DOES THE MESSAGE MATTER? ENHANCING PATIENT ADHERENCE THROUGH PERSUASIVE MESSAGES

To improve health and reduce costs, we need to encourage patients to make better healthcare decisions. Many informatics interventions are aimed at improving health outcomes by influencing patient behavior. However, we know little about how the content of a message in these interventions can influence a health-related decision. In this research we formulate a conceptual model to help explain and guide the design of “persuasive messages”, those which can change and influence patient behavior. We apply the conceptual model to design persuasive appointment reminder messages using humancentered design principles. Finally, we empirically test our hypotheses in a randomized controlled trial in order to determine the effectiveness of persuasive appointment reminders to reduce the number of missed appointments in a sample of 1016 subjects in a community health center. The results of the study confirm that reminder messages are effective in reducing missed appointment compared with no reminders (p=0.028). Further, reminder messages that incorporate heuristic cues such as authority, commitment, liking, and scarcity are more effective than reminder messages without such cues (p=0.006). However, the addition of systematic arguments or reasons for attending appointments have no effect on appointment adherence (p=0.646). The results of this research suggest that the content of reminder messages may be an important factor in helping to reduce missed appointments

AIDS Behav

Mobile health (mHealth) technology can be a valuable tool in the management of chronic illnesses, including HIV. Qualitative research methods were used to identify the desired content and features of a mobile app for meeting and improving the healthcare needs of persons living with HIV (PLWH). We conducted six focus group sessions with 50 English-or Spanish-speaking PLWH in New York City. To inform data analysis and to illustrate how mHealth technology can be used as a persuasive strategy for improving the health of PLWH, we integrated Fogg's functional role triad for computing technology model with the self-determination theory to illustrate how mHealth technology can be used as a persuasive strategy for improving the health of PLWH. Participants suggested several tools for meeting their healthcare needs, including: reminders/alerts, lab results tracking, and notes on health status. mHealth technology can function as a social actor by providing chat boxes/forums, testimonials of lived experiences, and personal outreach. Examples of media that can be used as a persuasive technology include games/virtual rewards, coding of health tasks, and simulations on how to connect with PLWH. Findings from these focus groups can be used to design a mobile app for PLWH\uc2\ua0that is targeted to meet their healthcare needs.1U01PS00371501/PS/NCHHSTP CDC HHS/United StatesK12 RR017648/RR/NCRR NIH HHS/United States2016-06-01T00:00:00Z25572830PMC449793

Promoting Pediatric Healthcare through Persuasive Information Systems: A Qualitative Study

This paper presents qualitative findings from a Randomized Controlled Trial that focused on applying a Persuasive Information System to promote Pediatric Healthcare following the guidelines of Integrated Management of Childhood Illnesses. The study was primarily designed to introduce Persuasive Information Systems for promoting pediatric healthcare in a relatively under-developed country. The study investigates potential impact of simple text-based reminders on improving parents’ knowledge and skills when dealing with a sick child at home before deciding to seek healthcare professionals. Reminders were selected for this study, as they are most commonly employed persuasive software features in the area of Persuasive Information Systems. For data collection, we conducted Focus Group Discussions with participants of both intervention groups. The qualitative findings indicate that the participants largely favored reminders although there were some skeptical remarks. The findings from presented study are expected to help system designers work in collaboration with parents and healthcare professionals to improve the content and delivery of reminders. The qualitative findings helped us identify five emerging themes that are expected to open research opportunities for improving child healthcare researchers

Comparison of a User-Centered Design, Self-Management App to Existing mHealth Apps for Persons Living With HIV

Background: There is preliminary evidence that mobile health (mHealth) apps are feasible, attractive, and an effective platform for the creation of self-management tools for persons living with HIV (PLWH). As a foundation for the current study, we conducted formative research using focus groups, participatory design sessions, and usability evaluation methods to inform the development of a health management app for PLWH. The formative research resulted in identification of the following functional requirements of a mHealth app for self-management: (1) communication between providers and peers, (2) medication reminders, (3) medication log, (4) lab reports, (5) pharmacy information, (6) nutrition and fitness, (7) resources (eg, social services, substance use, video testimonials), (8) settings, and (9) search function. Objective: The purpose of this study was to conduct an ecological review of the existing apps for PLWH and to compare the functionality of existing apps with the app specifications identified in our formative work. Methods: We searched two mobile app stores (Google Play and iTunes) and found a total of 5606 apps. We reviewed the apps, narrowed our search terms, and found a total of 112 apps. Of these, we excluded 97 (86.6%) apps that were either not in English (10/112, 8.9%), not HIV focused (32/112, 28.9%), or focused only on HIV prevention (2/112, 7.8%); targeted health care providers (26/112, 23.2%); provided information only on conference schedules and events (7/112, 6.3%), fundraisers (7/112, 6.3%), specific clinics (7/112, 6.3%), international or narrow local resources (3/112, 2.7%); or were identified in the first search but were no longer on the market at the next review (4/112, 3.6%). The 15 apps meeting inclusion criteria were then evaluated for inclusion of the nine functionalities identified in our earlier work. Results: Of the 15 apps that we included in our final review, none had all of the functionalities that were identified in our formative work. The apps that we identified included the following functionalities: communication with providers and/or peers (4/15, 27%), medication reminders (6/15, 40%), medication logs (7/15, 47%), lab reports (5/15, 33%), pharmacy information (4/15, 27%), resources (7/15, 47%), settings (11/15, 73%), and search function (6/15, 40%). No apps included nutrition or fitness information. Conclusions: Currently, there are only a small number of apps that have been designed for PLWH to manage their health. Of the apps that are currently available, none have all of the desired functionalities identified by PLWH and experts in our formative research. Findings from this work elucidate the need to develop and evaluate mobile apps that meet PLWH’s desired functional specifications

Designing behavior change support systems in the context of knowledge documentation: development of theory and practical implementation

Although innovation and operating efficiently require creating, transferring, and applying knowledge, successful knowledge documentation remains a challenge for organizations. While knowledge management systems support knowledge management activities, the missing link to applying knowledge management relies on human actions and their behaviors. This dissertation extends prior design knowledge about designing Behavior Change Support Systems in the context of knowledge documentation by developing theory and showing practical implementation. Combining technical and psychological models within information systems frameworks based on the principles of abstraction, originality, justification, and benefit, this dissertation draws on design science to propose prescriptive knowledge, for example, in the form of design principles and a specific artifact

mHealth Technology: Towards a New Persuasive Mobile Application for Caregivers That Addresses Motivation and Usability

With the increasing use of mobile technologies and smartphones, new methods of promoting personal health have been developed. For example, there is now software for recording and tracking one\u27s exercise activity or blood pressure. Even though there are already many of these services, the mobile health field still presents many opportunities for new research. One apparent area of need would be software to support the efforts of caregivers for the elderly, especially those who suffer from multiple chronic conditions, such as cognitive impairment, chronic heart failure or diabetes. Very few mobile applications (apps) have been created that target caregivers of the elderly and most seem to be limited to a single condition or to creating generic to-do lists or tracking medications. None seem to address the complex tracking of multiple chronic conditions, nor one of the key difficulties found with written checklists for this population, namely that caregivers quit recording health information regularly as time passes. This dissertation will explore methods for improving the consistency of usage of health tracking software for the caregivers of the elderly with multiple chronic conditions by creating designs that explicitly address the context and motivations of caregivers. This work will assess a number of existing approaches and provide a design and a prototype for a new motivating application to help the caregivers of patients with multiple chronic conditions. It will assess how well the tool seems to address factors associated with intrinsic motivation (e.g. autonomy, competence, relatedness, and feedback). The overall usability of the software application will also be addressed, following guidelines from ISO standards and Nielsen’s theories

How Can Skin Check Reminders be Personalised to Patient Conscientiousness?

This paper explores the potential of personalising health reminders to melanoma patients based on their personality (high vs low conscientiousness). We describe a study where we presented participants with a scenario with a fictional patient who has not performed a skin check for recurrent melanoma. The patient was described as either very conscientious, or very unconscientious. We asked participants to rate reminders inspired by Cialdini’s 6 principles of persuasion for their suitability for the patient. Participants then chose their favourite reminder and an alternative reminder to send if that one failed. We found that conscientiousness had an effect on both the ratings of reminder types and the most preferred reminders selected by participants

Design Knowledge for Virtual Learning Companions from a Value-centered Perspective

The increasing popularity of conversational agents such as ChatGPT has sparked interest in their potential use in educational contexts but undermines the role of companionship in learning with these tools. Our study targets the design of virtual learning companions (VLCs), focusing on bonding relationships for collaborative learning while facilitating students’ time management and motivation. We draw upon design science research (DSR) to derive prescriptive design knowledge for VLCs as the core of our contribution. Through three DSR cycles, we conducted interviews with working students and experts, held interdisciplinary workshops with the target group, designed and evaluated two conceptual prototypes, and fully coded a VLC instantiation, which we tested with students in class. Our approach has yielded 9 design principles, 28 meta-requirements, and 33 design features centered around the value-in-interaction. These encompass Human-likeness and Dialogue Management, Proactive and Reactive Behavior, and Relationship Building on the Relationship Layer (DP1,3,4), Adaptation (DP2) on the Matching Layer, as well as Provision of Supportive Content, Fostering Learning Competencies, Motivational Environment, and Ethical Responsibility (DP5-8) on the Service Layer