Why is it that lots of mobilists spend hours a day using some apps, but not much on mHealth? Could it be that mHealth isn’t good enough at its psychology? In a park recently, as in now in many other parks, lots of young people were wandering around from tree to tree, seemingly aimlessly, but playing Pokemon. Trees are good for health, but no mHealthers were in the crowd.
While technical imagination and usability are essential for app’s success, many commercial apps are relying on behaviourism, a branch of psychology from B F Skinner in the 1930s. Originating from his stimulus, response and reward using rats and boxes with mazes, levers and food, it’s taken on a new role by B J Fogg as behavioural design. Both are based on the theory that environment can shape behaviour.
An article in The Economists 1843 magazine says that designing the right box, and hey presto, behaviour’s controlled. The old, bad joke was what’s the difference between magicians and psychologists? Magicians pull rabbits out of hats, psychologists pull habits out of rats. Now, they’re putting habits into app users. Fogg found that people spent longer using computers if the computers had previously been helpful to them. The implication’s that apps can be designed using psychology so people will use them when they may not have done.
It’s Computers as Persuasive Technologies (captology), and now embedded into daily life rom Fogg’s laboratory at Stanford University’s Persuasive Technology Laboratory. This behavioural design model sets out to hack people and exploit their human instincts, quirks and frailties. The goal’s to supplement motivation and persuasion with a more effective option of making behaviour easier. When motivation’s high or behaviour’s easy, users respond to simple trigger, such as vibrating phones. Well-designed, called hot, triggers find users at exactly the time they’re ready to burst into action. They put hot triggers in the path of motivated users.
The challenge for mHealth developers’s to design hot triggers instead of just mundane triggers to appeal to users’ emotions in their computer transactions. This isn’t new. Fogg’s theory dates back a long time before social media invaded the world. Nir Eyal’s added to it since. His book Hooked, he sees hot triggers as internal factors, not internal as Fogg does, so apps succeed when they meet people’s basic emotional needs and unthinking choices before users are consciously aware of them. Tristan Harris, a former Google employee after Google bought his start-up and his app Apture, calls this “Whoever designs the menu controls the choices.”
Africa’s health systems can benefit by assessing their mHealth apps for effective hot triggers and technical prowess to ensure they’ll maximise benefits. For such a significant investment, it’s essential they‘re effective. They also should ensure that hot triggers are ethical, not just medically, but constitutionally. Borrowing from magic, the hot trigger Genie’s already out of the bottle. Africa’s health systems need to make sure it work well for everybody.