Motivating behavior is related to maximizing rewards and minimizing dangers as explained David Rock in the NeuroLeadership Journal (Issue One, 2008). SCARF: a brain-based model for collaborating with and influencing others. Understanding the SCARF model domains can increase our understanding of what drives motivation and decision making.
The SCARF model involves five domains of human social experience:
1. S = Status; Our relative importance to others
2. C = Certainty; Our ability to predict the future
3. A = Autonomy; Our sense of control over events
4. R = Relatedness; Our sense of safety with others (e.g., friend vs. foe)
5. F = Fairness; Our perception of fair exchanges between people
According to Rock, these five domains activate either the ‘primary reward’ or ‘primary threat’ brain circuitry. Rock provides the following example: “…a perceived threat to one’s status activates similar brain networks to a threat to one’s life. In the same way, a perceived increase in fairness activates the same
reward circuitry as receiving a monetary reward.” The SCARF model enables healthcare professionals, coaches and educators to better understand the subconscious drivers of human behavior. By knowing for example that a lack of autonomy activates a threat response, healthcare professionals may seek ways to increase patient engagement in their own long-term care planning. Similarly, knowing that increasing relatedness can trigger a reward response, healthcare professionals may seek to take a more empathetic and collaborative (vs. dictatorial) approach to patient communication to increase motivation.
Louise Huneault
Regional Lead and Business Developer
Europe
Duane Reade recently unveiled its newest retail platform in New York, powered by WalGreens which it touts as the “drugstore of the future.” (see photos http://drugstorenews.com/article/duane-reades-new-flagship-glimpse-drug-store-future)
Undeniably, the store concept is aimed to increase shopping basket with new fresh food, the Look boutique, sushi station and what I would call “Self Care Nooks.” This new store concept is infused with technology innovations to improve shopper experience.
This is just one of the recent proofs of the rapid influence of “self care” in pharmacy/drugstore retailing where the industry recognizes that "patients are consumers” because they need choices in order to find solutions to prevent, maintain, enhance and restore their health. In the past, retailers adopted the Health and Wellness corners, the issue with this concept is that it recognizes that Health and Wellness is the destination and aspiration of consumers but it is really Self Care that is the actionable behaviour.
So when retailers integrate “Self Care” throughout the store rather than isolate it in just one corner, consumers find it much easier to adopt new health solutions, new products or services because they are able to act on their health goals, hence can be more accepting of the prescribed or suggested behaviour change.
Could this be the ideal consumer state? Go and scour your local pharmacy retailer and be the judge.
Grace Soyao
Founder & Chief
Strategy Officer
I cannot imagine not eating breakfast. For me breakfast can be as simple as a bowl of oatmeal, a smoothie, miso soup with green peas, or boiled eggs. What I find baffling is despite all the breakfast fare that now comes in all types and shapes of boxes, paraded with mighty health claims, a recent survey by Kellogg revealed that most Americans forgo eating breakfast. This survey reported that while most Adults (54%) revealed they would like to eat breakfast, only 34% actually do. The more disturbing part is that Moms (89%) shared their desire for their children to eat breakfast everyday, however, 40% reported that their child doesn’t get their daily breakfast routine http://drugstorenews.com/article/kelloggs-survey-finds-many-americans-forgo-breakfast. WHY?
Many years ago, when we started visiting friends and family in the US , we always wondered why most people were willing to trade breakfast for a Latte or Espresso-Venti from Starbucks or kids could go by and hop into the car for school with only a half glass of milk. In the last 10 years of living in North America, observing people’s lifestyles and mixed culture formed against a backdrop of innovative breakfast fare available, it appears that the “breakfast territory” is losing ground to a sea change of people’s attitudes and behaviour toward what we (Nutritionists, Dieticians, Moms) believe is the most important meal of the day. Years of research and conventional wisdom tell us that meals and food are intertwined with social activities. It is a way to bond with people, to share stories, to celebrate, to let loose.
So…where does a bowl of cereal fit into the social norms associated with food and meals?
Grace Soyao
Founder & Chief
Strategy Officer
But now, going to the dentist really means going to the dental office.
Sometimes I don't even see the dentist anymore. I see the Dental
Hygenist. And, it's all about prevention. Floss to prevent this...use a
gum tool to prevent that...brush properly to prevent cavities, and on and
on. "Look at the x-ray, your teeth are wearing down sir, you should
use a mouth guard." Are you kidding? But, every day I floss
and every day I brush several times. In fact, I couldn't imaging NOT
doing it. Yes, the dental industry has got it right.
Did it happen overnight? Of course not. But it sure is a good model
to think about for the rest of our body parts.
Bob Waite
Senior Vice President
In the recent Health Evolution Partners Innovation Network Leadership Summit 2011, one of the themes that generated robust attention was what they termed as the Emerging "Health Super Consumer" who has evolved to become savvy in the use of health technology, collaborative decision making and self care of chronic diseases. I would in fact venture to add that this “super health consumer” is strongly supported by “super caregivers and advocates”. The rise of social media has essentially lit the firepower of patient and consumer decision making with access to more information, decision aids, influencers and platform to participate in creating better health solutions for better quality of life.
Our Super Health Consumer has begun to utilize technology to improve their health literacy and support their health decisions– great starting point! Up next is the area of the patient/user- driven innovation. In 2009, a pilot project (sponsored by the Nordic Innovation Centre) on bedwetting was completed in collaboration with Herlev Hospital (Denmark) based on the context of the “citizen-driven innovation” (Borger 2030, www.borger2030.dk). The target audience of this project were either the parents (caregivers of children) or the children, depending on who’s burdened. This research, however focused on understanding parent attitudes, behaviour and needs through storytelling. Innovative solutions on specific problem areas such as diaper aides, ringing devices including the role of teachers were generated from this user-driven research.
R & D will certainly continue to be part of healthcare solutions development but the industry will begin adopting the CPG companies’ consumer-centric innovation process as more patients and consumers demand participation. Who’s quality of life is at stake anyway?
Grace Soyao
Founder & Chief
Strategy Officer
Balancing the different factors in making treatment choices can be a real juggling act. For physicians, the main considerations tend to be drug efficacy, safety profile, adverse effects, and price/access. But what about patients? When they leave their physician’s office, what are they thinking? What shapes their decision to go with a particular treatment and stick with it - adhering to the plan?
It would be safe to assume that patients juggle some of the same elements as the
physician (though their weight-importance might vary e.g. biomarkers may not be
as important as symptoms and signs.) But published health psychology research
and our primary research at Self Care Catalysts suggest that patients
arguably have a more complicated juggling task.
In the simple case of antibiotics for a child with an ear infection: the parents want to ensure their child gets the full treatment of antibiotics at the right times but are heading on a car-trip family vacation the next week. Does the parent have to bring a cooler and ice packs, or do they just stop treatment – the child hasn’t finished the bottle, but seems a lot better. What if the physician-patient conversation revealed that it is crucial to complete the treatment but they could take antibiotics that don’t require cooling instead?
Decisions are made not only in the interest of their physical health but also shaped by how they currently feel and expect to feel.
In the case of chronic/long term conditions that are largely asymptomatic (hypertension, diabetes), they may be more influenced by immediate uncomfortable symptoms (mouth, fatigue) rather than their blood pressure or blood glucose readings. I don’t feel sick, so why check my levels right now?
Patients and caregivers have to juggle the demands (in energy, expense, time, mental effort) of managing their disease with that of other important roles in their life. They are not simply patients, but are parents, professionals, spouses etc. The demands of managing their illness are weighed against these other demands.
That’s why we consider them as consumers, referring to the person living with the illness. They juggle multiple roles and priorities in their day-to-day life.
Is there alignment between physician and patient health and medical decision making? If we ignore the other balls being juggled, how does that impact the success rate in patient adherence? By focusing on the consumer within the patient, the conversation can lead to better adherence, better marketing programs and better health.
Grace Soyao
Founder & Chief
Strategy Officer
“Consumer within the patient” could be diminishing the patient journey but it is really about understanding how patients actually manage their health. In reality, people don’t even want to be labeled “patients” they are people; but the moment they begin thinking about their health decision considerations to make their ultimate choice,– people are transformed to consumers; whether it is to choose a treatment regimen, diet and nutrition, lifestyle modifications or even the decision to decline a choice.
Recently, we investigated the patient journey of people with metastatic colorectal cancer. For them, it is a race against time. Their choices after chemotherapy are either to find other therapies that will slow down progression of malignancies or just to accept what inevitably will come. But patients are faced with decisional conflicts usually surrounding the pain of seeing their family struggle and their hope to buy more time. For some of these patients, there is still that “moment” which they hope to capture; hence the need for choices outside of the traditional regimen offered by their healthcare providers. Even at this point, this patient becomes a consumer because he seeks options beyond the standard of care.
In another project we did on menopause, we found women above 50, many in menopause, have their own unique health journeys… tossing and turning in bed and staring at the ceiling at 3 AM, joint pains, surprising wrinkles, changing relationship dynamics, etc. Interestingly, these women carve unique alleyways to deal with their health. Some are just determined to take all these in stride, committed to take an all-natural route and accept the aging phenomenon (with eyes closed), while some just can’t wait to hear the latest news that will reverse guidelines on use of HRT (with exuberant expectations). To quote the North American Menopause Society “Conclusions: Recent data support the initiation of HT around the time of menopause to treat menopause-related symptoms; to treat or reduce the risk of certain disorders, such as osteoporosis or fractures in select postmenopausal women; or both. The benefit-risk ratio for menopausal HT is favorable close to menopause but decreases with aging and with time since menopause in previously untreated women.” Whether this evidence-based position statement will change attitudes and behaviour of both clinicians and patients toward the use of HRT or not, the final decision will always remain among the women who are secretly hoping for a new choice or those who will choose to walk the fine line between toughing it out and ‘giving in.’ These consumers have difficult choices, but they seek quality of life most of all.
Grace Soyao
Founder & Chief
Strategy Officer
In today’s health and wellness climate – whether it’s to restore, treat, enhance, or prevent disease, people have greater information and knowledge, more health management choices, greater self responsibility, and more desire to control their own health. For health marketers, understanding self care is integral to understanding your market and what we call ‘finding the consumer within the patient.’
I like to think of health choices as a pie...
Today, if treatment choices were a pie, the consumer is considering many slices; diet, OTC, prescription, supplements, prayer and even ‘time with their pet’; and what’s more interesting, is that the pie is different for every condition type. (I was surprised when our BeePoll showed that in America, 11% of people use Spirituality to treat their Eczema!)
And with more choices, or pie pieces, comes more ability to consider how the options fit their quality of life, or the overall pie plate if you will. Health claims on packaging, efficacy statements, and physician recommendations are now the pie crust, on which all the filling sits. Gone are the days of a physician saying “take two of these and call me in the morning.” Self Care is transforming the consumer from the passive, treatment-oriented patient of the past, to the proactive consumer of the future.
Consumers want good pie, and they want lots of it!
For marketers, to ignore the impact of self care behaviour is to get an incomplete or even incorrect picture of their customer. Whether your product is the crust, the filling or even the whip cream, it’s all important to understanding that pie that is your consumer and their condition. Where does your product fit in? Can you get a bigger piece? Can you make the pie plate bigger? Do the other ingredients enhance your product offering?
Self care can be a complement, a competitor or both. Either way, it’s better to know than to go off half-baked – don’t pretend you’re the best cake in town when there is pie lurking in the next bakery.
Now, enough about pie, I’m trying to manage my diet!
Director Sales and Marketing
