The role of behavioral science is increasingly prevalent in the design of today’s software products. Within the Univ. of Washington’s Human-Centered Design & Engineering (HCDE) department, researchers are exploring new approaches to integrate psychology and behavioral science theory into the formal design process.
Under the guidance of both academic and industry researchers, our team explored the role of behavioral theory in supporting daily health behaviors. We designed a tool to help individuals with chronic health conditions more easily manage their medications.
Problem & Opportunity
Our goal for this project was to design behavioral nudges that would help users work towards a long-term goal. We chose to tackle medication adherence, a public health concern that impacts both individual health outcomes and overall health care costs.
The challenge was to identify behaviors that prevent patients from taking the prescribed dosages at the prescribed times. We determined how behavioral theory can be applied to help patients better manage their medication regimens. With these insights in mind, we designed a technological intervention aimed at helping patients more easily stay on track.
UX Designer; I worked alongside three other students in my Designing for Behavior Change class. I was involved in all stages of the design process, with added emphasis on design and prototyping.
Tools: Sketch, InVision
Timeline: March 2017 – June 2017
Type: Class Project
We talked to people around us to understand how medication adherence affects their lives. We heard stories about personal frustrations with long-term medication management, to concerns about family members with complex medication schedules, to the challenge of tracking daily vitamin intake. These insights contributed to a broad understanding of the benefits and barriers to medication adherence.
Subject Matter Expert Interviews
I spoke with a physician to discuss medication adherence from a health care provider’s perspective. I learned that certain regimens reflect a patient-centered approach, such as when dosage schedules are optimized to reduce cognitive load and to provide a buffer for occasional errors.
We analyzed existing technological solutions aimed at solving the issue of medical adherence, ranging from apps to smart pill boxes to mail delivery services.
We looked at academic research papers to understand both patient- and provider-side concerns. We also reviewed a set of psychology and behavioral science theories to understand how they’ve historically been applied to health interventions.
Defining a User-Centered POV
We synthesized our insights into a persona that would guide us through the design process. Based on our research, we narrowed our target user group to patients diagnosed with chronic health conditions, such as cardiovascular disease, which requires a daily preventative medication regimen.
We created a user flow to map out both desirable an undesirable behaviors related to medication adherence. The visual representation enabled everyone on the team to contribute and agree upon a vision before jumping into the design phase.
We identified a central psychological framework to inform our design. The Theory of Planned Behavior breaks down behavior and intention into individual constructs, which are translated into design principles below::
We held a day-long brainstorming session to share sketches and to further refine our intervention approach. Below are sample sketches from our brainstorming session:
Exploring notification styles
I decided to explore different designs for daily notifications. The overall aim is to help users log doses more easily, while preserving user privacy by obscuring medication information on the lock screen.
Testing our assumptions
Due to the challenges of recruiting users from our target group, we asked 4 individuals to role-play as our persona by imagining a time when they had to follow a prescribed medication regimen. From there, we assessed the ease of use and value of our solution through 3 different tasks: onboarding, inputing a medication, and refilling a prescription.
Our key findings include:
- Asking users to manually enter their motivations increased overhead
- Swiping gestures for dosage and refill options needed to be more discoverable
- Users liked the idea of leveraging social support for prescription refills, but the chatbot feature made the experience feel less personal
- Medication and refill preferences should be easier to edit
We also asked participants to complete an attitudes and intentions scale both prior to and after interacting with our prototype. By setting a baseline measurement, we were able to identify any patterns and overall changes in scores. Since medication adherence is an ongoing behavior, measurement over a longer period of time would help us derive more insights into the effectiveness of our design.
Throughout this project, I found myself revisiting the question of what constitutes ethical design when it has the potential to impact behavior on a mass scale. What level of “nudging” is acceptable, and how do we know if we’ve crossed the line by restricting freedom of choice? If designing choice architecture is unavoidable, how can we educate designers to make responsible decisions?
In this project, we design with the assumption that we’re improving the lives of our audience. We chose to address chronic health conditions because they rely on a routine of preventative actions, in which there are no immediate benefits. Rather, patients take medications with potentially negative side effects so that nothing happens in the future - it’s a classic separation of choice and consequence. On an intellectual level, we understand the fallacies of human decision-making and we want to create solutions that make up for these blind spots. However, it's important for designers to constantly engage with the people that they're designing for in order to validate the benefits or to uncover the unforeseen impacts of their design.