Designing for Behavior Change, 2nd Edition

Chapter 7. Exploring the Context

Clover Health’s Behavioral Science Team shows how we can combine qualitative and quantitative research to Explore the context of our users’ lives. From survey data, the team knew that some members reported difficulty getting the care they needed. So, the team tried to understand the underlying causes.¹

After talking with clients and checking the data, they found that people in lower income neighborhoods especially reported not getting quality care. The team hypothesized: perhaps lower income neighborhoods attracted lower quality doctors, making it essentially an issue of access?

However, the data showed this simply wasn’t true: low-income neighborhoods had high-quality doctors and enough to serve Clover’s members there. Members simply weren’t finding their way to those doctors. But why?

In interviewing members, they learned that the problem wasn’t access but learned behavior. Because many of these members had faced a lifetime of medical racism, they simply no longer believed that good doctors existed—and so they didn’t look for them. In a self-fulfilling prophecy, the very inequity they’d faced in the past led them to face continued inequity in the present. They took whichever doctor they found. If they happened to get a good doctor, they received good care. But if they ended up with a bad doctor, they simply ascribed it to an unjust system and ...