Narrative Strategy: Scaling Behavior Change
“New learning does not equal new outcomes.”
Those were the wise words of my mentor and boss, Jennifer Kenny, shared during a leadership workshop with a group of senior executives at a major research institute. She paused, letting the idea land before delivering the insight that transformed the room:
“New behaviors equal new outcomes.”
In that moment, something shifted. You could feel it. The executives weren’t craving another professional development seminar. They didn’t need more frameworks, models, or theories. They needed behavior change — practical, observable, and sustainable shifts in how they acted as individuals and as a system.
Over the course of the four-hour workshop, Jennifer walked them through how real change happens — not by adding more information, but by re-patterning the actions and decisions that people make every day. Months later, under her guidance, the organization began to implement new ways of working. They realigned incentives, restructured feedback loops, and fostered new habits. And they achieved the outcomes they had long aspired to but struggled to reach.
Witnessing this was formative. I was Jennifer’s business manager at the time, a supporting role on paper — but what I observed ignited something in me. I became obsessed with understanding how behavior change works, and more importantly, how to scale it.
Healthcare, I’ve come to believe, is the perfect proving ground for this exploration. You could argue that nearly everything in healthcare — from patient compliance to provider performance — boils down to behavior.
For patients: Did you take your medication as prescribed? Did you stick to your nutrition plan? Did you go for a walk?
For providers: Did you chart that visit correctly? Administer the right dosage? Recommend the right test or follow-up?
Every one of these questions points to a behavior. And every behavior contributes to an outcome. We often assume that if someone knows what to do, they’ll do it. But that’s rarely the case. Think of the number of people who understand the risks of smoking or poor diet — and continue the same behaviors anyway. Knowledge isn’t power if it’s not translated into action.
That’s where narrative comes in.
As a narrative strategist, I begin by identifying the behaviors that are producing current outcomes and the stories that are enabling them. I ask: what’s the dominant narrative here? What do people believe about success, risk, responsibility, or health? What’s the story they’re living inside of — and how is it shaping their actions?
Narrative isn’t just a message. It’s an ecosystem. It’s the shared understanding that shapes how we interpret facts, what we prioritize, and what we feel is possible. If the story in an organization glorifies speed over safety, people will act accordingly. If the narrative rewards perfectionism, then innovation and risk-taking will wither. Behaviors follow stories.
That’s why, to shift behavior at scale, we must shift the narrative. And not just by telling new stories, but by designing new narrative environments — what I call narrative strategy. This work involves mapping the existing story systems, identifying where they’re blocking desired outcomes, and introducing new stories that activate the behaviors we need.
When done well, narrative strategy makes behavior change feel not just possible, but natural. People begin to see themselves differently. They make different choices because the context — the story — has changed.
In this way, stories don’t merely inspire behavior change. They infrastructure it. And when stories travel — when people share and adopt them — we begin to scale change. It’s like pollination. The right story spreads through conversation, through culture, and through action.
We don’t scale behavior change by lecturing or instructing. We scale it by shifting the narrative landscape. With every new story, we plant the seeds of new behaviors. And when those behaviors take root, the outcomes speak for themselves.