Why have we been more successful with behavior change in the retirement domain than in the exercise domain? David Laibson, Chair of the Department of Economics at Harvard University, describes three critical elements for successful behavior change intervention: preexisting motive, a set of barriers to overcome, and a “universal bulldozer” — a cheap, scalable intervention that has universal capability to overcome all barriers.
It took 40 years, but the retirement domain successfully built a universal bulldozer that automatically moves money from a worker’s paycheck into her savings. In the exercise domain, many behavior change efforts have built “partial bulldozers,” such as gym access. But knocking down one barrier still leaves the others upright. To achieve successful behavior change, argues Laibson, we need to build complicated systems from the perspective of the designer that are simple for the user.
From the NEJM Catalyst event Patient Engagement: Behavioral Strategies for Better Health at the University of Pennsylvania, February 25, 2016.