Applying Behavioral Science to UX Research: How Neuro-Tools Diagnosed Vaccine Scheduling UX

The purpose of usability (UX) research is to help designers and developers deliver great user experiences in a very simple and accessible way. UX is simply the idea that a normal person should be able to use products without finding the process frustrating or annoying. But it can be difficult to unobtrusively measure these experiences. Traditional tools for UX include surveys and interviews (asked after the experience about the experience), eye tracking and behavioral recording analytics (tracking behaviors with the product), expert review (where an expert navigates the product and reports any issues), and speak-aloud qualitative research (hearing user experiences reported as they navigate a product). Most of these tools rely on either user recall of the experience or interrupting the experience in some way, and they lack a way of assessing experiences that are more difficult to self-report, such as emotions and cognitive effort.

A behavioral science approach to UX design can help increase calls to action by making the process simple, easy, and pleasing. And a great place to test this out was with vaccine scheduling websites.

Public health officials continue to stress the importance of vaccination as a way to curb the spread of Covid-19. Getting individuals to sign up for a vaccine appointment is a fundamental step in administering more shots. One major step in signing up for the vaccine is scheduling an appointment online. And in the early days of vaccine availability, this was a challenging task due to a combination of poor UX design and limited vaccines. Designing an intuitive website can actually encourage calls to action and help people who are actively seeking out the Covid-19 vaccine but are struggling to use the interface.

To better understand the pain points within the process of signing up for the Covid-19 vaccine, HCD Research partnered with IVP Research Labs to run a NeuroUX study using neuroscientific tools to get in-the-moment responses to two common vaccine sites, CVS Pharmacy (CVS) and Rite Aid. The use of an electroencephalography (EEG) recorded cognitive and emotional reactions in real time. Eye tracking (ET) was also incorporated to understand what the participant focused on during the event, helping to pinpoint and evaluate specific moments of the entire user experience. Pairing behavioral data, such as overall task completion time, with the tools available through NeuroUX shares the larger story of the complications within vaccine scheduling.

Let’s take a look at how website navigation varied between the two sites.

Getting behind the problem

As a rule, people don’t like to puzzle over how to do things. If a website doesn’t seem to care enough to make things obvious, it can erode confidence in the site and its products. The two Covid-19 scheduling sites have very different approaches towards navigating the site. Rite Aid’s landing page provides an easy-to-find banner ad encouraging individuals to “Stay Updated on Covid-19,” with an emphasis on scheduling the vaccine appointment by explicitly stating “Schedule Vaccine Appointment,” while highlighting the link in a different color. CVS’s page is much more text-heavy and lacks a clear direction to set up an appointment. It is unclear where to click, since the landing page is stressing CVS’s #OneStepCloser hashtag, rather than guiding the individual to schedule their first or second doses.

The confusion created on the landing page is reflected in the cognitive and emotional responses of the participant. Being on the CVS landing page showed a greater workload in comparison to Rite Aid, which is indicative of more mental effort required to broach the task. The Frontal Asymmetry Index, or the emotional index, on the landing page was very similar, with CVS having a slightly higher emotional index. The greater the emotional index, the more of a negative affect occurs. For both sites, the participant was orienting to the page and held similar levels of motivation to complete the task at hand. Therefore, it suggests the participant remained consistent in the beginning of the process between the two sites in terms of drive to completion.

To qualify or not to qualify- that is the question

Following the first impression, there were other times early on causing emotional activations. CVS includes a pre-check questionnaire about Covid-19 symptoms that also resulted in an increased negative affect emotional activation. In addition, extra pages are included defining the differences between receiving one-dose or two-dose vaccinations, asking the individual to specify the type of vaccine they are scheduling, etc. While these questions and additional information are concise, reflecting on if they or someone they know tested positive or had symptoms proved to be unpleasant, these extra steps extend the process, offering additional opportunities for individuals to drop off or give up.  

One major differentiator between the two sites was when the participant learned that there were no CVS appointments available in New Jersey. This frustration was reflected in the emotional index, with a major negative affect spike. Additionally, the pop-up provides a lot of information and is not clear as to where to click, which could also be impacting the workload index. The participant experienced a higher workload with a negative response, implying there is a struggle determining eligibility on the CVS site.

On the other site, Rite Aid shares information by including a PDF to guide participants about what “eligibility” means and includes a survey with straightforward questions, ultimately sharing if the participant qualifies. The PDF is very dense and full of facts, resulting in stress of excess information (causing a spike in negative affect). This overall streamlined approach makes it easier for the participant to make a decision about how to navigate the site. However, both CVS and Rite Aid would benefit by simplifying text-heavy sections, such as the PDF and the pop-up, to avoid the negative affect caused by information overload.

Do the users have “a shot” at a home run? 

When the participant finally reached the stage where they could set up an appointment, the cognitive responses exposed interesting insights. While the amount of cognitive demand remained similar (as seen through the workload index), the emotional activation differed. CVS has a drop in frontal asymmetry, implying a decline in negative affect. This response may be caused by the sense of relief in finally surpassing the various hurdles experienced throughout the overall sign-up process. Although Rite Aid did have a greater negative affect compared to CVS, when comparing the emotional activation to the overall Rite Aid experience, it stayed consistent.  Unlike the ups and downs experienced with CVS, the emotional reaction seen with the Rite Aid experience suggests the interactions caused a similar overall temperament.

Takeaways:

While both websites include potential areas of improvement, scheduling a vaccine appointment through Rite Aid presented an overall easier experience for the user. The lower workload during the landing page and steps to determine eligibility suggests the site is cognitively easier to navigate. It also seems more intuitive with a streamlined approach to setting up an appointment. Additionally, incorporating small rewards, such as the “Great news!” prompt encourages the individual to finish out the process and feel motivated to select a pharmacy.

The CVS scheduling experience was a longer, more arduous experience (with the overall time to completion being 4.7 minutes longer than Rite Aid). The instructions are unclear and include a lot of material which may contribute to confusion or uncertainty about using the interface. The differences between the cognitive and emotional responses expose where there is a lack of clarity on where to click. Incongruent interactions, such as scrolling back and forth to find no appointments are available, can spoil an experience. Giving visual cues to better indicate unavailable appointments, such as graying out the state, can clearly and quickly communicate the message of limited options in that state. Building trust during this experience is really important, given hesitation surrounding Covid-19 vaccines. By condensing the number of pages necessary to complete the task and creating a clear path through the site’s journey, CVS has the ability to create a better bond with the individual and provide a more satisfying experience.  

Although there are nuances to each site’s user experience, both would benefit from clearer calls to action. By recording brain activity during the task through a noninvasive approach such as EEG, the usability of both websites can be accurately assessed, and particular areas of improvement can be detected. Peaks in workload and emotional activation reveal areas of potential issues. NeuroUX serves as an additional indicator of cognitive workload and emotional activation, helping differentiate the two experiences and discovering in-the-moment responses that may be challenging for participants to recall or verbalize. The results analyzed can help vaccine clinics, website designers, and/or public health officials improve usability to avoid individuals from being discouraged from signing-up not only for the Covid-19 vaccine but also for seasonal flu shots. Making an effective and streamlined process can potentially help encourage all types of individuals, not just the tech-savvy, to take the appropriate steps for their health wants and needs. Addressing areas of confusion to improve the usability of the website has the potential to build trust and confidence in the larger picture of the vaccine, booster, or flu shot. Keeping to a simple and straightforward approach can reduce confusion, hesitation, and dropouts, ultimately creating a positive change for both the individual, the company, and the public health effort at large.

NeuroUX provides an opportunity to fully optimize any calls to action. From purchasing to subscriptions to just trying to give the consumer a little more information, every interface has the potential to improve with the insights gleaned from NeuroUX.  If you are interested in learning more about the benefits of NeuroUX research, please reach out to Allison Gutkowski at Allison.Gutkowski@hcdi.net