The Design of a Digital Behaviour Change Intervention for Third-Level Student Illicit Substance Use: A Persona Building Approach

Illicit substance use among third-level students is an issue of increasing concern. Digital behavioural change interventions have been developed to target this population, but reports of their effectiveness are mixed. The importance of end-user involvement in digital intervention development has been well established, but it appears that many interventions in this area did not engage end-users during development. This absence may have affected engagement, undermining their potential effectiveness. This paper describes the process and contributions of a persona-building approach in the development of a digital behaviour change intervention tailored to the needs of third-level students. Nine exploratory persona-building workshops were carried out with 31 students, and 7 project team members to develop personas for heavy, occasional and non-substance using third-level students. Early analysis has identified five archetypes which will contribute to the design of an acceptable and user-friendly intervention, and to the identification of targeted behavioural change techniques

The Behavioral Mechanisms Behind Feedback – A Preliminary Model for Quantifying Cause-Effect Relationships

The ubiquity of information technology makes it possible to provide individuals with personalized, context-specific, and timely feedback at low marginal cost. This allows for highly scalable behavioral interventions that can support behavior change even for frequent, habitual, and incidental behaviors. Despite the well-documented potential of feedback interventions in improving personal and societal outcomes, the associated theoretical insights – in particular for real-time feedback on everyday behaviors – are sparse. To this end, this research-in-progress paper proposes a conceptual model to formalize cause-effect relationships between feedback interventions, the antecedents of behavior, and resulting behavioral changes by integrating important concepts from feedback intervention theory and other behavioral theories. Moreover, this paper outlines the planned validation of the model and research hypotheses with an empirical field study. Ultimately, the results are expected to inform the development of (future) Information Systems for behavior change by holistically explaining behavioral mechanisms associated with feedback interventions

Stakeholder Perspectives about Developing and Implementing an Online Alternative to Out-of-School Suspension for First Time Substance Use Policy Violators

The purpose of this study was to explore statewide stakeholder perspectives about developing and implementing an online alternative to suspension (ATS) program in the Northwestern United States for youth who have violated school substance use policies. Out-of-school suspension has been linked to negative outcomes and alternatives to keep youth in school are desperately needed. Qualitative description methodology with content analysis was used to analyze data gathered from 201 stakeholders (principals & vice principals). Three themes were identified that described stakeholders’ perspectives about the development and implementation of an online ATS program: 1) the program must be impactful, 2) have a high degree of usability, and 3) additional support may be necessary. Themes identified can guide the development and implementation of an online ATS program. In collaboration with stakeholders, the initiation of an online ATS program could reduce out of school suspensions for middle and high school age youth

Proposed Conceptual Design Model of Persuasive Game for Upper limb for Stroke Rehabilitation

The gamification of stroke rehabilitation may increase patient's motivation and engagement towards their rehabilitation activity and hence contributes to faster recovery. Apart from the interactive experience that games offer, it also may be used as a persuasive tool. In this view, games may be used to persuade stroke patients in shaping a good behavior towards their rehabilitation activity. This paper reports our proposed conceptual design model of building persuasive game for stroke patients that follows the Persuasive System Design Model. We incorporate the persuasive software features that includes reduction, tailoring, self-monitoring, and rewards. The proposed game architecture is also discussed in this paper

Feasibility study for supporting medication adherence for adults with cystic fibrosis: mixed-methods process evaluation

Objectives: To undertake a process evaluation of an adherence support intervention for people with cystic fibrosis (PWCF), to assess its feasibility and acceptability. Setting: Two UK cystic fibrosis (CF) units. Participants: Fourteen adult PWCF; three professionals delivering adherence support (‘interventionists’); five multi-disciplinary CF team members. Interventions: Nebuliser with data recording and transfer capability, linked to a software platform, and strategies to support adherence to nebulised treatments facilitated by interventionists over 5 months (± 1 month). Primary and secondary measures: Feasibility and acceptability of the intervention, assessed through semistructured interviews, questionnaires, fidelity assessments and click analytics. Results: Interventionists were complimentary about the intervention and training. Key barriers to intervention feasibility and acceptability were identified. Interventionists had difficulty finding clinic space and time in normal working hours to conduct review visits. As a result, fewer than expected intervention visits were conducted and interviews indicated this may explain low adherence in some intervention arm participants. Adherence levels appeared to be >100% for some patients, due to inaccurate prescription data, particularly in patients with complex treatment regimens. Flatlines in adherence data at the start of the study were linked to device connectivity problems. Content and delivery quality fidelity were 100% and 60%–92%, respectively, indicating that interventionists needed to focus more on intervention ‘active ingredients’ during sessions. Conclusions: The process evaluation led to 14 key changes to intervention procedures to overcome barriers to intervention success. With the identified changes, it is feasible and acceptable to support medication adherence with this intervention. Trial registration number: ISRCTN13076797; Results

Cocreation of a digital patient health hub to enhance education and person-centred integrated care post hip fracture: a mixed-methods study protocol

INTRODUCTION: Older people with hip fractures often require long-term care and a crucial aspect is the provision of quality health information to patients and their carers to support continuity of care. If patients are well informed about their health condition and caring needs, particularly posthospital discharge into the community setting, this may support recovery and improve quality of life. As internet and mobile access reach every household, it is possible to deliver a new model of service using a digital education platform as a personal health hub where both patients and their providers of care can establish a more efficient information integration and exchange process. This protocol details proposed research, which aims to develop a 'model of care' by using a digital health solution that will allow delivery of high quality and patient-centred information, integrated into the existing process delivered within the community setting. METHODS AND ANALYSIS: This phase of the study uses a pragmatic mixed-methods design and a participatory approach through engagement of patients, their carers and healthcare providers from multiple disciplines to inform the development of a digital health platform. Quantitative methods will explore health literacy and e-health literacy among older people with hip fractures admitted to the two public tertiary care hospitals in Adelaide, South Australia. Qualitative methods will provide an understanding of aspects of content and context required for the digital health platform to be developed in order to deliver quality health information. The study will use appropriate theoretical frameworks and constructs to guide the design, analysis and overall conduct of the research study. The scope of the study intends to ultimately empower patients and their carers to improve self-management and to better use coordinated services at the community level. This could prevent further falls including associated injuries or new fractures; reduce new hospital admissions and improve confidence and engagement by limiting the psychologically restrictive 'fear of falls'. ETHICS AND DISSEMINATION: The study has been approved by the Human Research Ethics Committee of the Central Adelaide Local Health Network, South Australia (SA) Health, Government of South Australia and the University of Adelaide Human Research Ethics Committee. Findings from the study will be published in suitable peer-reviewed journals and disseminated through workshops or conferences.Lalit Yadav, Tiffany K Gill, Anita Taylor, Unyime Jasper, Jen De Young, Renuka Visvanathan, Mellick J Chehad

Understanding Personalization for Health Behavior Change Applications: A Review and Future Directions

Health behavior change (HBC) applications hold much promise for promoting healthy lifestyles, such as enhancing physical activity (PA), diet, and sleep. Incorporating personalization strategies is seen as key to designing effective HBC applications. However, researchers and application designers lack knowledge about the different kinds of personalization strategies, how to implement them, and what strategies work. Thus, we reviewed prior empirical studies on personalization for HBC applications and developed a framework to synthesize the prior studies we identified and to provide an integrative view of the personalization strategies, their inputs, and outcomes. Our findings suggest that researchers have much potential to conduct design research that employs demographic and contextual characteristics for personalization and that examines personalization strategies that target HBC applications’ interface and channels. In terms of implementation and adoption, we call for researchers to examine unaddressed issues such as low adherence and contextual barriers for these applications. We also suggest that researchers need to systematically examine the effects of specific personalization strategies on their efficacy. Other than providing an integrative view of extant studies, our study contributes by outlining key directions for future research in this area

Evaluating the Persuasiveness of Mobile Health: The Intersection of Persuasive System Design and Data Science

Persuasive technology is an umbrella term that encompasses any software (e.g., mobile app) or hardware (e.g., smartwatch) designed to influence users to perform a preferable behavior once or on a long-term basis. Considering the ubiquitous nature of mobile devices across all socioeconomic groups, user behavior modification thrives under the personalized care that persuasive technology can offer. This research examines the roles psychological characteristics play in interpreted mHealth screen perceived persuasiveness. A review of the literature revealed a gap regarding how developers of digital health technologies are often tasked with developing tools designed to engage patients, yet little emphasis has been placed on understanding what psychological characteristics motivate and demotivate their users to engage with digital health technologies. Developers must move past using a cookie-cutter, one size fits all solution, and seek to develop digital health technologies designed to traverse the terrain that navigates between the fluid nature of goals and user preferences. This terrain is often determined by user’s psychological characteristics and demographic (control) variables. An experiment was designed to evaluate how psychological characteristics (self-efficacy, xiv health consciousness, health motivation, and the Big Five personality traits) impact the perceived persuasiveness of digital health technologies utilizing the Persuasive System Design (PSD) framework. This study used multiple linear regressions and Contrast, a publicly available Python implementation of the contrast pattern mining algorithm Search and Testing for Understandable Consistent Contrasts (STUCCO), to study the multifaceted needs of the users of digital health technologies based on psychological characteristics. The results of this experiment show psychological characteristics (selfefficacy, health consciousness, health motivation, and extraversion) enhancing the perceived persuasiveness of digital health technologies. The findings of the study revealed that screens utilizing techniques for the primary task support have high perceived persuasiveness scores. System credibility techniques were found to be a contributor to perceived persuasiveness and should be used in the development of persuasive technologies. The results of this study show practitioners should abstain from using social support techniques. Persuasive techniques from the social support category were found to have very low perceived persuasive scores which indicate a lower ability to persuade mHealth app users to utilize the tool. The findings strongly suggest the distribution of perceived persuasiveness shifts from negatively skewed to positively skewed as participants get older. Additionally, this shift occurs earlier in females (i.e., in the 40-59 age group) compared to males who do not shift until the oldest age group (i.e., in the 60 and older age group). The results imply that an individual user’s psychological characteristics affect interpreted mHealth screen perceived persuasiveness, and that combinations of persuasive principles and psychological characteristics lead to greater perceived persuasiveness