Can a Positive “Process Mindset” Unlock Sustainable Behavior Change?

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Can changing your mindset change your health? For the past 15 years, Dr. Alia Crum has examined this question from a variety of angles. A clinical psychologist and principal investigator at the Stanford University Mind & Body Lab, Dr. Crum’s work has focused on a range of mindsets related to health and illness, such as stress and sleep, medications and illness management, and healthy eating habits. Her lab work explores the role of mindsets in maintaining good health in shaping behaviors and health outcomes.

In October 2021, Dr. Crum collaborated with the Omada Insights Lab to explore whether Omada’s virtual diabetes prevention program could change participants’ mindsets and lead to improved health outcomes.

The team spent two months asking every new enrollee in the Omada for Prevention program to complete a 28-question survey designed to measure their mindset as well as their behaviors and health metrics. By the end of November, they had collected initial data from 4,776 participants on several key metrics, including Process Mindset.

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What is a Process Mindset?

Process Mindset measures the extent to which a person associates the process of maintaining good health (e.g., exercising, eating well and taking medication) with appealing (pleasurable, fun, indulgent) versus unappealing (unpleasant, boring, depriving) qualities. Previous analysis shows that people who view the process of maintaining good health as more appealing are more likely to engage in healthy behaviors, while those who see it as unappealing are less likely to do so.

While this insight may seem obvious, Crum’s survey found that multiple attempts to promote healthier behavior (such as improved nutrition and exercise education) can sometimes instill negative mindsets, undermining the positive intent of other programs. However, within three weeks of starting Omada’s program, surveyed participants’ Process Mindsets appeared to be trending in a positive direction. The most statistically significant shifts moved mindsets from boring to fun, lonely to social and unpleasant to pleasurable.

Those who experienced a positive shift in Process Mindset tended to see positive changes in outcomes like self-reported mental health improvement, increased levels of activity and weight loss. Positive social support—such as a patient’s interaction with coaches and community members—was associated with a more positive Process Mindset.

Ryan Quan, director of data science at Omada Insights Lab, noted that such findings resonate with other analyses the lab has conducted. “What we’ve seen in our own data is that social support is associated with sustainable behavior change,” he said.

Crum hopes that the findings will encourage healthcare institutions, and other health tech companies, to apply mindset methodology to health programs and clinical care.

“Most programs just track people’s behavior and tell people what to do because it’s ‘good for them,’” Crum said. “That’s not bad information of course, but they’re focused on the behavior, not the mindsets that might shape and motivate that behavior. Mindsets matter, and we can do a lot more in helping people to adopt healthier, more adaptive and more inspiring mindsets.”

Crum plans to continue her collaboration with Omada Insights Lab. “I love that Omada is putting its time and money where its mouth is,” she said. “The first step was to assess how the program is doing to influence mindset, and it’s clear they’re doing something right.”

Dr. Crum’s contribution to this publication was as a paid consultant and was not part of her Stanford University duties or responsibilities.

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