The ‘information deficit model‘ assumes that when a person’s beliefs and attitudes, and consequently their behaviours, are not ‘rational’ or in line with what we would like, this is because of a lack of understanding caused by a lack of information.
Consequently, the information deficit model assumes that people are rational actors who will change their views based on the best information available to them.
Quite apart from the fact that this is intuitively untrue, the information deficit model has been comprehensively debunked by psychology in recent years. So why then does this disproven approach remain the predominant model of attempted behavioural change in healthcare?
In my work on digital health, I get to work with a range of startups, many of which are doing amazing things. Sadly, however, underlying a number of digital health solutions is still the idea that information provision is the answer to belief, attitude and behaviour change. Providing factsheets to patients is too often seen as the answer to health literacy challenges – “if only the patient read and understood this piece of paper then their behaviour would be different“.
Well, healthcare, it’s time to wake up. Not only is the information deficit model disproven and long dead, it also reinforces a unidirectional and paternalistic approach to healthcare delivery at exactly the point at which we need a partnership between provider and patient.
Recent world and political events (e.g. climate change, black lives matter, the global coronavirus pandemic and associated conspiracy theories, etc.) should reinforce the fact that the ways in which we form, hold and change our fundamental beliefs and attitudes is a complex process which owes as much (or more) to our tribal affiliation than it does to our rational thought processes.
A lot of my recent work has been looking at psychology and behavioural economics to better understand what models can be mined to support behavioural change in healthcare. It turns out that the field of marketing is arguably 30-40 years of medicine when it comes to attitude and behaviour change. However, there is great promise in looking at important theories like the elaboration likelihood model and applying them to healthcare, which I am starting to do in some software that I wrote to support social prescribing.
The first generation of behavioural change functionality built into mobile health apps has been pretty basic. The use of simple gamification, often using extrinsic reward for behaviour, has shown that it can motivate changed behaviour in the short term. A new generation of more sophisticated mobile health apps is quickly refining these techniques in a way that has great potential. However, we need to keep the true goal in mind – changing intrinsic attitudes and behaviours that have significant negative impact upon a person’s health and social wellbeing.
So as you go about your work this week, ask yourself this question – is providing a factsheet really what this patient needs?