“Digital technology has turned behavioural science in to a data-rich science” said Dr. William Riley of the National Institute of Health during the opening keynote of the 3rd Annual University College London (UCL) Centres for Behaviour Change Digital Health Conference. This was a key theme throughout the conference; using the vast potential afforded us with digital media we can both design, implement, augment, and measure the efficacy of behavioural interventions. And it is a theme that has numerous transferable insights for us in the healthcare market research space.
Attending as a representative of HRW Shift (our specialist behaviour change unit), I was delighted to be able to discuss and share with other digital technophiles, analysts, and behavioural scientists in several of these interconnected areas of modern life and research. There were numerous insightful and innovative keynotes, posters, panels, & oral presentations from universities and commercial agencies and both days were well-attended by thought leaders from the digital, health, and behavioural change spaces.
Some key themes for us as healthcare market researchers:
Passive monitoring technologies are critical – to get a true picture of adherence behaviours, we’ve known for years that we cannot rely on retrospective self-reporting; it has to be in the moment and ideally it has to be independent of bias. What’s exciting is that the variety of passive adherence monitoring technologies has expanded immensely; including those pointed out by NIH director Dr. Riley; breathalysers, glow caps, blood assays, and microchips. We’re excited to share results from our own patent-pending sensors during our paper at the BHBIA conference this May and I agreed to continue the conversation with Dr. Riley so we can stay up to date as the other categories continue to develop and identify which technologies show greatest ease, accuracy, and cost efficacy going forward.
Context remains critical but big data could support better targeting. Some of the most compelling examples of successful behavioural interventions did a particularly excellent job of identifying their users’ context -the University of Western Australia described how they considered social/competitive attitudes among Australian dads to develop a gamified ‘milkman’ app for men to support partners with breastfeeding, Danone considering the physical, social, and inner spaces when developing programmes and delivering multifaceted interventions including water delivery and education to support infant hydration in Poland. And using free chlamydia testing as a point to deliver condom trial packs alongside a discreet carrying case (hidden within a brightly coloured case with a free set of matching ear buds with a hidden pocket for condoms) to encourage safe sexual behaviours amongst adolescents. Big data is being used effectively to identify context and make interactions richer; but it is still an emerging field, for example Ching-Hua Chen from IBM research described how their team are in the business of testing apps to see whether they generate the data that they think they can. They undertake projects such as observing population based patterns with Fitbit use with the aim of reducing discontinuation. They assessed the potential for a smart app to mirror your use patterns and adapt targets to adjust to daily variations (e.g. ‘you slept really well last night, shall we increase your exercise goal for today?’ or ‘its been a slow morning, shall we go for a walk at lunchtime?’) and optimise impact.
‘traditional’ methodologies work to assess new technologies but holistic behavioural thinking and analysis are critical – consistent with the HRW perspective on the topic, behavioural science was not a key determinant of specific methodological choice for the majority of papers presented (with many using interviews, surveys, and observational methods). Rather the ‘behavioural’ aspects of the assessments were fed in at hypothesis development, design, and analysis stages. Underlining that the behavioural science community hasn’t yet ‘endorsed’ any particular methods and that a more overarching behavioural expertise and approach is still the cross-sector gold standard.
Most effective digital health interventions aren’t that ‘whizzy’ – although many of the successful interventions showcased during the conference did utilise newer or more distruptive technologies like virtual reality, the vast majority used common technologies (e.g. mobile apps and websites). This was because ultimately for an intervention to be successful it needs to be already a core choice for the target populations, which can sometimes mean including ‘old fashioned channels’ – for example one case study from Development media international (DMI) used radio in conjunction with Facebook to support dissemination of advice about maternal and child health in Africa. Yet there is a lot of existing success with newer technologies; Virtual reality has shown particular potential as a training tool to support both technical and softer skills training.
Furthermore, although we in the behavioural sciences work more regularly with academics anyway, there were very few representatives from commercial companies at the conference. And in this dynamic there were some observations I took away from the conference about the future of applied behavioural sciences between the academic and commercial sectors.
- Speed and agility have their benefits – it was clear from the presentations that ideas originating in the commercial space were realised more quickly. This meant they were implemented and validated in shorter timeframes. Furthermore, because of the resources and singular focus in the commercial space, they were usually more polished (fusing involvement from technical experts and user experience experts rather than being based on the science alone). Funding also obviously plays a big role in this as many academic experiments are having to get by on even more limited budgets.
- Academics are collecting evidence about what works – one of the most exciting elements for me was that the academic sphere are spending a lot of time modelling the behavioural interventions and collecting evidence of the efficacy of each approach. Although our recommendations are always informed by recent evidence across sectors, we don’t always have time or scope for randomised controlled trials and we often don’t have the longer-term view from our clients on how the behavioural interventions perform over time. Knowing that this library exists within academia gives us a clear source for where to seek validation/feed our own results to benefit the behavioural science community.
- Opportunities for partnership are rich – the academic community are looking for chances for their learnings to be applied in the ‘real world’ and also keen to consult with us in the commercial space. We found a great deal of interest from academics to hear insights from our ongoing self-funded studies using passive adherence sensors and virtual reality, and also picked up several contacts to consult on projects going forward.
All in all a delightful and productive series of days, for more information about the conference please visit the UCL CBC website, read more on the HRW twitter feed, or for more information about HRW’s industry leading behavioural science consultancy (HRW Shift) please get in touch for case studies or a free training session.
By Katy Irving, Research Director and Behaviourist at HRW Shift