All you need is a little encouragement from your friends

By Aline Holzwarth

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My phone buzzes with a text.

“Who’s running?” asks my friend Ankoor.

🏃‍♀️ replies Eileen; she’s in.

I perform a slow mental wince at the thought of dragging my body 3 miles in the North Carolina heat, but I already know I’m going to give in anyway. I pretty much always do. You see, my husband, friends and I go running together once a week before we gather around a pitcher of beer and food truck fare. Now I’m not afraid to admit that I’m not exactly what you’d call a “runner.” I will not be sharing my fastest mile with you today. There hasn’t been a single Thursday after a long day of work that I’ve wanted to go for a run – and yet, Thursday after Thursday, I show up for my friends.

There was nothing intentional about the creation of an accountabilibuddy text thread. We weren’t looking for a motivation solution. No one said, “Hey, don’t you think we would be more likely to show up if we checked in with each other before each run?” And yet, this small act of social alignment has kept me on track (no pun intended) week after week.

In fact, a great deal of research shows that social support (from our family, friends, and significant others) can hold us to our health goals. Social support works by moving us to act in ways that we believe are popular or socially desirable, and we are motivated by words of encouragement -- not only when we receive encouraging words, but also (actually, even more so) when we help others.

When we are supported, we experience better health outcomes. And there’s more than one type of social support. Both practical and emotional support are correlated with adherence to treatment recommendations, but in different ways. While practical social support (splitting the cost of a group tennis lesson, or sharing a ride to the soccer game) may be a more direct contributor to health, emotional social support may indirectly influence health factors by boosting mood and self-esteem and lowering stress (other people make us feel good, so we take better care of ourselves as a result). Social support may even alter our perception of how challenging a situation is. In one amusing study, for example, researchers found that people estimate hills to be less steep when they are with friends (as opposed to people judging hills alone or with non-friends).

But other people don’t just make us feel better; they can also hold us accountable by checking in on our progress to our goals. The Center for Advanced Hindsight’s Julie Miller argues that as adults we have (partially) lost the frankness that we held as children, and along with it some of the benefits of social accountability. To be perceived as agreeable, we manage others’ impressions of us and resort to lowest-common-denominator conversations about the weather and sports rather than important but sensitive-feeling questions about our medical conditions or whether we are saving enough for retirement. For the most part, we forget to leverage the most powerful motivators that we have access to: our social connections.

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That’s one reason that Pattern brings these social connections up front and center in patients’ care plans. Through Care Circle chats and interactions, Pattern offers a more sophisticated version of the group text that my friends created. In the Pattern app, patients set up their Care Circle (a group of people who care about that patient, whether it is a group of friends, similar patients, coworkers, caretakers, and so on). The group then gets notified of that patients’ activity, and the Care Circle can give support and encouragement.

So when you get a notification that your Uncle Po missed his medication, you can check in to see whether everything is alright and offer to help or simply give a few words of encouragement. You might give him a tip to put his pill bottle next to his toothbrush so that he remembers to take his twice-daily meds each time he brushes teeth. Whatever you decide to say, your uncle knows that you care about his health, and he will be more likely to take the right actions with your support.

And when I get that Thursday afternoon text from my friends, you can be sure I’ll put on my running shoes and head out the door.

References

  1. Uchino, B. (2009). Understanding the links between social support and physical health: A life-span perspective with emphasis on the separability of perceived and received support. Perspectives on Psychological Science. 4: 236–255.

  2. DiMatteo, M. R. (2004). Social support and patient adherence to medical treatment: a meta-analysis. Health psychology, 23(2), 207

  3. Mohr, D. C., Cuijpers, P., & Lehman, K. (2011). Supportive Accountability: A Model for Providing Human Support to Enhance Adherence to eHealth Interventions. Journal of Medical Internet Research, 13(1), e30.

About the Author

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Aline Holzwarth

Head of Behavioral Science

Aline Holzwarth is an applied behavioral scientist, primarily focusing on digital health research and scientifically informed product design. She is Head of Behavioral Science at Pattern Health, an evidence-based connected care platform that leverages behavioral science to help patients stick to their care plans. She also co-founded the Behavior Shop, a behavioral science advisory company, and holds an appointment as Principal of the Center for Advanced Hindsight at Duke University, an applied behavioral science lab that helps people be happier, healthier and wealthier, at home and abroad.