Health Behavior Change Support Systems
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ItemAssessing Interventional Components in a Weight Loss App( 2023-01-03)Many mHealth interventions for health behavior change are considered effective for improving health outcomes. However, there is a limited understanding of the role of the components in an intervention on its effectiveness. Insights into intervention components such as content and software features are needed to design efficient and effective interventions. In this study, we conducted an exploratory analysis of objective data from the usage of a weight management app to understand the role of intervention components in weight loss. We identified a positive correlation between weight loss and the use of the intervention. We also found differences in the app feature use among those who lost weight. To lose weight, users needed to comply with the intervention by completing a combination of tasks. They needed to complete 70% of some tasks and up to a maximum of 30% of other tasks. In the future, we hope to use other types of collected data (logged and survey data) to gain more nuanced insights into how interventions are used. With the help of data analytics, we may find optimal paths of use and determine a satisfactory level of compliance to achieve desired goals. This can deepen our understanding of what works in an intervention.
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ItemDesign Requirements for Behavior Change Support Systems with High Use Continuance: Insights for the Target Group of Students( 2023-01-03)To counteract the high academic stress of students and subsequent health problems, a behavior change support system (BCSS) for self-regulated learning is developed. Since use continence is a prerequisite for the system’s supporting effects, this study examines design requirements that promote its use continuance. While previous studies on BCSS’s use continuance are mostly quantitative using pre-defined constructs, this study additionally considers qualitative statements to exploratively identify additional requirements. Analysis of statements from 54 students and quantitative data from 25 students identifies 19 design requirements, which can be synthesized into ten meta requirements. These findings support the integration of already defined design principles, e.g., self-monitoring, but also reveal new requirements, e.g., a low-threshold character or the promotion of learning about the targeted behavior. The data also suggest that the design of the BCSS does not affect all students equally, but that perceptions of use continuance are dependent on individual preferences.
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ItemPreferred Gamification Elements in a Health Behavior Change Support System for Stress Management( 2023-01-03)Stress is a serious hazard to individuals. Health behavior change support systems (HBCSSs) may support individuals to modify their behaviors toward a healthy lifestyle. Previous studies have shown that HBCSSs for stress management can improve individual coping behavior but their success depends on the users’ adoption and long-term use. Gamification elements (GEs) can contribute to continuous use by motivating their users, enabling sustained healthy stress coping behavior. With a mixed-methods approach, we identified suitable GEs through six interviews with users of a mobile coping assistant prototype. Based on those insights, we designed GE mockups and surveyed 204 participants using the best-worst-scaling method to examine the users’ preferences. The results demonstrate that users mostly prefer feedback elements, such as scoreboards and progress bars in HBCSSs for stress management. Social interaction GEs score worst. Our interviews indicate that this could be due to privacy reasons.
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ItemGamification and Policy Compliance: Results from an Online Vignette Experiment in the Context of Social Distancing for Public Health Security( 2023-01-03)The commonly applied strategies for promoting compliance with public health and safety policies can be inefficient and coercive, posing a need to examine novel motivational strategies to aid in this endeavor. Gamification, which aims to foster engagement and intrinsic motivation towards mundane activities and behaviors, is one of the vanguard design approaches among behavioral change support systems. Despite the increasing interest in gamification, the corpus lacks studies on its effects on policy compliance. Therefore, this study examines the relationships between gamification design types, gameful experience, and policy compliance in the social distancing context (during COVID-19) using a vignette-based online experiment (n=937). Based on the results, gameful experience mediates the positive relationships between achievement and progression-based, competitive, and immersive gamification and policy compliance, while social gamification is not associated with gameful experience. The results provide evidence of gamification’s potential as a non-coercive method of helping people follow policies.
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ItemDiversity in Digital Pill Systems: Differences in Perceptions and Attitudes Towards Use of a Digital Pill System for HIV Pre-Exposure Prophylaxis Among Men Who Have Sex With Men with Diverse Racial and Ethnic Identities( 2023-01-03)Nonadherence, particularly among men who have sex with men (MSM) with substance use disorders increases the risk of both HIV acquisition in those who are uninfected and the risk of disease progression and transmission in those with HIV. Measuring adherence to HIV pre-exposure chemoprophylaxis (PrEP) and antiretroviral therapy (ART), and responding to suboptimal adherence or changes in adherence behavior, remains a challenging public health problem. Despite the importance of accurate adherence measurement, there remains no gold standard for detecting medication ingestion events in HIV research. Technologies have been developed that indirectly infer ingestion events (e.g., via smart pill bottles) or directly measure adherence over periods of time (e.g., via drug concentration in plasma and red blood cells), yet such approaches fail to provide direct confirmation of ingestions and contextual information surrounding adherence and nonadherence. The use of a digital pill system (DPS) – a novel tool that leverages ingestible radiofrequency sensors to measure actual ingestion events – has the potential to advance adherence measurement in HIV research. In this study, we examined the willingness of MSM across racial and ethnic identities to operate a DPS in the context of PrEP adherence measurement and suggest potential future applications of this technology.