Motivation and Health Behavior Change

Why do people get started making a health behavior change, and what keeps them going?

Like many straightforward questions, the answer is complex.

“People need to feel a sense of mastery,” Jennifer La Guardia, founder and principal consultant at Motivated for Health, told the recent Health Experience Refactored conference. “They need that to deal with the disappointments that are going to happen.

Which turns us to Self-Determination Theory. The belief that humans have a natural or intrinsic tendency to behave in effective and healthy ways.

Central to designing in an SDT framework is recognizing and aligning with three basic psychological needs: Autonomy, competence, and relatedness.

In the design environment, addressing autonomy requires understanding the client perspective and maintaining personally relevant, meaningful goals, La Guardia says. Competence meaning recognizing the client, or target, need to experience challenge and mastery of activities, and relatedness couples with feelings of engagement and the desire for unconditional positive regard.

Those three needs lead to Autonomous Regulation but motives must be differentiated as a need for:
• enjoyment and interest
• big-picture values, life goals and health
• internal pressure to avoid feeling bad
• direct pressures or rewards for positive behavior.

“The first two are autonomous, the bottom two are controlled,” La Guardia told the Mad*Pow-sponsored conference. “The top two are more likely to be maintained; the bottom two are harder to maintain.”

Amy Bucher, behavior change design director at Mad*Pow, added that the challenge of designing for competence includes, “identifying the gaps in your user’s ability and find ways to address them and structure goals.”

“There will inevitably be failures -- falling short of goals -- so we need to provide feedback to help them try again," she said, “as well as recognizing people’s needs for support change.”

Heather Patrick, vice president of behavioral science at Carrotsense, noted that the question is “what do we do with the people who are not motivated for change?”

If ignored, then the designer learns nothing about how to work with them. The instant thought to “educate” them assumes ignorance, and “cheerleading” is not effective, she said.

Additionally, she believes the role of relatedness in design has received the least attention. Are designers asking themselves, “Do I know what this is like.”?

One approach to help expand the understanding of self-determination has been through the use of health/life coaches.

Steven Ledbetter, CEO and co-founder of Habitry, is an experienced coach, but says it would be more apt to describe his job as “motivator.”

“When it comes to being a health coach it’s easy to get lost in a lot of the content,” he said. The reality is the person needing coaching “knows what they have to do, but they can’t make themselves do it.”

He described his current involvement in supporting and developing a group of personal trainers in the United Kingdom, where his group had to realize they were not getting more or faster results. Instead, they pleasantly discovered, “we were getting a wider spectrum of people more consistent results.”


By: Karl Swanson

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Contributed by:
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