A health app can use the same persuasion tools as a social feed. What separates the two is what the system is rewarded for and whether it lets you say no. That is the idea behind my conversation with Amy Bucher, chief behavioral officer at Lirio.
Reward the outcome, not the click
Amy points out that social apps are built to never be done. An infinite feed has no unit test, no end of semester, no finish line. Our brains look for those markers, and without them it takes willpower to stop. She says she canceled her Facebook account partly for this reason, and she still falls for it herself.
Her team works the other way around. Lirio calls itself objective driven. At the start of a client project, they ask what success looks like. In a hypertension program with Cone Health in North Carolina, the algorithms were tuned to clinical measurements such as blood pressure. Clicks and time spent on a page counted for much less. As Amy put it, “What we need to know is are you getting healthier?”
Her view traces back to an early job at a digital coaching startup. The founder said that if you reach a point where you no longer need the product, the product has worked.
Let people say no
The second part is autonomy. Amy holds to a principle she calls volitional non-adherence. In her words, “if a person says I don’t want to do that you have to respect that.” You can keep engaging, share evidence, or offer incentives. You should not force the choice.
Part of her reasoning is practical. Health behaviors rarely happen once. Even a colonoscopy comes around every decade or so. Pressure can backfire, and research on psychological reactance describes how people resist messages they see as threats to their freedom to choose. A forced visit may cost you the next one.
So the design includes exits. People can unsubscribe, set detailed preferences, or snooze a campaign until a date they pick. Amy also favors disclosure. People still react emotionally to automated systems when they know they are automated, as work on social rejection in computer games suggests. She sees no reason to hide that an algorithm is involved.
Something to try
Pick one app you open out of habit. Ask two questions. What is it rewarded for when you use it? Does it give you a clear way to stop or step back? Then change one setting. Turn off a notification, set a time limit, or delete the app for a week. Notice what changes.