One of the pieces of research that I personally found fascinating was not changing organizations but changing individuals. Because organizations don’t change, people change. It’s when you get a critical mass of people who are willing to change their behaviors that you start to see those organizational transformations.
So we asked ourselves, what makes individuals change their behaviors? Especially deeply rooted, deeply anchored behaviors. We found a fascinating piece of research that was done in the US, on the West Coast, that was exactly at the heart of the problem. How to get heart patients to change their behaviors.
The context was a group of researchers, where the heart patients had one or more of five serious behavioral issues: they ate too much, drank too much, smoked too much, had too much stress in their lives, or didn’t exercise enough. Hopefully nothing that anyone recognizes. But as a direct consequence of those behaviors, they had serious heart disease, which led to a major coronary bypass operation. Statistically, in the next five years, if they didn’t change their behaviors, they would die. The statistics, the research, was overwhelming.
The doctors told the patients, “Change or die.” This is the ultimate burning platform. This isn’t like life or death; this genuinely is life or death. But what was horrifying, was that even faced with that ultimate burning platform, only 10 percent of those heart patients were able to change their behaviors in a sustainable way. So that’s the bad news.
The good news is that the researchers said, “We’ve got to do something different. We have to find some other approaches. We have to figure out how we can change the odds.” So they developed an integrative, comprehensive program that pulls on the four levers that we believe are most critical to get sustainable, successful behavioral change.
The first thing they did was to have a compelling story. They worked on creating understanding and conviction, and not just the what and the how, but the why. It wasn’t just a burning platform; they also created a positive vision of the future. So if you change your behavior, you’ll be able to walk your daughter down the aisle when she gets married, you’ll see your son graduate from college. They created a positive change story, as well as being honest with people, that “If you don’t change, then you will die.”
The second thing that they did was they created reinforcing mechanisms. They had people meet regularly. They set targets. They monitored and measured those targets.
The third thing is that they taught them skills. Many of these people didn’t know how to quit smoking. They didn’t know how to cook in a healthier or different way. They needed to be taught meditation techniques, and exercises that they could do that were compatible with their heart condition. There was a whole element around creating the skills and capabilities that they needed in order to change their behavior.
The fourth was role modeling. They brought in people from the previous group, from the 10 percent who had successfully changed. People just like them, who came back and shared their experiences and gave them hope and confidence.
What we find in our work across organizations is that, in order to get organizations to change, you have to get individuals to change. In order to get individuals to change, you need all four of these elements.