Photo by by swgn
At MeYou Health we are trying to design products for people who need to take the first step. This means resisting the urge to design for people who are already aware and achieving in health, and instead trying to think up how we can build something for people who find today's widely available products unrealistic, inconvenient, misaligned with their personal goals, and assume, since they are prescribed by their health plan or employer, disingenuous by nature.
We are on a path to do this using the Daily Challenge. We send you a quick email once a day (7am) with some small "challenge" for you to do some time during the day. If you do it, click DONE in the email. If you don't do it, you will get a reminder (4pm). Rolled up in that are opportunities in a social layer (for support and motivation), and a game layer (for progress). Eventually there will be a few more layers to deepen the experience once you are ready.
Most of the time, people say "that's it? You send me an email?" Yep. That is it. Although lots of different types of people can take advantage of such a light weight intervention, the simplicity is actually part of adhering to four design principals that I have come to believe not enough health products respect.
- Be Realistic
- Be Convenient
- Be Immediate
- Be Genuine
Realistic
For everything we build, we must recognize and respect the challenges and capabilities of unwell people and give them achievable tasks.
I really like this because it is something that gaming does very well. Through the use of progressive difficulty, you are never asked to do something that feels like too much of a stretch. The difficulty and complexity of a game increases overtime, moving from novice to expert to master, so that everything seems achievable.
Our idea of small actions goes right at this concept. Small actions build momentum and cut through the lack of confidence that most people face. If you can do a small thing, maybe you can do the next small thing.
The science behind the population affects of small actions is also well documented, so there is a bit of validity around just getting large numbers of people to do small things:
- Stroebele N, de Castro JM, Stuht J, Catenacci V, Wyatt HR, and Hill JO. A small-changes approach reduces energy intake in free-living humans. J Am Coll Nutr. 2009, Feb;28(1):63-8.
- Lutes LD, Winett RA, Barger SD, Wojcik JR, Herbert WG, Nickols-Richardson SM, and Anderson ES. Small changes in nutrition and physical activity promote weight loss and maintenance: 3-month evidence from the ASPIRE randomized trial. Ann Behav Med. 2008, Jun;35(3):351-7.
- Rodearmel SJ, Wyatt HR, Stroebele N, Smith SM, Ogden LG, and Hill JO. Small changes in dietary sugar and physical activity as an approach to preventing excessive weight gain: the America on the Move family study. Pediatrics. 2007, Oct;120(4):e869-79.
- Hill JO, Wyatt HR, Reed GW, and Peters JC. Obesity and the environment: where do we go from here? Science. 2003, Feb 7;299(5608):853-5.
As we build a system at scale that helps people complete small actions, we hope that MeYou Health can ultimately contribute to this ongoing research.
Convenient
For everything we build, we must be aware of the time constraints that everyone is under and provide solutions that easily fit into those constraints.
This is one that I think us product developers overlook the most. We assume that because our intervention is so effective that people will naturally do it! Or we assume that because it is in someone’s best interest to be healthy, they will realize that and will put in the effort needed if we can only convey it with enough urgency!
A classic on-boarding experience of many health products is something like this:
- Hi! Welcome to our health product! By signing up, you have put yourself on a path to a new you!
- Here please take this HRA... er... I mean quiz that will customize your experience.
- Please enter your blood glucous level... my what?!
- (Somewhere in there you enter your height and weight)
- Oh sorry, looks like your BMI calculation means you are overweight.
- You better start working out, here is your list of at-home exercises.
- ...and we have this discounted gym membership for you!
- ...and here is a weekly nutrition plan, print this out. It has food on it that you never eat and barely tells you how to prepare it.
- ...and here is a great mobile app for your iPhone to log calories of everything you eat!
- ...and if you don’t have an iPhone you can always log back into this site which is really not convenient for you at all to update all your calories at the end of the day when you are the most tired from work.
- ...and if none of this seems interesting, or you choose not to participate at this time, what if we give you 5 bucks? Would 5 bucks convince you? How about $10?
- etc...
To be convenient, we have to keep in mind the attention economy. All that means is you acknowledge that the attention of a human being is a scarce commodity. You have to assume at all times you are going to get nothing from people. Almost everyone we talked to in our market research was severely time-impoverished. Whether they actually are or just think they are doesn't matter.
As a health application designer, you are playing a zero-sum game. To get 10 minutes of their time, you are probably pulling it from 10 minutes somewhere else in their life where they really enjoy spending it. One women we talked to in our interviews told us that in order to spend 90 minutes with us that morning, she was giving up 90 minutes of her six hours per night sleep. (she worked the night shift and slept in the mornings).
If we are going to ask anyone to do anything, we have to treat the time they give us with the utmost respect, almost to a completely radical degree if we expect them to keep giving it to us.
Immediate
For everything we build, we must provide value from the very first interaction, and create a sense of tangible progress.
I think the real power of gaming comes from the creation of immediate feedback. It could be points, it could be levels, but whatever it is, it makes progress out of essentially nothing but the smallest of incremental actions.
The new neologism for this is "gamification". I personally belive that using that term presumes that you carry forward some of the other aspects of games, like fun, narrative, characters, etc.. I think of points and levels as a way to create a tangible sense of progress. Putting a progress bar to fill out your profile on LinkedIN, doesn't make it a "game" in a strict sense. So I argue that adding points to an app that a user accurues for engagement doesn't make it a game either. Points are just another type of progress bar. If I do something, and then come back and do something else, and then come back a third time and do something else, how do I know on the third time that I have made any progress? If I get 100 points each time and at the end I have 300 points it is pretty clear to me (and others in a social context) where I am at.
Progress is really important to create immediate feedback. We are committing to real well-being products that create behaviors and perspective that last a life time. You can’t really lead with that (see principal #1)!
If we can give people something to do today. And they can do it today. And they can get that quick win today. And it can make them more mindful today. And they can maybe have a fulfilling discussion with someone today. They will be much more likely to come back tomorrow.
Genuine
We must never, ever trivialize the challenges that others face pursuing well-being.
Making things “fun” has to be the hottest catch phrase in health these days. I am a gamer. I know what fun games are to me... But fun is a really overloaded word. If we overly focus on fun experiences we potentially miss the decidedly non-fun experiences that can be equally rewarding and engaging.
Keely Rued said it best in some commentary about the topic in an article called “Having Fun Isn’t always the point”:
People can be deeply engaged, motivated and, ultimately, entertained by experiences and media that are downright disturbing, sad, and leave us with more questions than answers, more tension than resolution. Moreover, people can be entertained by games, media, and experiences that are patently dull, repetitive, and frustrating as hell (for example, the grind to get experience points (XP) in your favorite massively multiplayer online (MMO) title – sure, it has a payoff at the end, but it isn’t always fun while you’re doing it).
If you are someone with low well-being, you are facing some pretty serious challenges. Many of the things you will be asked to do will be dull and repetitive... and frustrating... and maybe sad... and that is ok. It isn’t always going to be fun.
If the products we build trivialize your challenges. We’ve lost you. More importantly, we’ve failed you. After all, that is why we all got into this industry right? To genuinely help people improve their lives?
That said, I am the first to admit that building something genuine is really, really hard. It is surprisingly easy to fall off the wagon and just do something fun and light-hearted, and in the process alienate the audience we need to help the most.
Conclusion
So in the coming years as we unleash an entirely new generation of well-being products on the millions of people that can really benefit from them I am promising myself that I will always push my solutions to be realistic, convenient, immediate, and genuine.
That is how I plan to change the world. Shhhh don't tell.
Comments