Why do some digital health experiences feel effortless, while others just... don’t?
It’s not only about design or UX as most of us know it, but it's about how motivation is treated and and delivered.
Most digital health products (and my team has done lots of audits) still treat motivation like something you can add from the outside, where you can just push people with reminders, streaks, points, or little dopamine tricks!
In the short term, that may work, but that is not going to keep people around if their goal is actually to achieve a positive health outcome.
You see, good motivation design is meant to pull people in, whereas bad motivation design pushes them around.
You need to understand that motivation is not a static simple thing, instead it is a system that changes moment to moment - that is what I explain to my advisory and consulting clients.
It’s not about willpower, it’s about creating conditions where the right thing feels easy, meaningful, and maybe even satisfying, because keeping motivation alive is harder than just starting it.
Something we use and which we have made practical for digital health design is called PRIME Theory (not many people I know use it in design - mostly used by behavioural scientists at the moment, so I encourage you to look into it)
Prime (by Robert West) explains why our actions shift moment to moment and why we don’t always do what we plan to do.
For your products this means:
1. Stop designing for static motivation - remember you’re shaping the conditions that influence which impulse wins right now.
2) Target multiple levels: -Interface and environment → affect impulses and responses. -Messaging and meaning → affect motives and evaluations. -Onboarding, identity cues, social norms → affect plans and values.
3) Design for state transitions, not traits - every feature, message, or interaction should help a user carry a motive from one moment to the next.
4) Bridge “oughts” to “wants” - engagement rises when what people believe they should do becomes something they want to do.
5) Identity is the deep lever - changing what people see themselves as (“I’m the kind of person who...”) reorganizes multiple PRIME layers at once.
At any moment, one can override the others, and that is why you can want to be healthy, plan to exercise, but still skip the gym because your impulse to rest wins.
Designing for engagement means you stop fighting human nature and start designing around it - a) You make the behavior easier for the moments people are tired or distracted b) You make the experience feel rewarding in itself c) You reduce the noise that pulls them away.
That’s what real engagement design looks like, not the dark patterns and manipulation that some apps are driving these days with badly implemented gamification tactics, which in health can have really bad unintended consequences.