What’s Next Health: The Motivation Bias

Nov 27, 2013, 7:00 AM, Posted by Pioneer Blog Team

Debra Joy Pérez, vice president for Knowledge Support at the Annie E. Casey Foundation Debra Joy Pérez, vice president for Knowledge Support at the Annie E. Casey Foundation

Each month, What’s Next Health talks with leading thinkers about the future of health and health care. Recently, we talked with BJ Fogg, director of the Stanford Persuasive Tech Lab, to discuss motivation versus ability, and to better understand which matters more in creating long-term change. In this post, Debra Joy Pérez, former assistant vice president for Research and Evaluation at the Robert Wood Johnson Foundation, who is now working with the Annie E. Casey Foundation, shares her impressions of BJ’s model and how it might impact the work of organizations like ours.

By Debra Joy Pérez

There is something magically simple in how BJ Fogg’s Behavioral Model addresses behavior change. When just three elements coincide—motivation, ability and a trigger—behavior change happens.

From my own experience, I can tell you that BJ’s model can work in developing new and healthy habits. I heard from BJ that immediately after he pees, he does push-ups. He is attaching a new habit he wants to create to an old habit he already has. Every time he relieves himself, he is triggered to perform a simple action that has him looking and feeling healthier. Like BJ, I wanted to improve my health (motivation)—specifically, I wanted to drink more water. My trigger was green tea. I drink a lot of it, so after each cup, I remember to fill the empty cup with water. I’m pleasantly surprised when I see that I’m nearing half a gallon by the middle of the day. It's working.

WNH logo- no Pioneer branding 2-14-13

What does this mean for our field and trying to get more people to engage in healthy behaviors?  I’m afraid to say that there have been some biases in our approach that limit our effectiveness to increase healthy behaviors—and both have to do with motivation.

The first bias is that we too often emphasize the motivation part of the equation, thinking that healthy behavior is often just a question of personal choice or individual will. If we could motivate people to exercise more, or eat right, they would. According to BJ, this is the most difficult lever to move. It's really hard to motivate someone to do something they don't already want to do. If we increase people’s motivation but haven’t done anything to increase their ability, if we haven't made the behavior easier to do, then all we have to show for our effort is frustration—ours and theirs.

This leads to the second area of bias and perhaps the more dangerous one. If we believe that motivation is key, and that less healthy behaviors result from unmotivated people, then when we look at vulnerable populations who disproportionately suffer from poor health, we are led to think that this is a question of their own personal motivation or will. The reality is that when it comes to healthy behaviors, you can find motivated and unmotivated people equally spread across the socioeconomic and education spectrums. What you won’t find spread equally is ability (in the form of time, resources, and access). It’s also just as likely you won’t see nearly as effective triggers or prompts promoting healthy behavior for those more vulnerable among us.

So if we want to create more behavior change around healthy habits for all people, wouldn’t we be best served to find and invest in more ways to make healthy behavior easier to do—to increase ability? And then once people have the motivation and ability to change, to find the right triggers? Isn’t that what making the healthy choice the easy choice really comes down to?

We can already see how this happens across some of RWJF's grants. Working with the Safe Routes to School National Partnership, we don’t motivate kids to walk or bike to school without first making sure there is the ability to safely do so. With our work through the Partnership for a Healthier America, we don’t ask Americans to eat healthier or be more physically active. We first work with companies and organizations to make sure that healthier options are available and compelling triggers (like information on menus) are there to help them make the healthier choice.

Thanks to BJ, we are reminded that change is not only possible but can be more probable when we think differently about how it happens. For me, it started when I began thinking about my own habits. I realized that they weren’t just a question of motivation. Once I overcame this personal bias, I’ll never think about behavior change the same way again. And now, with this bias removed, I’m starting to see my work more clearly.

Like I said, magically simple.

To learn more about BJ’s ideas and his model for behavior change, visit What’s Next Health to watch a conversation with BJ and RWJF’s Brian Quinn and view an infographic highlighting how motivation, ability and triggers need to align for behavior change to occur.