Understanding How Behavioral Theories Impact Health Plans’ Digital Engagement Strategies

Why do people behave the way they do?

Health-related decisions significantly influence individual well-being. Deciding whether to undergo a colonoscopy, get vaccinated, continue medications, or schedule an annual wellness visit are crucial choices that can be daunting. Individuals require guidance and support to navigate these decisions effectively. Research from behavioral scientists indicates that the most effective way to encourage health-related actions is by understanding a person's motivations and the logistic and psychological obstacles they face, and then tailoring interventions to address these factors.

Over the last 50 years, scientific research has advanced and validated many theories that model and explain decision-making processes. One such theory, the Theory of Planned Behavior (TPB), proposed by Fishbein and Ajzen in 1985 and further refined in 2010, has been extensively applied within real-world healthcare to predict and influence human behavior. The TPB suggests that our actions, such as getting a flu shot, are driven by our attitudes (e.g., belief in the vaccine's efficacy), perceived social norms (e.g., what others do or expect us to do), and self-efficacy (e.g., our confidence in our ability to get vaccinated). These factors, shaped by our experiences, can also be altered through exposure to new information, thereby leveraging persuasion to effect behavioral change.?

In simple terms, understanding why individuals avoid certain actions, such as undergoing a colonoscopy, significantly enhances the likelihood of persuading them to take these important health measures

For health plans and systems managing tens of thousands of members or patients, scaling theories like the Theory of Planned Behavior pose a significant challenge. Understanding individual motivations typically requires in-depth interviews conducted by well-trained representatives. While this method may be feasible for hundreds of members, it becomes impractical when dealing with thousands or millions of members.

MedOrion bridges the gap between behavioral science and scalability, allowing plans to apply behavioral theories at scale within the quality improvement space. Our platform integrates dozens of behavioral science theories with AI to uncover member-specific barriers to action and automates member engagement based on these tailored barriers.?

At the heart of the MedOrion solution is the EBR: Electronic Behavioral Records. Inspired by medical record technology, the EBR documents members’ behavioral data in the form of a decision model. This data enables health plans and systems to gain a continuous understanding and overview of members' psychological barriers and motivation for health-related decisions. The EBR allows health plans to shift from a generic 'persona' approach to truly personalized and individualized behavioral management.

The solution is deployed across leading national and regional health plans, showing excellent results in medication adherence, HEDIS measures, and more. It often improves outcomes for populations previously considered 'lost causes'.

Resources:

Ajzen, I. (1991). The Theory of Planned Behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211. https://doi.org/10.1016/0749-5978(91)90020-T

Fishbein, M., & Ajzen, I. (2010). Predicting and changing behavior: The reasoned action approach. New York, NY: Psychology Press.