Popular Adherence: Long Haul Stickiness

Ok, so I've really been thinking alot about Adherence, which is case you aren't familiar, is really just a name for a combination of Compliance and Persistence. Adherence is a common word when we talk about medications, but what I thinbk alot of people don't consider is that Adherence is a process that is applicable to just about everything in our lives. And I don't mean obvious things like "adhering to a diet". I mean: teenage use of texting could be described in Adherence language. A drug addicts' use of drugs could be desrcibed as Adherence, taking the car for maintenance, getting your nails done. These all consist of protocols that are easily followed or not, and the length of time for which they are followed can be considered in terms of persistence. How about Religion? your job? same basic formula. There is a protocol that describes the methods that needs to be followed to maintain the prescription, and there is a length of time over which the protocol is followed. For almost every activity, adherence will wax and wane. This is true for drug addicts, teenage texters, religious folk, and everyone else. Which is interesting because when we talk about adherence, the conversation is almost always dominated by "negative adjustments" that must be adhered to. fine, we understand. people who don;t like to exercise, or who need to eat less junk food, need to make what they perceive as "negattive adjustments" to their lives. or in otherwords, they level of pleasurable activity they are accustomed to is being curtailed, and the perception of this requirement is "negative but necessary". But, lets now consider activities which are inherently pleasurable, and should not need to be curtailed(due to adverse effects) but demonstrate waxing and waning adherence. I just discovered Mafia Wars on Face Book. It failed to engage me, but it has succeeded with 5 million other people. These folks comply with the protocol: they press the buttons, do the jobs, make the money, etc. click, click, click. that site is stiiiiiiicky. And they persist. everyday, lots of times everyday....make the money, do the job, click, click. I could get into what motivates people to Adhere to this game, but that is a whole post on its own(extremely relevant and essential, but needs to wait). so now we have 5m people clicking away daily. all pleasure. they are not gaining weight, cholesterol is not going up, etc. but........after awhile.......game players stop playing. if this were not true, everyone today would still be obsessed with Pac Man. so what happens? why stop adhering to such an awesome protocol? boredom, popularity shift, competing games, who knows. What is important is tha even the most purely pleasurable activities see Adherence wax and wane. So, why should we be so shocked when negatively perceived activities have fluctuating adherence. Well you say, "health should always be the priority. for some its a matter of life and death. how can you not adhere to a protocol that will save your life?" I would wager that if you told a kid that me must follow a protocol daily that resulted in a daily ice cream cone, you would see adherence wane over time. How can this be? Well we need to know exactly why this is, in order to understand why Uncle Fred stopped taking his cholesterol meds(all things being equal such as ability to pay, negative sides, etc). Where we end up: Adherence Profiles. these can be constructed by gathering data that describes a patients lifelong performance in regards to a miriad of activities: from brushing teeth, to watching football, to mowing the lawn, religion, etc. The point is: we must accept that there are unique profiles that describe a persons track record to adhering to anything. Through the definition and analysis of this profile, we can then construct an Adherence program that will best suite the patient. In many ways, the programs can be exactly the same, BUT, we apply an "Engagement Skin", which is an overlay on top of a common infrastructure, designed to get all sort of people engaged in performing what is essentially exactly the same activity.(Ilearned this trick from the MafiaWars/Sorority Life folks). Stay stuned for more on Life Adherence Profiles