Moving Behavioral Theories into the 21st Century

By Wendy J. Nilsen and Misha Pavel

NOTE: This is an overview of the entire article, which appeared in the September/October 2013 issue of IEEE Pulse magazine.
Click here to read the entire article.

Combining behavioral theories with technological advances may help individuals live longer, improve their quality of life, and reduce their health care costs. Chronic diseases such as obesity, heart disease, diabetes, and lung disease are increasing in the Western world. Likewise, in low and middle income countries, chronic disease is cited as an emerging problem impacting mortality rates, morbidity, and financial costs. It has been estimated that approximately 49% of all premature deaths are due to behavioral patterns that could likely be modified.

Improving and enhancing health behavior to prevent disease has been shown to decrease adverse health events over time. However, behavior change programs present many challenges including cost, staffing, and time issues as well as a lack of available data on the multiple influences affecting behavior that often change over time. Assessment is another challenge to behavior change research because of the loosely defined constructs such as motivation, stress, and self-control. Also, most health-behavior change occurs outside the context of professional settings and one-on-one interventions, which poses a problem for behavioral change in the real world.

A system-theoretic approach, familiar to control engineers, has been used in recent attempts to model behavior and decision making. This modelling could lead to more effective, personalized means of helping people to modify their behavior. This approach (shown in the Figure below) utilizes a model of the individual’s behavior. That behavior is driven by various inputs, and by intervention measures. The outputs of the model are quantifiable behaviors of the individual.

A schematic diagram of the control-theoretic framework for optimal behavioral change is shown.

The article describes how new technologies can assist in formulating the model and in providing input and output measurements. The authors emphasize that although behavior change research has come a long way over several decades, there is still much room for improvement. With the use of smartphones and universal sensors providing continuous-longitudinal data, researchers can begin developing behavior change programs that are optimized for the individual and that adapt to the individual’s changing behavior. Hopefully, these techniques will help people live longer and with an improved quality of life.


Wendy J. Nilsen ( is with the Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland.

Misha Pavel is with Computer, Informational Systems, and Engineering, National Science Foundation, Arlington, Virginia.