Patient or Customer Habit Building and Adherence

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Patient or Customer Habit Building and Adherence

Best practices for encouraging patient and/or customer habit-building and adherence are assisting clients in setting small goals and by using simplistic digital triggers, like text messages or email messages.

Set Small Goals

  • In order to help patients build healthy habits, providers should assist them in breaking down larger goals into smaller, specific changes. These smaller changes can be thought of as "stepping-stones" to reach the bigger lifestyle shift.
  • According to Caroline Arnold, author of Small Move, Big Change, "willpower alone is not enough to override our ingrained habits. The key to creating long-term change .... is to set smaller but winnable goals that then lead to a pattern of sustainable habits."
  • BJ Fogg, "a behavior change researcher, the director of the Stanford Behavior Design Lab, and author of Tiny Habits: The Small Changes That Change Everything" states that: “to create a new habit, you must first simplify the behavior... Make it tiny, even ridiculous. A good tiny behavior is easy to do — and fast.” As these small wins accrue, it will provide personal satisfaction and thus the habit-former will continue to perform the behavior. Fogg states: “the more you succeed...the more capable you get at succeeding in the future.”
  • The American Journal of Clinical Nutrition, in an article focused on behavioral treatment for obesity, states that “the more specific the goal, the better.

Simplistic Digital Triggers

  • Research suggests that simplistic digital triggers, such as text messages, emails, or push notifications, "improve individuals’ engagement in interventions with a specific target, such as appointment adherence, medication adherence, homework completion, and engagement in medical and psychological treatments." These have been shown to work in areas such as smoking cessation, alcohol use reduction, and prenatal care.
  • Research in the American Journal of Preventative Medicine found that "text message interventions are capable of producing positive change in preventive health behaviors. Preliminary evidence indicates that these effects can be maintained after the intervention stops."
  • Todd Rose, director of the Mind, Brain, & Education Program at the Harvard Graduate School of Education, believes that texting may work to help reinforce behavior changes because "it’s anchored in mobile phones, has the ability to be with you all the time, and that gives us an enormous flexibility on precision... When people lead busy lives, they need timely, targeted, actionable information.

Companies That Encourage Habit-Building

Two companies that encourage habit-building in their customers are Text4Baby and Thrive Global. Information regarding these companies has been provided below and entered into the project slides.


  • Text4Baby is a texting service designed for pregnancy and baby's first year that "sends messages to pregnant women and caregivers with reminders about doctor visits and providing important health information."
  • The service is free and can be utilized via a phone app or simply through text messages.
  • The service was launched in 2010 and with the help of partners, including National Healthy Mothers, Healthy Babies Coalition, Voxiva, The Wireless Foundation, and the U.S. Department of Health and Human Services, has reached more than 850,000 new and expectant mothers.
  • In an evaluation of Text4Baby by the U.S. Health Resources and Services Administration (HRSA), “81 percent of women who signed up for Text4baby responded ‘correctly’ to at least three of the four” questions related to safe sleep, infant feeding, the best time to deliver in a healthy pregnancy, and the meaning of full-term, compared with only 60 to 62 percent of other CHC prenatal care patients."
  • According to Lilliam Koppelman, Executive Director of Health Care Coalition of Southern Oregon, Text4Baby makes sense because "delivering information to young moms — and dads — via mobile phones makes sense.... People in this age group — young women of reproductive age — are texters. This is how they get their information."

Thrive Global

  • Thrive Global offers a digital platform designed to "help the world’s leading enterprises unlock their people’s potential and create sustainable peak performance cultures." The company developed the "world's first cross-channel behavior change platform combining data, stories, and actionable Microsteps to take...people on a lifetime journey of improved well-being and performance."
  • In order to help users build habits, they make use of science-backed strategies for habit development including breaking down goals into "microsteps", exposing users to positive role models using storytelling, and using inside-out storytelling from users that have successfully made changes.
  • After using Thrive Global, 92% of users reported "being more equipped to manage stress", 97% reported "increases in productivity", and companies have reported saving $20 million due to improved employee retention.

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