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- END OF WATCH What happens when you try to change behavior without behavioral science?
- SMART criteria
- Behavioral Change Models
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Rene Ritchie: I'm Rene Ritchie, and this is "Vector." Yes, my studio is still not finished. I'm still setting it up. I'm still recording remotely. I'm still relying on the genius of Jim Metzendorf to make me sound even halfway passable, so please forgive me. I will get all this sorted eventually, as soon as possible.
I was originally going to talk about HomePod today and a lot of the questions that I've been getting about it, and explain what it is, why it is, what it does, what it doesn't do, all those sorts of things. Then I saw an article on The Verge, and it was about Apple Watch. It struck me as something that I want to talk about almost immediately.
It's titled "END OF WATCH -- What happens when you try to change behavior without behavioral science?" I'm super happy this article was written, because it's a great discussion to have.
I'm not really happy about the way it was written because I think it is a highly subjective, highly personal, highly opinion-based article that uses science, or actually, and I hate saying this, misuses science to make it sound more objective than it is.
That's important to talk about because that happens all too often in our industry. There are a lot of valid opinions. I want to hear all of them. I want to hear how products fail people. There's an important distinction between how a product has failed a person and what a person would rather see, how it could be improved for them, or just how it's not the right product for them.
Couching that in something that makes it sound more authoritative, more objective than it actually is. This kind of stuff is really deep and really involved.
I have the luxury of knowing a lot about the Apple Watch process. Just reading the article, a lot of it rang just not right with me. I want to talk about it. I want to discuss it. I reached out to a really experienced psychologist and someone who knows deeply about all this stuff and also happens to use an Apple Watch so we could have a discussion about it.
Maybe I'm wrong. [laughs] Maybe this article is exactly on point. I wanted to find out. I think it's important that people know about it because people are buying products like this in the hopes, some of them at least, some of them just want notifications, some of them just want a cool watch, some of them just want an Apple, people are buying it for IDs.
There are some people who are buying it because they are interested in the way that Apple is doing health, doing activity, doing motivation, doing achievements, and all those things.
I want to make sure they have as much information as possible about that because at the end of the day whether they choose to like it or not like it, I want them to choose to like it or not like it smart with the best information available and the widest range of opinions as possible. Here we go.
Joining me right now, this was last minute and didn't have time to get this cleared so I'm going to keep this super casual just to try to make it as easy for everyone involved as possible. I'm talking to a psychologist, a practicing psychologist. How long have you practiced for?
Psychologist: I've been registered for 14 years.
Rene: 14 years. You work at what we considered a major institution?
Rene: I sent you an article to look at. It was an article that ran on The Verge. I'll give you the title, END OF WATCH -- What happens when you try to change behavior without behavioral science?
It was attached to a Tweet. I want to make sure I get this right so forgive me. I just want to make sure I read the...The Apple Watch is a behavioral intervention designed without consulting behaviorists. What does that mean for users?
As background, when you hear the term behavioral science or behaviorist, what does that mean?
Psychologist: Behavioral science is broad, and just like anything, there are multiple different theories or frameworks that people use. In general, I don't know that many people would describe themselves completely as a behaviorist, so that label was less clear to me.
Rene: The premise of the article is that Apple uses the activity app, which has rings for stand, for Move, and for workout, and various ways of encouraging that both through notifications and through achievements as a way of encouraging people to be more active. The article took issue with that.
Psychologist: Yes, they seem to take great issue with that.
Rene: You've had an Apple Watch for two or three years now I think?
Psychologist: Mm-hmm, yeah.
Rene: To me just reading through the article, it seemed more like a personal opinion than an actual scientific work. I don't know if that's fair or not though.
Psychologist: The thing is weight loss is inherently complicated, and irrespective of what intervention you use, it's hard to get a really good outcome and to sustain that really good outcome. That's with some of the best science or interventions that we have.
The truth is you're talking about multiple different changes that people have to make, and that's incredibly complicated. Most people don't adhere to anything 100 percent of the time.
Rene: Breaking it down, I'm going to go through it first. In the beginning, she talks about being able to cheat the activity thing. My understanding is that any system that is created can be cheated. The minute you create rules, those rules can be broken.
Psychologist: That's a great point. The thing is it depends ultimately what your goal is. You can never achieve everything. If your goal is really to collect a certain number of points, then I'm sure there's multiple ways for you to do that. Then your end goal would be getting that, I got that circle today. I actually don't always get them, but I thought, "Wow, that's kind of a pretty circle."
If your ultimate goal is to get those completion circles, then yeah, I'm sure there's multiple ways to get that. If your ultimate goal is to change your habits, then on any given day, you may or may not get the circle even though you've made some really great choices. It really depends at the end of the day what your main goal is.
As with anything in life, it's rare that you can have everything. The truth is as much as most of us would want to eat anything we want any time we want, and do as little as we can to exercise on the days that we feel really, really busy or on the days that we're more tired than others, you can't have it all. Everything is about choices and the balance. There are natural consequences to the choices we make.
Rene: That's how I look at it. The way I look at the Apple Watch, I want to be motivated. I find that the rings, the achievements, and all those things help me to feel motivated. I'm guessing if I didn't like them, they would not be motivational at all.
If my goal, like you said, was to only get the ring, I could figure out ways, in fact I have figured out ways, [inaudible 7:01] an article on ways that you could cheat them if your goal was to get the achievement but you wanted to build in something like a rest day or something. That feels like it's more about me and less about the Apple Watch.
Psychologist: It's about the goal. If your goal is to learn to cheat a system, then you may have accomplished it. That is a goal in and of itself, but then you probably can't also achieve your fitness goal.
Rene: It's like a tool, and the tool in itself doesn't have any agency. It only takes what I project onto it.
Psychologist: It does. The biggest piece really is that there is no one fast fix, tool, or anything that's going to get you to consistently change how you do things to get you to what is actually a really big goal, which is maintaining your health across time.
The biggest piece to stay motivated, and that's what I really heard was the truth is when you're trying to achieve something and you aren't feeling like your efforts are being validated, and so maybe you're not getting the goal or maybe you're concentrating more on that sticker than some of the other changes that you're seeing, then I think it's about managing your expectations.
I had that. My Move goal was really high. Every week, I didn't get it. I wasn't actually going for the goal, but I thought, "Huh, this message is kind of telling me that, you know, maybe I do need to think about this, and maybe I do need to lower the goal, or maybe I need to be more purposeful."
What it's doing for people is it's giving them a chance to get data, feedback, and to reflect on the choices that they make. It can't control choices that you make, but being able to take your temperature or your pulse, and being able to think about whether you might do it differently the next day is going to be helpful for a number of different people.
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We often don't do it in a way that's actually conducive to resting, to repairing. Sleep is so important to us. We have all this stuff in our head all day, and it's basically in cache. Sleep is when we get to write it to the drive. It's when we get to store stuff. It's when we get to sort through everything that happened.
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Rene: I remember when I was training, I had to learn that there's a difference between repetition and conscious repetition. Repetition is mindless and robotic, where conscious repetition, every time you do something you're picking one aspect that you can make better the next time you do it. [laughs] I could go down a rabbit hole on that.
I think you're absolutely right, and I think that we come to this with those [inaudible 13:01] preconceptions. If you're saying, "I don't like this product, and this is why I don't like it," and you make those into failures of the product, again, I think that comes down to personal opinion.
Where if you're coming to the product and you're saying, "How can I use this product to help me given the limitations and the advantages of the product?" I think, for example, Apple suggests that people typically set a low Move goal. That's what I do for rest days is I have a very low Move goal. Then, that's why they built in the 2x and the 3x rewards.
Those don't exist in the other circles. For this one I think it's important, because you can do what you consider your minimum workout. On the days your pushing yourselves, you get that 2x or that 3x. Then you have a scale to your achievements.
Psychologist: That's a great point. What I saw in the article is both how easy it is to become disillusioned with the tool and how easy it is to be hard on yourself, and to feel like...
Psychologist: ...never going to change. The truth is it is. We want change to be fast, we want to see it, and that's so very human. I don't think that we're as simplistic as a one-to-one behavioral reinforcement schedule though, and that's why the theories of behavioral change are so complex.
That's why there is no one quick, easy answer for staying healthy and doing everything you possibly could in the day to stay healthy. Some people do that, those are usually people who've made a career out of it. For those of us who have other careers, it really is about fitting it into your lifestyle in a way that's doable.
Just like you said, what most of us recommend is you pick one goal, and one goal that you're pretty close to achieving anyway. Maybe you're pretty good at actually standing and stretching your legs, so maybe that's going to be the first goal.
You set it, and then once you've achieved that, then you've got a success. Then you build on the next goal. Your next goal might be Move, and you set it to something that you're close to reaching so that you can just push yourself that little bit more.
Rene: Yeah, I like that.
Psychologist: You move it a little bit away, almost like what you do with a child that's just learning how to walk. They stand, and you're bending over your back, which is really, really horrible for you because it's painful. At the same time, it's so incredibly magical, because they're walking. Nobody expects them to run that moment, it's kind of gradual. That's what it is.
The bigger the goal, the bigger the stretch, the less likely we are to be able to go full tilt. One of the biggest things that happens, whether it's diet or exercise, is we get motivated. This is the New Year's pledge, where everybody joins a gym at the beginning of the year, and then they don't go through with it.
It's often because we aimed our goal in a way that we weren't either yet ready to do or were not able to sustain in our lifestyles. Really it is about something like taking the stairs once a day rather than maybe getting the full membership if you're not ready to do that. It's these small goals that you can put into your life so it becomes a lifestyle change.
Rene: That's very valid. I think when you first set up the Apple Watch, it asks you some basic scientific questions. It will try to make a template answer just to give you something to start with. Because if it didn't give you any goals to start with, you would just stare at that blank screen. You'd have paralysis through analysis.
Once you put that number in, it starts to look at your actual activity. Then if you're blowing past it, it'll suggest you raise it. If you're not quite reaching it, it'll suggest you lower it. Then quickly through your own behavior, it will try to find a goal that is attainable for you.
It's not like it sets an arbitrary goal, and if you fail it, it just makes you feel like a failure constantly. It's trying to give you something that you can build towards.
Psychologist: Absolutely. All of this is really different. Some people need a lot of that external reinforcement, and so it would be very crushing for them when they're not getting it. Some people don't need that.
The goals are less relevant. I'm one of those people where for me it's less about the goal part than about me getting to the end of the day and realizing that I was so focused on my administrative tasks, I actually didn't stand enough.
Then linking that into, wow, I actually have more pain today. Tomorrow, I'm going to make more of a conscious effort to really pay attention to when the watch tells me to get up and move, and maybe have a walking meeting. I think different people are able to link it to different ways that they motivate themselves or the different ways that they think.
Rene: Absolutely. One of the points in the article is that there's no data to say that you need to stand up for one minute out of the hour, but that's not what it is to me. I have a standing desk for various reasons, but I also often work from a couch, a coffee shop, or someplace where it's just not as easy to stand.
Then if I'm working, I will forget the passage of time. I'll forget to eat. I'll forget to sleep, and I will forget to stand. Having that thing go off, it's less about it going off every hour and asking me to stand for a minute, but of reminding me of the passage of time, that as a human being, I feed off of motion the same way that I feed off of food. If I starve myself from motion, I lose more and more ability to move.
Psychologist: Absolutely. At the end of the day, we often make this joke that we're so plugged into so many other things that you sometimes don't even know you need to go to the bathroom until you absolutely cannot wait to go to the bathroom. If you work in an institution, and all of the bathrooms are full, it's pretty bad.
You could get so into things that you didn't need or you didn't eat properly. One of the things that we have lost touch with sometimes is just paying attention to what's going on inside, and the internal monitoring. That could be about feelings. It could be about thoughts. We often talk about taking your temperature or taking your pulse.
It's also things like have you stood enough today? Have you walked enough today? Were you mindful when you were eating? Did you eat things that, at the end of the day, are going to balance out to cover all of the different nutrients you needed so that your body and your brain can function?
Altogether, it gives you a nice way to either be prompted if you forgot, and the busier we are, the more likely we are to forget. I also think one of the things that it does for us when we're in such a busy world is that it reminds us to pay attention to ourselves.
That's really important, because we're spending less and less time sitting and paying attention to ourselves, and more and more time being pulled in multiple directions.
Whether it's that the workday has extended because it's easier to reach people than it was before there were phones, or whether you've got multiple kids, or whether there's dings and bings going on around you. This gives you a moment to think about what's happening with you at the most basic level.
Rene: Totally. That mindfulness is so key. I don't want to get again down the rabbit hole. That self-care is so key. That also in the article is referenced to a calorie study which I think was not the best study in the world. It's also my understanding that coffee studies, or anything, science is not a road, it's a winding path.
Psychologist: You're right. Pick anything, and there are often multiple ways to...probably not anything. Somebody is going to find one thing that is absolutely certain.
Rene: There's always an exception. [laughs]
Psychologist: For many things, and particularly for something that's as complicated as health, weight loss, or getting healthy, there are multiple pathways for people to do it. So much is really about a fit.
When we're talking about health and wellness with colleagues, with patients, or with clients, one of the things that we definitely do talk about is it's a buffet. It's rarely going to be a one-size-fits-all. It's really about paying attention to what it is that you need, and finding that best fit.
One of the things that you notice that's similar in the behavior change theory, and there are multiple behavior change theories, because it's so broad and it crosses multiple professions like psychology, anthropology, and sociology. There isn't even one profession that's looking at this, because it's so complex. There are systems, and there are relationships. There's not just the individual person.
What we do know is you want to be clear at the end of the day about what your main goal is, because if you have 20 goals, you often end up with conflicting goals. You can't meet conflicting goals. You want to be clear what your main goal is, and your main purpose. Then you want to find a pathway that will allow you to achieve success, success consistently, and success as early as possible.
That's why a lot of people boil these goals down to smart goals -- specific, measurable, and achievable. Now I'm planking on the...
Rene: Quantified life. [laughs]
Psychologist: Exactly. It's really thinking of one thing. One thing that you're going to do now. Now that we are having this conversation, because I realize now that I sat all day, maybe my smart goal tomorrow will be to stand up on every hour, and make sure that I've done that.
It is measurable. You know the watch is going to track it for me, because it's really easy in day to think you stood up, and you didn't stand up, because it was three hours and you thought it was one hour. That is absolutely achievable. I can, for the most part, unless an emergency happens, make myself stand up. It's reasonable, absolutely.
I'm fortunate that I have the ability to control that in the work environment that I'm in. Now I got to tea, and I can't remember what tea is, but probably Apple can look that up. That's all to say there's a reason why people boil a lot of that stuff down to two smart goals, because it does focus you on something that you can do in the right now. Then you get that success, and then you move on to the next things.
Again, it's about making sure that you don't pick so many things that you're going to essentially decrease your ability to succeed in the way that you want to. Then you're going to get demoralized, and then you're going to lose hope. When you lose hope, it's a spiral down.
Rene: Yeah. Then you find a pro watch to blame. The last thing I wanted to ask is, I always have problems with these kinds of articles, because there's huge value in personal opinion. There's huge value in multiple opinions. I'd love to read how an Apple Watch failed somebody, because there's important lessons to learn.
The premise of this article was problematic for two reasons. One, it asserted that Apple didn't consult with behaviorists when making the watch. Based just on what I know of Apple, that's ludicrous.
They might not have gone out and hired people who write books about behavioral psychology, but you can probably make an incredibly safe wager that they have some incredibly deep talent on the people and the teams that were designing it.
The other thing is that when you start invoking science in an article, for the reader, it starts making it seem like it's not subjective, it's objective. It adds an authority to it that maybe shouldn't be added to an opinion piece. You can ask psychologists their opinions. Of course, absolutely. Please, do.
When the focus of the article makes it sound like science, and it's really not even pseudoscience, it's totally subjective stuff, that's dangerous, because it could make people who are already reticent about technology that is highly approachable and could be beneficial to them, it makes them scared and reticent about them, and then they might not approach it.
That is a huge loss. Not for the product. Not for Apple -- they're a huge company. They can take care of themselves -- but for people who could benefit from the hyper motivation that's available on these products.
Psychologist: That's a good point. As I'm looking at this, we know our viewpoint. When we learn about something, we subscribe to it, we tend to see it in that way.
One of the wonderful things about working with people from across different fields -- which is what they're encouraging people to do more and more, particularly for grants and research -- is you realize that any one of us, even in the profession, has a viewpoint.
By asking people from different professions, there could have been a psychologist, there also could have been a physiotherapist. You could have somebody from public health, who do such a great job in terms of behavior change. You have experts. They've multiple different behavior change theories.
You also have people, endocrinologists, who can talk to you about why some people might be able to do something and lose weight faster than other people. The truth is, it's so incredibly complicated that you could probably bring in anybody who's ever done anything to do with weight loss and behavior change, and it still wouldn't be a perfect tool.
Rene: Yeah. It reminds me of expert witnesses in a trial. They're there to advocate a viewpoint. They're not there to explain what is happening.
Psychologist: It's that complex. Something that I learned in the last couple of years -- and it's sad that only it's in the last couple of years -- is that research is broader than the randomized control trial that we often think about as being the best gold standard evidence.
First comes innovation, and then comes quality, and then there might be research. It's probably not on that one dimension, but all to say, all of those things are important.
When you think about Apple Watch, or if you think about the fitness trackers, yes, it's true that record keeping has gone on for a long time. There's a reason why it's gone on for a long time. It's effective. This is a new method of doing it. It's a new method of doing it that probably is wonderful for a generation that's primarily grown up with technology.
It's also a way for people to connect with each other about these things. The other thing that we know about weight loss, or eating well, or those kinds of things, is that if you tell people about it, you're much more likely to honor your goal. This [inaudible 27:07] the ability to tell a broader range of people.
Depending on who you are, there's a basic package. That, in and of itself, was the innovation. That's an amazing thing. The thing about an innovation is you start with something, because you've got to start with something, otherwise you could spend forever asking everybody, and you'll probably never get the product out.
You start with something, and then you collect data, and you look at it, you finesse it, you fine-tune it. What I think is wonderful is it started a movement where different people started to create apps. That's an innovation, and you see more and more researchers doing it as well. Isn't that wonderful? There's some research going on in Parkinson's, and a number of different things.
Rene: Heart studies now.
Psychologist: Isn't that amazing, because then it allows you to think about, for me, what is it that I'm going to take? What am I going to do? What's going to be the next add-on that I'm going to add for myself in order to get me to achieve my goal? That's the next step.
What's important about that is it's allowing people to really take a moment to think about what it is that's the best fit for them? What might be able to help them to get to where they need?
There are going to be some people where it isn't going to work for them to use their phones or their watches. They're going to benefit more either from treatment -- a treating professional, whether it's physician, or a psychologist, or whomever.
There's some people where there's a reason why weight watchers' groups or some of those other groups are so popular. The biggest piece is they need that in-person social connection, or they need that walking buddy, or they need that cooking buddy.
Again, it's really about knowing yourself, and what is it that gets you going? What is it that keeps you going? Then you set that system up.
Rene: I love that point. Looking back now, you made me actually think about it, when the Apple Watch launched, it had very basic activity circles. That was good if you were intrinsically motivated, if you wanted to work with the rings and see what you could do with them, what you could achieve with them.
Then they added activity sharing. I share with a bunch of people, and I get alerts. One of my friends in California, I get alerts from her like 5:00 AM, or Megan Morrone from TWiT. She gets like five workouts in a day, and it's incredibly motivational for me. Also, I know they're getting my alerts. That prompts me. I don't want to be the only one left behind.
That gives me that intrinsic motivation to go out and do it. Now they have the coaching, where it says you can still make your stand goal. You can still just go out for a 10-minute walk. Just go out for a 20-minute walk. You can fill your rings. That's a reminder that it's not that hard. I still have a chance to do it. I didn't forget about it. It's not all hope is lost.
As you get more and more people, there's now tens of millions, probably towards 50 million people with Apple Watches now, and they're getting back all these data from all these different people. People who are turning it off, people who are turning it on. People who are using some features, not other features. People who are giving them feedback.
They can refactor that in. There really, really are a lot of experts at Apple, behaviorists and beyond that. They can look at all that and figure out what the next step in this is going to be.
Psychologist: Absolutely. You just said it perfectly, which is at the end of the day, it's about figuring out whether it's a good working system for you or it's not. If it isn't a good working system, that's OK. Nothing works for everyone. What are you going to let go of? What are the parts that you actually do like? How do you stay hooked into those?
If the tracking or the health app isn't the thing that keeps you going, maybe it's that you can listen to music on your watch, and that's what keeps you going. Maybe it's that you can access recipes on your watch, and that's what keeps you going.
That's only one tool in the entire watch. If you look at all the other tools there, there are other ways to link those things -- because it's all about lifestyle -- into changing your health behaviors.
I think for all of us it really is about taking that moment and saying just because that works maybe for the majority of people, or just because they thought that would work for the majority of people, doesn't mean it's a best fit for me, and that's OK.
Rene: Yeah, I think that's true. The thing is to recognize when something is not working for you rather than something is not working, when the problem is your interaction with the system and not the system.
I've used this analogy before, but there are a lot of really dumb movies that I love, and a lot of brilliant movies that I don't particularly like. The objective and the subjective are completely different things. Your opinion about each is valid. You've just got to be clear about which one there is, because other people have a harder time sorting through it if you're not.
Rene: All right, well thank you so much for spending your time and agreeing to do this on incredibly short notice. I just wanted to make sure that because people were talking about it in a scientific way that I actually talked to somebody in the field and got at least another opinion about how [laughs] this stuff works.
Psychologist: My pleasure.
Rene: Thank you. I'd like to know what you think about all this. If you use an Apple Watch, if you use Activity, if it's working for you, if it's not working for you. If you like the idea of rest it. Just anything, any of your thoughts on this, let me know, @reneritchie on Twitter, firstname.lastname@example.org if you want to send me email. Whatever works for you, that's great.
I want to thank you so much for listening. That's the show. I am out.
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