Use Precision Nudging™ to Overcome Barriers to Women's Healthcare

Breast Cancer Awareness Month in October is a good time to frame the conversation around women’s health by looking at what may be keeping them from getting the kind of preventive care, like annual mammograms, they need. According to the U.S. Department of Labor, women make 80% of healthcare decisions for their children. Because women are central medical decision makers, healthcare teams know conversations with women can have a significant impact on the health of the entire family. A well-woman exam provides an excellent opportunity to promote health behaviors with women and, indirectly, with their families.

Since the Affordable Care Act (ACA) passed in 2010, the annual well-woman exam has evolved significantly. Once anchored on acute and urgent needs, it is now disease prevention focused. Healthcare organizations are now recognizing care for women should be an integrated continuum approach to health rather than a series of episodic events. A study from the American College of Obstetricians and Gynecologists found “the periodic well-woman care visit should include screening, evaluation and counseling, and immunizations based on age and risk factors.”

There’s only one problem: the percentage of women who report a preventive medical visit in the past year, which in 2019 was 67% for women aged 18-44, is too low. A full one-third of women may not be benefiting from a preventive well-woman exam.

This is especially true now as more people are concerned about the impact of the pandemic on their health and financial wellbeing. An estimated 78% of consumers polled in a PwC survey said they would skip at least one healthcare visit whether it was a wellness exam, a maintenance visit for a chronic illness, or a recommended lab test or screening. The pandemic has also shifted more caretaking duties to women, adding more competing demands to their already packed agendas.

Given this environment, it is more important than ever to understand why women opt out of preventive care, and how to overcome those reasons.

The Right Communication for the Right Reason

Change begins with effective health communications. They are the key to engaging women to schedule — and keep — their wellness appointments. This is especially true for traditionally hard-to-engage populations shaped by past health behaviors, cultural differences, and living in vulnerable social and/or economic situations. This same group tends to have the highest rate of preventable chronic and terminal health conditions.

Health interventions grounded in behavioral science theory are more effective than interventions that are not. A message’s presentation or framing affects people’s interpretation and subsequent behaviors. Our loss aversion bias, for example, may prevent us from taking positive action because we are more motivated to avoid losses (can’t afford to take time off work or caregiving for a wellness exam) than we are motivated to obtain gains (peace of mind that may come from a preventive screening). Communications targeting loss aversion bias must emphasize “here’s what you’re missing” instead of “here’s what you need.”

Another bias to consider is commitment and consistency, where it’s important to tap into people’s desire to be—and to appear to be—consistent with what they have already done. Understanding this bias can help change behavior voluntarily without having the individual feel pressured. There are many other cognitive biases to consider and counter in ways that encourage more women to receive preventative health care, such as omission bias and availability bias.

Other barriers inhibiting positive habit formation and behavior change include being embarrassed about the appointment, fearing an undesirable visit, and believing the visit is unnecessary.

Lirio Precision Nudging™ Overcomes Barriers and Engages Women in Their Care

Effective engagement depends on matching the right message to each person and their ever-changing circumstances. Effective communication is personalized to overcome what gets in a person’s way today, and over time – smartly and dynamically responding to the person in their environment – to keep patients engaged long-term.

Behavior change artificial intelligence (AI) brings together behavioral science solutions with AI technology to assemble and deliver Precision Nudging™ (i.e., hyper-personalized communication) matched to each person within a population. These communications leverage evidence-based ingredients from behavioral science and sophisticated machine learning (ML) algorithms to move a population and the individuals within it along their unique journeys toward better health.

It was this solution that helped a Lirio client improve patients’ engagement in wellness exams. While the client’s existing email open rate was 1.4x higher than the industry standard, patients were not scheduling and attending their appointments at a comparably impressive rate. To help the client address this challenge, Lirio:

Identified the full range of decision-making biases and behavioral barriers to scheduling and showing up to a women’s wellness appointment.
Mapped behavioral science solutions to overcome identified barriers to action.
Used these solutions to inform message elements that when combined created more than 20,000 unique communications.

As the project progressed, Lirio’s ML agent optimized and assembled the appropriate message elements to create effective messages needed to boost conversion rates. As the ML agent continued to learn, open rates continued to improve.

After only four months, Lirio’s personalized communications achieved a 28% higher conversion rate compared to the client’s existing, high-performing emails. That initial, but not final lift (the agent had fully optimized), translated to 191 more women’s wellness appointments in a single quarter compared to the client’s email. With the agent still learning and improvements continuously being made to the program, we anticipate the final conversion rate would be substantially better and the end of the year return higher than what this short timeframe could demonstrate.

An ounce of prevention is indeed worth a pound of cure, as the saying, attributed to Benjamin Franklin, goes. Getting women to a recommended women’s wellness exam advances individual as well as foundational population health goals. Lirio is the tide that lifts all boats and is uniquely poised to augment and accelerate industry-leading communication efforts.

Watch Our Recent Webinar

To learn more about how to meet each patient where they are, and to move every individual along their unique journeys to better health and wellness, check out Lirio’s latest webinar, “Precision Nudging™: The Solution to Scalable Behavior Change.” We discussed how Lirio’s hyper-personalized approach, Precision Nudging™, is a scalable behavior change that can transform consumer and patient engagement everywhere – particularly among hard-to-engage populations.

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