Thinking about changing behaviors

I had a conversation with a doctor recently that got me thinking. This doctor works in a large, inner-city teaching hospital. He was talking about how to get groups of people to do something... in this case getting people tested for HIV.

It's a significant behavior change. It means addressing at lot of things that people don't like to think about, much less talk about.

He was gently trying to tell me that computer mediated-communication wasn't the best way to change behavior. He said that, in his experience, the most successful outreach was through traditional broadcast media. It was important to reach people with their own communities. There was also a need to have a physical presence in those communities somehow.

But even that doesn't always work. His point was that to make people change dangerous behaviors (like smoking, not getting tested for HIV, or even not getting enough exercise), you are dealing with a lot of complicated norms and attitudes -- some very social and some very personal.

Creating healthy behavior (like creating world peace or fixing the environment) is a "wicked problem". It impacts a very large number of diverse people -- all of whom have different ideas of what "success" looks like and all of whom have problems and issues in their lives that impact making these healthy changes in some significant way. "Wicked" problems are basically problems that are impossible to solve.

Yet things do change.

The doctor I was talking to said that people needed a catalyst to make these behavior changes a priority. They needed a close call -- a close friend or family member unexpectedly dying perhaps -- to pluck this one issue out of mad soup of day-to-day problems and make it a priority. If the issue stayed a priority in the person's life for more than about three months, it tended to become a permanent behavior change.

As a strategist who spends a lot of her time working wicked problems, this is an interesting insight -- a subtle consistency to hang a theory on. It tells me that:

• There is probably not much my web site will do to change a behavior, except keep reminding people that there is a behavior that should be changed.
• I need to be ready when this person experiences his or her "close call" and strongly support the changes that he or she is willing to make for about three months.
• This is all happening on a very personal, very individual level and that I need to speak to that person with a very personal voice.