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Introducing the Human Behaviour-Change Project (HBCP): Using Machine Learning and Artificial Intelligence to improve behavioural science

ucjubil11 April 2017

By: Dr Emma Norris, Dr Ailbhe Finnerty and Prof Susan Michie

The need

Human behaviour needs radical change to protect our individual and collective health and well-being. To achieve this, we need to develop more effective behaviour change interventions, tailored to the behaviour, population and setting. The Human Behaviour-Change Project (HBCP) is working to build an Artificial Intelligence system to continually scan the world literature on behaviour change, extract key information, and use this to build and update a model of human behaviour to answer the big question: (more…)

Cross-sector collaboration in digital health

Carmen E Lefevre8 October 2016

By Dr Fiona Adshead, Chief Wellbeing Officer at Bupa

Earlier this year, at the UCL Behaviour Change Conference on Digital Health and Wellbeing, I chaired a thought-provoking discussion on Challenges to creating sustainable, high impact interventions.

One of the central themes of that discussion – and of other conversations over the two days – was: how can we get better collaboration across academics, researchers, healthcare professionals and industry in digital health.

Why is collaboration so important?

If there is one message that came through loud and clear it’s that digital health isn’t just about digital.

Whilst digital technologies offer us unprecedented ways to engage, enable, quantify, measure and tailor interventions – digital health fundamentally comes down to changing human behaviour.

Those who attended the conference may remember the brilliant video ‘Uninvited Guests’, wherein an older man has a range of ‘smart’ devices to improve his health foisted onto him by his well-meaning children. What this video so wonderfully demonstrates is that technology alone does not guarantee better health, where human beings and behaviour are concerned.

The best technology is useless without designing for context and starting from a deep understanding of the individual. Harnessed properly, however, technology can play a powerful role at every stage of the behaviour change journey – offerings us scalable, targeted and economical ways to transform outcomes.

Without collaboration across sectors, we cannot fully address the complex, multi-faceted challenges of creating sustained behavioural change, or realise the full potential of what can be achieved.

We need to bring together different perspectives, resources, evidence and creativity to properly understand the problems we want solve and how we can best do it.

What works?

There is no ‘one size fits all’ approach to effective collaboration, but there are certainly some guiding principles.

Collaboration of any kind – even within an organisation or within a single sector – is inherently challenging. Differing priorities, ‘cultural’ differences and conflicts of interest can all stunt effective collaboration. However, if managed well, they can create a very positive tension, driving innovation and dynamism.

For me, some key principles are:

  • Choose the right partners: As in life, the right partners are not necessarily those who are most similar to us, but those who share our underlying values and complement our strengths. It may be less about sector, and more about ambitions and what skills and resources each partner can bring.
  • Don’t overlook the private sector: Speaking from my current vantage point in industry, it is important not to see the private sector as one homogenous group. It is a much more nuanced landscape of different kinds of businesses, with different values, business models, geographical footprints and expertise. By thinking more laterally about who you might find shared value with, you can unlock collaboration opportunities beyond the traditional territories of corporate sponsorship or charitable donations.
  • Find the shared value: It is very tempting to start from what matters to us and what we need. However, just talking about what we care about tends to switch others off. Whether you’re approaching potential partners or working together on a shared agenda, it is really important to focus on shared value. You need to understand each others’ priorities, and find the areas of overlap. During my time in Government, I saw many people come to speak to ministers about a particular challenge or cause. Very few would think through why it was relevant to the minister, but if they did come at it from that angle, they got far better results.
  • Agree on a clear, common goal: Simple to say but often hard to do – you need to be clear on what you are trying to achieve. If your ambition is clear and owned by all, it is much easier to overcome any conflicts or challenges that arise.
  • Recognise and encourage diversity: It is often easier to work with familiar organisations, people, evidence or techniques. However, the point of collaboration is to reach a whole that is greater than the sum of the parts. So we need to look beyond the obvious and be willing to leave our comfort zones. We need to accept and respect differences, find ways of working that play to everyone’s strengths, and be clear about what each party can bring.
  • Be human: Collaboration is ultimately about people and power, trust and relationships. When it is successful, it is because those involved are willing to give up some power to others. Collaborative relationships must be characterised by trust, transparency and a willingness to have frank conversations in the pursuit of a common goal

 

Putting it into practice

Collaboration is something we are passionate about at Bupa – we know we can unlock far more with others than we can alone. By working with UCL’s Centre for Behaviour Change we aim to bring evidence into our practice, and share what works to create tomorrow’s evidence.

As someone who has worked across sectors – at Bupa, the WHO, in government and as a doctor – I know it can be hard to cross the barriers between public, private, NGO, IGO and academia.

It can initially seem we are coming from totally different worlds and – even if we find potential partners – we are speaking different languages and can’t get genuine, effective collaboration off the ground.

However, I genuinely believe these are barriers that can be and should be overcome – by following principles like the above and being open-minded to the possibilities.

The bottom line: try to think laterally about who you could work with. Don’t start from their sector, start from their values and ambitions. And always think through how you can approach people in terms of what matters to them, as well as what matter to you.

You never know – they might be as passionate about improving health by changing behaviour as you are.

BIO: Fiona is Bupa’s Chief Wellbeing Officer, and is responsible for globally leading work on wellbeing, behaviour change and workplace health. Before joining Bupa, Fiona was Director of Chronic Disease and Health Promotion at the World Health Organization, with five years’ experience as Deputy Chief Medical Officer and Director General in the UK Government, responsible for health improvement and health inequalities. Fiona is currently an international adviser to the Royal College of Physicians, a visiting Professor at UCL, Brunel, Exeter, and the Chinese University of Hong Kong. She is a Senior Associate at Cambridge University’s Sustainability Leadership Programme, where she teaches regularly. Fiona is also a trustee of the UK Health Forum and the London Sustainability Exchange.

If You Build It, Will They Come?

Carmen E Lefevre28 September 2016

By Dustin DiTommaso, Behaviour Change Design department head at Mad*Pow

We are in the (messy) midst of a digital health renaissance where health systems, insurers, big pharma, governments, tech giants, startups, behavioural scientists and health researchers are exploring digital technologies to transform the ways in which healthcare is delivered and patients and consumers engage in beneficial health conducive activities. A noble cause to be sure, as many of our infrastructures for providing quality care are in need of radical innovation. Arguably, at the center of our efforts to improve outcomes, lies human behaviour and our attempts to influence and direct it through the provisioning of mobile apps, web platforms, wearables and the like. Well-designed, evidence-based digital behaviour change interventions carry tremendous potential to positively impact clinical, economic and distributional outcomes but these objectives can only be met if and when people engage with them. This leaves us thinking about how to address the perennial question of “If you build it, will they come?” and how to best go about developing digital interventions with impact.

When we survey the digital landscape we find no shortage of tools and services available for public consumption, some highly rated and quite popular (e.g., 4/5 star ratings, millions of downloads) and others much more modest in their reach (e.g., less than 500 downloads). While many of us know, and more continue to discover – “Popular does not equal effective” and yet being effective requires a certain amount of popularity. Our process for designing and implementing digital interventions must not only be thoughtful and precise in terms of change objectives and outcomes but also in promotion, rollout, uptake and usage. To this end, it can be most productive to take a multi-disciplinary approach to the design and implementation of digital interventions where those expert in the underlying mechanics of change and intervention design (e.g., health researchers & behavioural scientists) collaborate with those expert in creating products and services that provide value and resonate deeply with their target audience/customer base (e.g., experience/service/interaction designers & marketing/content strategists). Hybrids welcome, of course.

In this configuration, research and science lead the framing and diagnosis of the problem space and the intervention design strategy (i.e., intervention functions, behaviour change techniques, etc.) while designers and strategists work to codify the unmet needs, wants and preferences of the target audience to guide the voice and tone of the intervention copy, value proposition and persuasive communication strategy and supporting artifacts. Creative translation of the intervention design strategy into a solution that is appealing, engaging and valued while retaining the fidelity and intent of the intervention functions and behaviour change techniques is where art and craft meets science (and trial & error). Close collaboration and iteration is critical here to ensure that the active ingredients of a digital intervention are being delivered in ways that are maximally consumed by the intended audience.

As digital interventions often require active opt-in via download, sign-up or sign-in, recipients must be both aware that it exists and interested in engaging with it. Creating a persuasive messaging strategy that details the audience relevant benefits as well as where and when to reach them along with a staged roll-out plan for how to scale up to critical mass while learning and adapting along the way is where content and marketing strategists can really shine. This iterative approach also applies to the development of the digital intervention itself, of course.

Though there are certainly several different configurations that teams can take, collaborative approaches like the ones outlined above help to align resources on all sides of the impact equation – uptake, engagement and outcomes – allowing each team to focus on what they do best and maximizing the chances that the digital interventions developed together will have the greatest intended effects possible.

What collaborative configurations have you tried in the past? What has worked well and where have you gotten stuck? Where do you think the greatest opportunities for collaboration lie? I would love to learn about and discuss your experiences in the comments below!

 

BIO: Dustin DiTommaso heads the Behaviour Change Design department at Mad*Pow and teaches Behaviour Change Design at Rhode Island School of Design. A designer and researcher, Dustin’s work involves the study and application of behavioural science, motivational psychology and human-computer interaction to the design of technology-assisted behaviour change interventions, products and services. His client portfolio includes partnerships with a range of innovative start-ups, non-profits, government agencies and Fortune 500 companies across domains, including healthcare, financial services, education and social impact.  

Academic collaboration – a startup point of view

Carmen E Lefevre20 September 2016

By Dr Jussi Tolvi, co-founder and behavioural lead at Club Soda

Club Soda is a social startup business. We use technology to help people set goals for their alcohol use, and to reach those goals. We also work with pubs and bars, nudging them to being more welcoming for mindful drinkers – customers who want to drink less or not at all.

One of the key values of Club Soda is to use evidence in everything we do, from product development to content creation. We benefit enormously from research findings, seminars and conferences, and talking to academics about their work. And we know that our customers (though we prefer to call them members) also like it that we have some science behind us.

We would like to do more research and evaluation work ourselves as well, but the reality is that we just do not have the resources for much of it at the moment. Most academic research grants may not be measured in millions, but we have to make do with much less, and without secure monthly salaries to fall back on.

And we would love to collaborate more with our academic partners. Of course we will always help them find study participants when needed, and will happily share what we have learnt. But we also have to think of ourselves a bit: if a grant funded academic team creates an app in our domain, it might not be in our best interests to have that app freely available to our potential paying customers. We will always have to have one eye on revenue to pay for our continued existence.

Understanding consumer demand is not a bad thing for academic research either. There is real value in learning from and about people who have made a choice, and spent their cash on a product or service offered to them by a business. Club Soda is more than a set of behaviour change techniques. We offer people membership in a tribe: who you get sober with is as important as who you get drunk with – and we know there is fascinating research material in our community on this topic too!

There is bound to be some tension between academia and business. Sometimes we will have shared aims, sometimes not. We won’t always understand where the other one is coming from. But we believe it is beneficial for us both to keep cooperating, learning from, and sharing our unique areas of expertise.

With that in mind, I wonder whether there are particular types of businesses that academic researchers would prefer to work with?

BIO: Dr Jussi Tolvi is a former academic and City worker, now co-founder and behavioural lead at Club Soda, a startup nudging people and licensed venues towards healthier and more mindful drinking. He studied economics before behavioural economics was fashionable, so has had to work hard to forget most of what he learned at university.

Academics working with industry: Opportunities and challenges

Carmen E Lefevre12 September 2016

By John Blythe, Research Associate at UCL Centre for Behaviour Change

If you work in academia or industry, you will have at some point heard about the benefits of collaborating with one another. This may have been through public engagement discussions or from your research and business department. Industry and academia are often seen as quite separate entities, where one is fast paced, organisationally driven, and the other is slow paced and research driven. Either way, knowledge transfer between the two is important for continued development of the sectors. Industry can play many important roles in academia such as acting in an advisory capacity, to participating in research projects or providing sponsorship for internships, research projects and knowledge transfer partnerships. In this blog post, I will be talking about my positive and negative experiences of working with industry for study participation.

My previous work has involved research into organisational psychology so understandably working with industry is part of what I do. Studying employee behaviour requires access to actual employees, and as such, the many difficulties and challenges that are associated with participant recruitment. The positive sides of using organisational samples is that you can have measurable impact by providing organisations with feedback reports of study findings which can be used to improve organisational practice. You are also given access to a real world samples and the opportunity to explore occupational behaviour in its natural setting. In an ideal scenario, you would be given access to many employees and those employees would be allowed to complete your study during working hours. Realistically, organisational recruitment is a difficult task and not one that we are necessarily trained to do (as psychologists anyway).  Limited time resources, restricted sample access or withdrawal from studies are just some of the many issues you may face.

My experience of working with industry has largely depended on the nature of the topic I am researching. When I have researched employee wellbeing, access to occupational samples has been relatively straightforward as it is often of interest to the organisation’s HR department. These departments often welcome this kind of research as it is in line with the strategic aims. However, for the last four years I have been exploring cyber security behaviour in organisations. This hasn’t been the easiest topic to recruit for. HR departments weren’t as interested in the topic as it is not something that was of the greatest concern to them, and often considered to be the problem of IT departments. I encountered greater interest and engagement from stakeholders when I worked with individuals from IT departments, but that often brought about new issues as they did not often have access or the authority to give me access to the employment samples. Furthermore, organisations do not want to be associated with poor cyber security practices which can often be identified in this kind of research, and this was an issue that hampered recruitment. You may remember the TalkTalk[1] or LinkedIn[2] breaches that have plagued the media in the last few years and the ultimate impact of this on their business reputations. Understandably these stories create concerns for companies. However, these reputational concerns can be alleviated through non-disclosure agreements (NDAs). Ultimately, the process of organisational recruitment requires perseverance and contingency planning to ensure timely completion of your project.

Here are some tips for aiding your organisational recruitment:

  1. Accessibility of your research – draft a research proposal, highlight benefits for taking part and make it easy to understand for your target audience
  2. Identify the right stakeholder – find the department most interested in your study findings or input
  3. Manage relationships – things happen a lot quicker in industry and by the time you have gone through the many research procedures, they may no longer be interested. Ensure timely updates and be transparent during initial contracting.
  4. Alleviating concerns – consider NDAs or any other contractual or legal issues such as intellectual property during initial stages if the topic is particularly sensitive to the organisation

Researchers, what tips do you have for working with industry? And those in industry, what are we researchers missing?

 

BIO: John is a Research Associate at the UCL Centre for Behaviour Change and conducts research on the interaction between work, technology and psychology. His previous research has focussed on changing employee cyber security behaviours, understanding users’ trust in e-health websites and exploring the links between employee engagement and occupational performance. Currently, he is investigating protective behaviours in the context of the Internet of Things as part of the PETRAS Hub (http://www.petrashub.org/). 


References:

[1] https://www.theguardian.com/business/2016/feb/02/talktalk-cyberattack-costs-customers-leave

[2] http://fortune.com/2016/05/18/linkedin-data-breach-email-password/