Why Open-Source is the Future of Behavior Change
"At the end of the day, your health is your responsibility."
It's a common refrain in our society and a shared belief among health professionals of all kinds — each of us is individually responsible for our own health outcomes.
This belief is prevalent because...
1) Western culture in particular places a strong emphasis on individualism, a cultural value that prioritizes personal autonomy, self-reliance, and independence.
2) There are social stigmas that result in negative attitudes, beliefs, and stereotypes being placed on groups of people who have specific health conditions.
3) Many health professionals aren't adequately trained in behavioral science, social determinants of health, cultural competency, or other factors that can influence health outcomes.
This single belief that health is your responsibility has left ripples in the field of health and wellness that can be felt in many ways.
First, it has made it very easy to shame and blame people for their health outcomes. The argument being that they fail at being healthy because of their individual choices and behaviors. So those stigmas being placed on others result in people being viewed as lacking willpower or the self-control necessary to manage their own health. This reinforces individualism as a dominant paradigm in health care and leads to comments like the one below being shared in discussion groups, comment threads, and social media feeds across the web:
"What mental health really is: Blaming no one or nothing for your own feelings, thoughts, or mental state. Taking full responsibility and not counting on an external system to do your introspection for you. That’s the unpalatable truth. Pointing your finger at stigma is just one more reason people make up to continue avoiding the hard work of facing their own minds and deflecting responsibility on the system rather than becoming fully self accountable. People will do anything to defend their mental habits and maintain unhelpful conditioned mind patterns. That’s not on stigma, that’s on the person." (source)
Second, it has caused many to deprioritize, ignore, or remain oblivious to the wide landscape of factors related to diversity, equity, and inclusivity. From the social determinants of health, which the World Health Organization defines as “the conditions in which people are born, grow, live, work and age,” which are “shaped by the distribution of money, power, and resources,” to understanding cultures outside our own — these broader social and environmental factors have a significant impact on health outcomes, yet they're frequently overlooked resulting in programs that fail to address the root causes of health issues, such as poverty, discrimination, and environmental hazards.
And third, it has led to the development of very vanilla health programs and interventions. The systems being built to support people in their effort to change fail to unlock their full capability and maximize their reach because...
They're based on a one-size-fits-all approach. Personalizing and tailoring can be resource intensive, so we generalize and make assumptions about our audience -- lump them into large groups or no groups at all. This means not everything will apply or be relevant and what we ask of them may be too easy or too difficult. And yes, it will work for some -- as every program will. But the possibilities are stunted and the full potential is missed.
They're hand-me-down programs. These are programs we take from some other organization with little to no thought about how they will fit our audience. It goes a little something like this: Find a program that seems to be successful, take all the components of that program, re-skin, and redistribute. It worked for them, so it should work for us. Unfortunately, it's never that simple.
There are still far too many people struggling with a multitude of health issues despite there being countless solutions available. It's been this way for too long and it's time for us to aim our truth-seeking spotlight on the reason behind the problem.
It's us.
When it comes to changing behavior, systems fail, not people.
We need to build better solutions.
Now that doesn't mean people should never be held accountable or that they aren't ever responsible for their own actions. It means that with behavior change, everyone needs their own system for success because everyone has their own unique set of traits to start with and obstacles to overcome. Some obstacles are quite low while others can be practically insurmountable.
But we're the creators and it's our responsibility to find or create programs that support our audience. A system that evolves and adapts to the varying types of people who engage with it.
Change is elemental. Every individual has a set of elements that when combined will lead to behavioral success. Our job is to help discover what they are and use them as the foundation for a supportive system.
It's time to open-source behavior change.
The spirit of open-source lies in fostering a culture of collaboration, innovation, and unrestricted sharing. It champions the virtues of transparency, open exchange, experimentation, and iteration, all of which have the power to revolutionize the health and wellness sector. Open-source can accelerate progress in the field of health and wellness and help create a more cohesive and united front in the fight for desirable health behaviors.
But to build our behavioral Shangri-la, we need three things:
To break free from the "behavioral blinders" mindset. We need to begin viewing behavior change from a top-down, 30,000-foot view. At that height, we can see all the elements that could potentially impact someone's ability to change and we're able to notice the order that exists among these elements and the relationships they have with each other. Seeing and understanding the connections between elements helps shine a light on the network of factors that can influence and shape the behavior of our audience. We've devised a way to achieve this using what we call the Periodic Table of Change. It's a collection of 105 elements carefully organized into five distinct categories -- behavioral domains, catalysts and barriers, behavior change techniques, key principles of change, and theories and models. It provides a single point of reference for anyone wanting to understand all the major factors that can influence change and how they're interrelated.
A comprehensive, reliable framework upon which to build our programs. Creating change is much easier when we have a trusted framework to follow. One that considers all the major elements that can amplify or influence our audience's ability to change. That guides us through the process of creating a blueprint for our program. A blueprint that shows how the program will be designed, what elements we need to account for, and how all the pieces will come together. This is the purpose of our Creating Change Framework (currently in production). It will be an indispensable guide for how to put the Table of Change into action.
An open community where members can contribute to the science of behavior change. This is where it all comes together. After following the Creating Change Framework, community members can submit the blueprint of their own health and wellness program allowing others to see a breakdown of what elements were combined, what audience and behaviors were targeted, and what, if any, outcomes have been found.
Those three pillars support the creation of an open-source behavior change ecosystem where:
Everyone speaks the same language — tools and terms are the same for everyone.
A collection of programmatic blueprints for all dimensions of health and for any population is organized and kept open to the public. Giving community members an opportunity to investigate, analyze, and provide feedback.
Collective feedback contributes to the evolution and creation of more impactful health and wellness programs.
Responsible experimentation is encouraged to determine which elements have the greatest influence and which compounds have the greatest effect.
New elements and elemental compounds are discovered, pushing the science of behavior change forward in new and practical ways.
Data and research have great value but aren't buried behind overly complicated explanations, equations, charts, and tables. All that is saved for the professional journals.
How we shaped behavior in the past can’t support the future.
The problems of today are quickly pulling away from yesterday’s solutions. Technology and the way we interpret, interact with, and utilize health information are rapidly evolving. We need a reliable framework and open community that is built to keep pace.
We need health professionals, researchers, students, and other individuals who want to share best practices, discuss behavioral science, and create innovative, evidence-based programs.
This is how we shape the future of behavior change and we need your help to make it happen. Subscribe to our newsletter to keep up with our progress as we openly build this community. We have so much more we can’t wait to share!