem solving, these conversations quickly devolve into the city of Babel or attempts to convince the other side that our POV is the correct one. Constantinides (2006) summarized over 40 papers that have been critical of, or presented alternatives, to the 4Ps marketing mix framework. It moves us from being ‘customer-focused' not just in the beginning of a project when we conduct formative research, but throughout the process - especially when people discover or create the value of change for themselves. Are we, in fact, simply applying our old prejudices for rational decision-making and persuasion by implementing policies that mandate the delivery of more information (think about BMI report cards in schools, restaurant menu-labeling programs for example)? Yet, even by the early 1990s, we can recall where social marketing and community development components of Health Canada could not find common ground for collaboration.
For example, physical activity is influenced by self-efficacy at the individual level, social support from family and friends at the interpersonal level, and perceptions of crime and safety at the community level. META-Kinetics is of interest to those seeking a deeper understanding of mind-body medicine, taking us beyond risk factors into the unconscious causes of our health challenges.
Also at the back of Robert's mind was his experience of a childhood kidney illness - modern medicine had never been able to explain why he'd experienced it. We remain in this state until the problem is resolved, either through a real-life change or through unconsciously letting go.When we let go, we drop into Phase 2. The enquiry process precedes therapy: once we know the reason behind the health issue, we can identify and apply the most appropriate therapies for each client in a more precise way.
In the medical sciences it is the name given to the study of muscles and the movement of the body.
We can use META-Kinetics to elicit information about the root cause of a symptom, uncover the beliefs and emotions keeping a client stuck, and ask the body which therapeutic interventions are needed. In that case, the theory of change needs to determine how to make it clear to DV survivors that their calling the helpline is legitimate, will be welcomed and may contribute to improving their situation. With reference to theories of change, Soul City bases its intervention on Bandura’s Theory of Social Learning, Lewin’s Theory of Change and Paulo Freire’s notion of Critical Consciousness. Bandura’s Social Learning Theory states that people learn through observation, imitation and modeling. The notion of learning-through-action-and-reflection underlies Soul City’s community based work.
The theory further explains the role of beliefs, anticipated outcomes, norms, roles, self-concept, emotions, and attitudes in determining behaviour. From a meta perspective, Soul City’s interventions are influenced by a Complexity Thinking Approach in that behaviour is seen as the product of interactions between components of a whole system and that these interactions create effects (often unforeseen) which the components could not have generated singly (i.e.
However, change getting fit into keeping track of your distances, sharing with friends and beating your best — it become less cognitively intense and enjoyable.
Now, the wanted behavior is not the main aim, it’s superseeded by something more achievable (just bringing the list), and becomes a consequence. Scarcity causes us to ‘tunnel’ – to adopt a mindset that focuses only on what seems, at least at that moment, to matter most.


Simply put, when scarcity captures our mind it helps us focus on doing a better job with our most pressing needs; yet it also makes us less insightful, less forward-thinking and less controlled. They were given a test of cognitive ability, the Raven’s Progressive Matrices, before being given the scenario and then a few minutes after considering their response.
The frame problem proposes that it is impossible to know all the potentially relevant facts and determinants of a puzzle, given the overwhelming number of possibilities and combinations of variables. This problem is embedded in definitions of social marketing as changing individual behaviors in order to achieve social good.
Theories, whether based on common sense, past experience or empirical evidence, create frameworks for our work. And the use of the wrong theory to understand a problem and develop strategies to address it is one of the primary sources of program failures. That is, the notion that we conduct research to unearth the ‘benefit’ that will compel people to exchange with us is misguided; we cannot presume to be the final arbiters of ‘value’ – the user must create or find that value as they engage with the behavior, product or service we are offering. They may surprise us by noting that over time they are experiencing other benefits that are now more important to them.
In this post, and the following one, I extend the S-D Logic to social marketing (and thank Bob Lusch for his review and comments on an earlier draft).
People will behave differently only if they find the new behavior (or discontinuing an old one) leads to self-defined value (benefits) when they engage in it (put it to use).
The presumption is that citizens and consumers will analyse the various pieces of information from politicians, governments and markets, the numerous incentives offered to us and act in their best interests (however they define their best interests, or - more paternalistically - however policymakers define them). Or are we focusing on changing the context in which judgments and decisions about health behaviors are made? As more practitioners appropriated social marketing as the basis for the development of ‘new’ health communication campaigns, the term became associated (and in some quarters still is) with mass media campaigns that segmented their audience, pretested materials and considered the 4Ps only in the context of communication planning, not marketing.
Searching online in 2005, Robert came across the International META-Medicine Association (IMMA)[1] and META-Medicine seemed to fill in those missing links!
For example, the tendons and ligaments in the knee enable us to walk, run, kick and move forwards. Energy moves from the mental to the physical body to enable us to recover from the preceding stress and regain balance. Part 2: Cyberkinetics - 'The Body Never Lies'The next piece of the puzzle came through our colleague, Tremayne Reiss.
Testing the muscle response has long been used in conventional medicine to assess the motor system.
Self-efficacy influences behaviour in that people are more likely to engage in certain behaviours when they believe they are capable of successfully modeling the behaviour. As in the case of individual behaviour, collective efficacy is important in that communities are more likely to take action if they believe their action will make a difference.
The game explosion and their application for driving positive behaviour change is going to intensify. The bad news is that the associated reduced bandwidth can lead to more scarcity as we continue to ‘tunnel,’ or neglect other, less immediate concerns that then becomes tomorrow’s, or next month’s or next year’s pressing need. Not so easy.] The point of EAST is that these are methods to apply after your learn about the people you intend to serve with your program and have selected the specific behavior you want to focus on with them - regardless of the theory you bring to the table.
Consequently, it is then difficult to selectively focus on only certain ones and ignore the others, to look for example at only psychological determinants or to consider only solutions that employ persuasive communications. Although the intentions are commendable, the actual process of moving from individual behavior change to changes at the societal level is ignored, as if this transition will occur automatically - that it is simply a matter of increasing the numbers of people practicing the behavior.
Marketers who attempt to imbue their products or services with value, or benefits that consumers will find attractive, are reflecting ‘goods dominant’ logic. Within the larger networks in which we operate, the S-D Logic also involves creating value propositions for stakeholders and partners. Yet, how frequently, if ever, do we understand if our offerings actually result in value for people who use them (whether that value was what we proposed, or what the value is they 'created' or discovered when they used or practiced it themselves)? And should we also be asking how we can expand the frame for policy-making even more and focus on the marketplace itself to improve health behaviors by increasing access and opportunities to healthier behavioral options, products and services?
For example, social support for exercise from co-workers may interact with the availability of exercise equipment at the worksite to lead to increased physical activity. Five years later, we are the UK's first META-Medicine Master Trainers and are furthering the field with the development of META-Kinetics.
If an individual has a knee problem, such as inflammation, this indicates a corresponding issue with their capability to kick something away or move forwards in an area of their life. The general signs of regeneration include tiredness, increased appetite, fever, and mental haziness. An avid explorer of consciousness, Tremayne had already completed a degree in Herbal Medicine and trained in META-Medicine when he met Alan Sales (now deceased), founder of Cyberkinetics, 'by chance' at a conference.
In the 1960s, Chiropractor George Goodheart discovered that muscle testing could reveal much more than motor function, and developed the system of Applied Kinesiology. Soul City’s intervention is further influenced by Complexity Theory as meta-theory as it recognizes the dynamic, emergent nature of change emanating from the interaction of a multitude of components in the broader system. The synergistic interaction among all these influences - if supportive - results in sustained behavior change. Thus through advocacy, social mobilization and media, Soul City facilitates the capacity to learn and models the direction of change whilst addressing many of the barriers to change. It is the tunneling phenomenon that is the central culprit for poor decision-making and behavior choices.
The authors’ explanation is simple, yet may provide the insight for many programs serving the poor: the $3,000 scenario got poorer people to consider their own money scarcity (“How could I come up with that?”) and this tunneling (or preoccupation) carried over to their performance on the Progressive Matrices in the post-test. Unfortunately, as many of you have no doubt discovered, all of the health and social puzzles we tackle rarely conform to one theoretical model.
Frameworks, or heuristics, such as EAST and the 4Ps, help you make the shift from being a problem describer to a solution seeker. What the frame problem poses to social marketers is that we cannot know for certain whether we have selected the right set of variables when we choose a theory, or frame, to guide us in thinking about our puzzle.
As Watts (2011) notes, how micro behaviors become macro solutions is a puzzle in search of an explanation in many disciplines, and this puzzle cannot be simply dismissed or explained away as inconsequential.
Rather, social marketing can be thought about as facilitating customer experiences or discoveries of value when using the product, trying the service or practicing the behavior. As with customers, the value for organizations to participate with us comes from their investment of information and resources to co-create value in the partnership (it is not something that is simply handed over, or exchanged, with them). Because the classic analysis of exchanges has focused on the immediate exchange of money for products, the value the product provides to a person (the customer) after the transaction is completed is ignored. The alternative proposed by S-D Logic is to think about exchanges of knowledge and skills, not one-way offerings; that the people we serve become producers of value for us as well as for themselves (co-value producers). Traditionally, and especially in clinical settings, strategies to change health behaviors have focused on individual-level factors such as knowledge, beliefs, and skills. Most of the typical symptoms we've labelled as 'illness' are experienced during this phase, including headaches, diarrhoea, cramps, colds and 'flu, stomach bugs, and musculoskeletal aches and pains.
Touch for Health followed in the 1970s, and many forms of Kinesiology have since been developed.[5] In the complementary health field today, Kinesiology is primarily used to identify imbalances in the body's structural, chemical, emotional or other energetic systems, to establish the body's priority healing needs, and to evaluate energy changes brought about by therapeutic procedures. Raising Voices visualizes this theory of change as shown in the table below (Naker & Michau, 2004. A primary source of failure of interventions is the use of the wrong theory to understand and address the puzzle.Behavioral economics is one domain that has captured the interest of policy-makers and social marketers alike.
In short, value is uniquely experienced by each customer when they use our offering – not in how persuasively or creatively we ‘sell it’ to them.
Since the early years of social  marketing, many people have struggled with how to apply the logic of economic exchanges to social marketing ones - usually without much success. The value of an S-D Logic perspective for social marketers includes asking what do we learn from our customers, are we open to changing ourselves and offerings as a result of their input and response, and have we created opportunities for them to participate in a reciprocal process?
As ecological thinking has gained currency, intervention strategies have broadened to target factors at other levels of influence such as organizational policies and the built environment.
Far from being a mistake, they are an integral part of healing!Understanding Health as BalanceIn modern Western society, the regeneration phase tends to be viewed as a problem to be avoided! Kinesiology is based on the premise that we can access the unconscious mind through the muscles, which are in a delta state, thus largely bypassing conscious thinking processes.
The authors note that these differences correspond to a drop in IQ of 14 points (a shift in an intelligence score of this magnitude can result in a person of average intelligence being reconsidered as ‘borderline deficient’ – just because of the bandwidth tax imposed by thinking about one’s tight financial situation). The point Watts is making is that many disciplines work with many different scales of reality and they are difficult to integrate.
The S-D Logic perspective encourages marketers to suggest what the value might be - value propositions (“we think you may like this because it…satisfies a need you are experiencing now, solves a problem for you, facilitates your getting a job done, or helps you reach a goal”) - that customers must then validate through their experience of using the offering (product, service or behavior) in their lives.
This recognition of the complex range of factors that shape health behaviors can make the selection of intervention strategies daunting. Principle 2: The Synchronous Unity of Mind, Body and Social BehaviourMETA-Medicine is a bio-psycho-social system, demonstrating the interconnectedness of all aspects of our being - biological, psychological, social and emotional. META-Medicine redresses this misconception, encouraging us to honour the natural rhythm of our organism and take time to heal. It would be difficult to depict the complex processes that happen at several levels in a more linear manner.
The same effect, they show in another study, holds true for farmers in India before harvest (when times are lean) and then after it (they have now been paid for their crops).
This perspective on how value is created by users means we must design interactions (or service touch points) to facilitate value-in-use and feedback. A New Definition of HealthWith META-Medicine, our perception of health changes from that of an absence of illness or symptoms to a conscious journey, in which our symptoms enable us to look deeper into ourselves, and transcend our hidden issues. Cyberkinetics: A Quantum LeapCyberkinetics was developed by the late Alan Sales, who was a control systems engineer before becoming a master Kinesiologist. META-Medicine enables us to perceive the connection between the back ache (biological), the client's low self-belief (psychological), feelings of inferiority (emotional) and submissive or dominant behaviour with family members and colleagues (social). Instead of blaming the body for our symptoms, dis-ease is seen as a meaningful process, an integral part of human existence, and the path to healing becomes a journey of personal and spiritual development. He was thus familiar with Cybernetics, the study of systems and processes, explaining how living systems constantly adapt to their environment through continual monitoring and feedback loops.[6]Cyberkinetics is a distillation of the best aspects of various schools of Kinesiology with some new discoveries based on cybernetic thinking.
This is not because they are less capable, but rather because part of their mind is captured by scarcity” (p. Instead, biologists and other scientists invoke the idea of emergence to describe the shifting from one scale of reality to the next, and use ideas such as complexity, interactions, and systems to consider more than one scale at a time (an atomic scale versus a biochemical or physiological one). In a classic social marketing approach, the first task would be to understand from the potential customers’ perspective, and there may be several segments of them with different perspectives, what benefits and barriers they perceive in quitting smoking.
Principle 3: Stressful Events Mark the Beginning of a Dis-easeWith the exception of poisoning, malnutrition and physical trauma, the beginning of illness can be traced back to significant emotional events (SEEs). META-Medicine occupies a uniquely integrative position in the field of healthcare, bringing together professionals from modern, complementary and alternative medicine.
These are negative life events which are unexpected, momentarily throw us of balance, cause a specific physiological reaction and become held in memory. Then we would incorporate smokers into every facet of our discovery, design, creation and rollout of the program – not just invite them into focus groups and testing sessions. It provides a common basis of knowledge and a diagnostic process for getting to the root cause of client's issues, and enhances practitioners' precision and results. Finally, we would treat our value offering as a proposition and not be so sure we have actually ‘made value’ for a smoker who is trying to quit (see above for 4 possible approaches). Is it Possible that Illness is Meaningful?One of the most prevalent underlying beliefs about health in the Western world is that illness is a mistake. Emotion is key: the emotion felt in the moment of shock determines which symptoms develop in response.
META-Medicine takes this understanding further, demonstrating with the aid of CT (Computer Tomography) scan evidence that the brain acts as a mind-body interface: specific regions of the brain relay information to and from specific organs. Recent research in neuroscience, such as that by Dr Joseph LeDoux, demonstrates that emotions are subconscious brain-based control systems that shape our biological responses, and are far more powerful in determining our reactions than our conscious mind.[3] After the initial event, we only need to experience the same emotion (such as feeling powerless and unable to speak up) in response to a similar situation (such as hearing aggression in someone's voice) to re-trigger the same symptom pattern (such as laryngitis).
When we experience a SEE, the shock registers as a marking in the area of the brain which directs the relevant organ. Mistrusting the body's ability to self-heal, we often seek a quick fix, whether conventional or alternative, to suppress or remove 'problem symptoms'. These stimulus-response patterns are neurologically bound and programme our thoughts, feelings, physiology and behaviour, leading to chronic health issues. The original research in brain relay diagnostics was undertaken by German medical doctors in the 1980s, most notably the controversial Ryke Geerd Hamer.[4] This mapping of the organ-brain connection is now available to META-Medicine students and practitioners. It provides practitioners with a solid scientific (verifiable and testable) understanding of the organ-brain-psyche connection, which can be corroborated with client testimony.
META-Medicine enables a conscious shift from fearing symptoms to understanding the bio-logical and evolutionary meaning behind them. The META-Medicine Principles META-Medicine is based on ten core principles, the first four of which we will introduce here.



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