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In this episode of Longevity by Design, Dr. Kate Wolin discusses the tactics of behavior change science that can promote sustainable healthy habits. As a behavioral epidemiologist, Dr. Wolin provides actionable advice for health promotion in many contexts. She explains the science of motivation and how leveraging one’s motivation can promote behavior change. She also dives into how our environment facilitates positive or negative health behaviors and how to alter them. Tune in to hear the latest science on behavior change and forming healthy habits.
About Dr. Kate Wolin
Dr. Kate Wolin is a behavioral epidemiologist specializing in the intersection of health psychology, epidemiology, and biostatistics. Dr. Wolin has over 20 years of healthcare experience as a scientist, founder, and executive leader in entrepreneurial, growth, and Fortune 10 organizations. As a behavioral epidemiologist, she was an internationally known leader in population health and is a fellow in both the Society of Behavioral Medicine and the American College of Sports Medicine. Dr. Wolin was the founder and CEO of ScaleDown, a digital health company that Anthem acquired. She has been named a Forbes Healthcare Innovator That You Should Know. Dr. Wolin is an advisor to digital health companies, a partner at PACE Healthcare Capital, and a professor of entrepreneurship at Kellogg School of Management.
The science of motivation
There are two different forms of motivation: intrinsic and extrinsic. Dr. Wolin distinguishes between the two, explaining their unique roles in supporting behavior change.
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Intrinsic motivation includes participating in an activity for an incentive from within, for example, engaging in a specific activity because it brings joy and personal satisfaction.
- Extrinsic motivation includes participating in an activity for an external incentive from others, for example, pursuing an activity to gain an external reward or avoid a punishment.
While external motivation tends to be effective in the short term, intrinsic motivation is crucial for sustaining behavior change over time. Dr. Wolin explains that being rewarded may force someone to pursue a behavior one time, but intrinsic motivation is necessary for sustained positive health behaviors.
Use short and positive feedback loops to increase motivation
Dr. Wolin discusses positive reinforcement as an integral part of one’s motivation and how the length of feedback loops can help create sustainable change. Positive health behaviors—for example, exercising and choosing healthy foods—are often discussed as disease prevention tools. But this can be challenging for an individual to conceptualize because the reward for the behavior—avoidance of disease—can be years down the road. Shortening the feedback loop by identifying an intrinsic motivator that has more immediate benefit, explains Dr. Wolin. For example, Dr. Wolin personally feels more productive and optimistic when her day starts with exercise—therefore, her intrinsic motivation for a morning workout is to feel happier and more successful afterward.
Key takeaway: Behaviors are more likely to be sustained when the positive feedback loop is shorter. Routines, reminders, and some external motivation to scaffold around intrinsic motivation can be used in tandem to promote change.
Set goals and track your progress over time
Tracking health metrics is one way that Dr. Wolin encourages listeners to measure progress toward achieving a health goal. One example is measuring LDL cholesterol to maintain healthy cholesterol levels and reduce the risk of heart disease. “If you have high LDL and your goal is to prevent heart disease, set a goal of lowering LDL and come up with an action plan. This could be to eat five servings of vegetables every day and engage in regular exercise for six weeks, and then remeasure your LDL and track your progress that way." Measuring and tracking a health metric over time enhances personal accountability and serves as a quantifiable metric to understand goal achievement. And when it comes to making dietary changes, Dr. Wolin notes that people typically respond more positively to additive rather than subtractive food messaging. For example, “stop drinking soda” can be reframed to “choose water.” A person can also track how many glasses of water they’ve had in a day and can set a goal to increase this number.
Key takeaway: Look for opportunities to reframe new health behaviors in a positive light and track your progress towards achieving the goal.
Community builds accountability
Dr. Wolin dives into the surrounding community’s influence on behavior change. The people we surround ourselves with can both positively and negatively influence our behavior. For example, fitness apps like Strava can foster positive relationships that promote physical activity while simultaneously building a community of like-minded individuals.
On the other hand, the surrounding community can hinder progress toward health goals. For example, an individual who aims to increase exercise and eat healthy foods can be inhibited by someone who actively discourages these behaviors.
Key takeaway: Find a partner or group of friends who encourage you to engage in healthy behaviors to progress you toward your health goal.
Behavior change tactics to build healthy habits
Throughout the episode, Dr. Wolin provides actionable, evidence-based strategies to promote positive behavior change. Here are her top five tips for creating sustainable, nutritious and exercise habits:
1. Change your environment. The food environment at home plays a huge role in our daily food choices, and making healthy choices readily available makes the healthy choice the easy choice. Add a fruit bowl to the kitchen table or prep your vegetables to make grabbing a healthy snack simple. Here are other tips for planning ahead:
- Pack your gym bag the night before a morning workout to reduce the effort in the morning.
- Place your sneakers by your bed to slip into before a morning workout.
- Set a reminder on your phone to take a walk during the day.
3. Adjust to setbacks. Having the ability to adjust to setbacks is essential for behavior change. There will inevitably be days and situations where eating patterns stray from optimal; it’s part of being human! Dr. Wolin encourages listeners to enjoy their time in social settings and resume their healthy habits afterward.
4. Surround yourself with supportive people. Social relationships can strongly influence health behaviors. Studies show that the people we surround ourselves with can significantly impact adherence to a new diet or exercise regimen. Dr. Wolin strongly encourages listeners to identify friends and family that support their health goals for accountability and motivation. She also suggests limiting the time spent with those who are negative influences and instead spending time with those who are positive.
5. Make healthy habits social. When making plans with friends or family, consider choosing an activity that adheres to your health goal, for example, going for a walk, an exercise class, or a restaurant with nutritious choices.
Does technology promote behavior change?
While fitness-tracking technology has greatly advanced in the past decade, the fundamentals of behavior change have not. Dr. Wolin explains that successful adherence to activity comes down to feedback loops—receiving insights and education from technology is key. “It's not enough to know your numbers through the technology, it's really the insights that can be married to the data from that technology that drives the behavior change, and we need to see it consistently over time,” explains Dr. Wolin. Dr. Wolin is optimistic that technology can deliver value to people by pairing real-time feedback with coaching through dietitians and trainers to enforce positive feedback loops.
Building habits through improvements in health scores
Today, fitness trackers have various health scores, e.g., activity rings, recovery scores, and readiness scores. What role do health scores play in behavior change? Dr. Wolin notes that while these scores may not always be clinically relevant or validated, they motivate the end user and therefore serve a productive purpose. Health scores can uniquely marry multiple metrics from different facets of health into one simple score, highlighting the importance of holistic health rather.
How do you maintain healthy habits while traveling?
Dr. Wolin has tips for those who often travel yet want to maintain healthy food habits. Dr. Wolin recommends packing healthy snack options like fruit and protein bars. She also suggests revisiting action planning—evaluating when and where healthy food options will be available and planning to eat during those times and places.
How do you create healthy environments at work?
Dr. Wolin shares tips to encourage healthy behaviors at work. And while all workplaces are unique, it’s possible to achieve an environment that promotes nutritious and active choices. For example:
- Go for a walk during your one-on-one with a team member rather than sitting at your computer.
- Provide healthy meal and snack options in addition to the standard to provide more choices.
How geography impacts health behaviors
The truth is that geography and one’s physical environment impact health behaviors. People spend their time differently depending on where they reside. For example, states like Colorado and California have made physical activity a core part of their daily environment, making hiking, biking, and running accessible. In fact, the risk of certain chronic diseases is lower in these states. On the other hand, geography can negatively impact our ability to engage in preventative health. Communities with limited access to healthy food stores also tend to have inadequate access to physically active environments and access to primary healthcare. Public health interventions must address environments to promote positive population health changes.
Top tip for healthspan
Dr. Wolin's top tip for health is to get adequate sleep. She's working to optimize her sleep by controlling factors linked to optimal sleep, for example, by altering the temperature in her room.
