Get Out the Vote: Implementing Intention

Nov 1, 2012
Presidential campaigns are increasing voter turnout through "implementation intention," an approach we also use to lift medication adherence.

A recent article in The New York Times outlined how the presidential campaigns are employing techniques from the behavioral sciences to encourage voting among their likely supporters:

[The campaigns will be] asking voters whether they plan to walk or drive to the polls, what time of day they will vote and what they plan to do afterward.The answers themselves are unimportant. Rather, simply forcing voters to think through the logistics of voting has been shown, in multiple experiments, to increase the odds that someone will actually cast a ballot.

This is an example of implementation intention, a cognitive strategy that has been shown to lead to goal attainment. By having voters think about how they will go about voting, the campaigns are encouraging the formulation of a plan that can increase the likelihood of following through.

Applying Implementation Intention to Medication Adherence

This same strategy can be applied to patients taking medications. While many patients may have a goal to take their medication exactly as prescribed, the plan to make that goal a reality is often not thought through. Express Scripts has applied these principles in a pilot program where we suggest that patients take their medication when they brush their teeth. This simple plan of, “If I am brushing my teeth, then I will take my medication,” is often enough to increase the desired behavior.

In fact, we’ve seen this technique improve medication adherence more effectively than pill boxes.

As we’ve discussed before on this blog, there is a clear gap between our intentions, which are usually good, and our ultimate behaviors, which often fall short. Implementation intention helps close this “intent-behavior gap” by giving patients a way to plant their intentions so that the goal can be implemented. This process helps convert our intended behavior from decision to automatic response. Using the above example, patients no longer need to think about when to take their medication because it becomes an automatic part of brushing their teeth.

“Voting is habit-forming,” said David W. Nickerson, a professor at the University of Notre Dame. The same can be said for taking medications.

One just needs the tools to form the habit.

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Lab Staff
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