Breaking the mold

Editor's note: Kathryn Ambroze is a behavioral research scientist at HCD Research, Flemington, N.J. 

A simple morning routine – get out of bed, get dressed, make some coffee – is a daily experience that becomes so repetitive that it doesn’t even require direct deliberation. These experiences grow into a repeated behavior that inevitably feels automatic. These habits are embedded in our daily lives, impacted by our environments and enhanced by repetition. Exploration of this continuous loop of cues, routines and rewards can be implemented in various fields, including pharmaceuticals.

Each brain is a map of an individual’s experiences that, through neuroplasticity, is adapting throughout one’s life. These constant adaptations in the brain are creating neural networks, or pathways, which quickly communicate and respond to environmental cues (Berkman, 2018). The habit loops of cues, routines and rewards are then either strengthened or weakened based on how frequently the same pathways need to occur. Doing so allows the brain to conserve energy for common actions. Consider a new driver’s experience the first time behind the wheel of a car. The amount of awareness required to understand the space of the vehicle and how it moves on the road can be overwhelming. Yet over time, driving becomes nearly automatic to the point where the driver no longer has to consciously focus on the task due to the frequency of driving overall. With a routine experience, the neural networks create stronger connections that require less energy to fire messages.

In the same way, physicians who see patients with the same profile have created heuristics, mental shortcuts, to their prescribing plan. Heuristics allow individuals to simplify complex ideas by breaking them down into smaller, more digestible topics (Kahneman, 2011). A target question could ask how a prescription drug will improve the general population’s health per dollar spent, while a heuristic question approaches the topic by reflecting on how a doctor feels when a sick patient can’t afford medicine.

If there is a recurring cue resulting in a reward, that overall routine is referred to as a habit loop. The cue causes an automatic response to encourage the following behavior associated with the cue due to the expectation of the reward. The release of the neurotransmitter dopamine in the brain activates the reward system, furthering motivation to pursue the same actions again. The gratification of the dopamine release is what motivates a repeated action which eventually evolves into a habit (Berkman, 2018). The brain, however, is not able to label a habit as good, bad or indifferent. Yet, through awareness, we can find mastery in developing positive habits to achieve higher order benefits.

Products themselves can be incorporated into habitual routines, such as taking a medication right before brushing your teeth. Furthermore, brand loyalty is a byproduct of habits in prescribing and patient compliance. Physician and patient satisfaction are supported through meeting or surpassing the expectation of the benefit, or reward, of a product. By analyzing a product’s positioning against competitors or evaluating certain key attributes that are anticipated to be associated with the product, the company can improve its strategy to fit the expectations of its audience and, ultimately, encourage prescribing loyalty. 

Detect strength of biases 

To understand the respondent expectations, psychological tools such as implicit response detect the strength of mental biases of our automatic associations among various attributes and stimuli. Understanding the participant’s semantic network through reaction time provides underlying associations between concepts such as brands and attributes. Furthermore, the implicit tests tease apart the multiple concepts being tested through the strength of each association. For example, a physician can have a very strong association between Product X and efficacy but a weak association with longevity, whereas Product Z is highly associated with longevity and efficacy.

Need gaps emerge by exploring the expectations or drivers of the audience when compared to perceptions of the company. Implicit tests either reaffirm that the product is meeting the need of the physician or provides areas of innovation to expand. The opportunity to transform and improve the positioning and messaging allows the company to differentiate among competitors. Physicians seek out credibility in health care, with an emphasis on relevancy and success. Outdated messaging can detract, especially if the product is not something of peak interest. Employing any form of an implicit test will provide deeper insights into how the product or stimuli is positioned to the audience.

Minimize risk

Biases of a company may hinder potential growth. These assumptions are often known as anchors since it is a reference point. Consumers, including physicians or patients, base a lot of their expectations and decisions about a product on a comparison of another similar reference. Humans use anchoring as a method to minimize risk; however, it can be misleading if the reference point is incorrect (Wong and Kodagoda, 2016).

Did you ever have to estimate how many jelly beans were in a jar? Using your hand to scale the jar and then measure the number of jelly beans that could fit on your hand is a way to strategize an educated guess. However, if you over- or underestimate the anchor, the number of jelly beans will sequentially be incorrect. Similarly, if a physician assumes a pharmaceutical drug is less effective than the competition, there is an opportunity to modify how it is framed to better understand the comparison data. Through evaluating perceptions of products and companies, we can better understand both what the current anchors are and how to improve the anchor environment to better align with the company objectives or fulfill a strategic communication opportunity.

To improve the way that the target audience interprets a product, breaking anchors will help develop a closer connection between the audience and the product. Reinforcing a cue is possible whenever an opportunity arises for the product to be evaluated. By creating an authentic frame of reference, such as medicine packaging emphasizing the lungs to suggest cough relief, the reliability of the brand is strengthened. Through the establishment of a cohesive messaging, the branding can reinforce the intended cues.

Brand harmony involves analyzing communication, sensory input and experiences to promote a unified message. Linking each component of a brand portfolio, from first ad exposure to product experience, should be intentionally consistent. Be critical of the nonverbal and explicit information extracted from the brand profile to ensure that the subliminal experience is matching the outward messaging. Developing a consistent, multilevel integrated design minimizes potential confusion or disruption that could deter the target audience.

More appealing

The phrasing of a prompt or message is a crucial component that can alter how it is interpreted and, furthermore, reacted to. By shifting phrasing or messaging to hint at the rewards of a habit loop, it may entice target audiences to find an experience more appealing. The affect heuristic, or the way that emotional shortcuts influence decisions, can be impacted by perceived risk (Wu, Zeng and Wu, 2018). For example, learning about potential outcomes of a product may induce a sense of fear which in turn increases the perceived estimated risk. By homing in on the emotional experience of a situation, a designed approach catered to sharing information that focuses on rewards can increase engagement. Emotional scales, such as the self-assessment manikin (SAM), are examples of how to determine the intensity of the pleasure, arousal, dominance (PAD) emotional states model. By combining behavioral economics tactics with emotional scales, insights can be given into how an experience resonates with the audience.

System-thinking classifications are ingrained into the way that market research approaches studies. Analyzing the instinctive and unconscious (System 1) or rational and deliberate (System 2) components of human decision-making is helpful in developing a productive communication (Kahneman, 2011). The perception of marketing messages or product experiences can be measured through psycho-physiological, traditional or psychological testing. During surveys or interviews, physicians and patients can provide a conscious opinion of a product or experience.

In addition to the System 1 and System 2 processes, a third component is emerging, referred to as System 3, which can promote innovation and ideal concepts. As a future-facing methodology, System 3 considers projections on how a product or service can improve to meet the direct needs of the consumer (Baumeister, Maranges and Sjåstad, 2018). During the use of System 3, consumers are asked to predict how either a specific industry, competitor or product will evolve. Investigating how physicians or consumers predict changes to medical practices or the health care industry can provide insight into the expected roles of pharmaceutical companies. Provoking exploration through imagination also motivates the patient or physician to prioritize what would be most advantageous.

Using sensitive psycho-physiological measures in communication research, such as facial electromyography for emotional valences or heartrate variability for cognition, can uncover in-depth analysis of the emotional experience. There is an advantage of recording involuntary reactions to an experience while utilizing psycho-physiological tools. These measures provide unbiased outputs that can be analyzed to determine how the communication is affecting the respondent on a deeper level.

The use of eye-tracking can also provide meaningful outputs as a means of measuring visual attention. Exploring what a participant views while exposed to brand communication allows the researchers to conduct quantitative analysis of gaze behavior. Eye-tracking demonstrates if, upon first exposure, certain components of a concept are being ignored or emphasized by the consumer. The campaigns may not be perceived as intended because the consumers are not focusing on areas of interest. Eye-tracking can expose what drives focus and ultimately allow the researchers to optimize the visual landscape of stimuli.

Better articulate their messaging 

Taking advantage of various research methods, from something as simple as a survey to as in-depth as psycho-physiological testing, can provide both a stronger appreciation for and wider context about the best type of design to achieve company objectives, as well as high-order benefits. Through the process of exploration and innovation, companies will be able to better articulate their messaging to consumers. Shaping the communication strategies through the manipulation of cues, routines and rewards can provide strong groundwork to encourage informed decision-making. Promoting an overall positive experience for the consumer can help link experience with expectation through a rational, effective and consistent design to ultimately increase engagement. 


Baumeister, R.F., Maranges, H.M., and Sjåstad, H. (2018). “Consciousness of the future as a matrix of maybe: Pragmatic prospection and the simulation of alternative possibilities.” Psychology of Consciousness: Theory, Research and Practice, 5(3), 223.

Berkman, E. (2018). “The neuroscience of goals and behavior change.” Consulting Psychology Journal: Practice and Research, 70(1), 28–44.

Kahneman, D. (2011). Thinking, Fast and Slow. Macmillan.

Wong, B.W., and Kodagoda, N. (2016, September). “How analysts think: Anchoring, laddering and associations.” In Proceedings of the Human Factors and Ergonomics Society annual meeting (Vol. 60, No. 1, pp. 178-182). Los Angeles: SAGE Publications.

Wu, L., Zeng, S., and Wu, Y. (2018). “Affect heuristic and format effect in risk perception.” (Report). Social Behavior and Personality: An International Journal, 46(8), 1331–1344.