Digital Human Representations for Health Behavior Change: A Structured Literature Review

Organizations have increasingly begun using digital human representations (DHRs), such as avatars and embodied agents, to deliver health behavior change interventions (BCIs) that target modifiable risk factors in the smoking, nutrition, alcohol overconsumption, and physical inactivity (SNAP) domain. We conducted a structured literature review of 60 papers from the computing, health, and psychology literatures to investigate how DHRs’ social design affects whether BCIs succeed. Specifically, we analyzed how differences in social cues that DHRs use affect user psychology and how this can support or hinder different intervention functions. Building on established frameworks from the human-computer interaction and BCI literatures, we structure extant knowledge that can guide efforts to design future DHR-delivered BCIs. We conclude that we need more field studies to better understand the temporal dynamics and the mid-term and long-term effects of DHR social design on user perception and intervention outcomes

Examining the Persuasive Potential of Web-based Health Behavior Change Support Systems

Understanding the persuasive potential of systems to support behavior change is increasingly important. If systems are not designed properly, their persuasive potential is not fulfilled. Previous research has shown that persuasive system design has a significant impact on adherence. Moreover, persuasive system features are likely to be advantageous in boosting effective user engagement with the technology and keeping the users motivated in their endeavors. In this study, we identify persuasive system features used in a selection of Web-based health behavior change support systems targeting excessive alcohol use and weight loss. We conducted en expert-based evaluation using the persuasive systems design model as a lens to view the twelve selected Web-based systems. The evaluation included a hands-on approach in which we used the systems for at least one month each and evaluated in terms of four categories: primary task support, computer-human dialogue support, system credibility, and social support. The results suggest that the systems harness a decent number of persuasive features. However, they had room for improvement (e.g., in terms of tailoring). Further research is needed to increase our understanding of how and under what conditions specific persuasive system features, either in isolation or collectively, lead to positive health outcomes in behavior change support systems across diverse contexts and populations. This study adds to the body of knowledge on designing persuasive health behavior change support systems

Selecting effective persuasive strategies in behavior change support systems: Third International Workshop on Behavior Change Support Systems (BCSS 2015)

The Third International Workshop on Behavior Change Support Systems provides a place to discuss recent advances in BCSS research. The selected papers show that research into behavior change support systems is expanding: not only by trying to reach more and other people, but also by expanding the contexts where BCSSs are employed. A key point for all BCSSs, for each target group and for each context, is to select the right persuasive strategies. From the proceedings we can learn that there are several ways to select and evaluate these features, but this remains an issue that deserves continuous research attention

Overcoming Cognitive and Motivational Barriers to Media Literacy: A Dual-Process Approach

In today\u27s fast-paced, hyper-mediated society, the ability to balance accuracy and efficiency is essential. Media literacy educational programs have arisen to meet this need and proliferated in recent years. Although the practice of media literacy is thriving, its underlying mechanisms are poorly understood and evidence of effectiveness is mixed (e.g., Bergsma & Carney, 2008). A social psychological perspective has the potential to illuminate previously overlooked variables and inform research and practice in this growing field. In particular, whereas media literacy efforts typically emphasize thorough processing of media messages, dual-process theories of persuasion (e.g., Eagly & Chaiken, 1993; Petty & Cacioppo, 1986) suggest this is not always realistic. When motivation or ability is compromised, individuals default to a low-effort processing mode, relying on peripheral cues or heuristics rather than carefully evaluating message arguments. In this mode, media messages can persuade unconsciously. Using a dual-process approach, the present research investigated how specific barriers to motivation (perceptions of personal invulnerability) and processing ability (emotion-based advertising, environmental distractions) influence the processes of media literacy. Participants (N = 882) were randomly assigned to 16 conditions in a 2 [vulnerability: demonstrated, control] x 2 [distractions: present, absent] x 2(2) [ad type: informational, emotional; two replicates of each type] between-subjects nested design. The vulnerability manipulation increased distrust in the target ads and reduced their persuasiveness, not through the hypothesized mechanism of heightened perceptions of vulnerability, but mediated by increased counterarguing. Relative to informational ads, emotional ads were judged more persuasive, attractive, similar to personal experience, and elicited greater identification. However, they were also rated less trustworthy than informational ads, suggesting emotional advertising largely bypasses logical decision-making processes. Distraction reduced counterarguing only among those who found the ad relatively unpersuasive. The results of this research highlight the central role of trust in media literacy processes. Although individuals recognize and distrust emotional forms of advertising, they are nonetheless persuaded by such appeals. Given the sophistication of contemporary advertising techniques and the ubiquity of distractions, the present research suggests new approaches to media literacy are needed, specifically tailored to decision-making under these more realistic media-use conditions

Tackling student binge drinking: pairing incongruent messages and measures reduces alcohol consumption

Objectives: Excessive alcohol consumption is a persistent problem in Northern European cultures. Across a 2-week period, we tested the effect of varying message frames, message types, and response measures, in reducing alcohol consumption. Design: Three hundred and twenty-three respondents were allocated to a 2 (message frame: gain vs. loss) × 2 (message type: health vs. social) × 2 (response type: engaging vs. refraining) mixed design. Method: Binge drinking and units consumed were measured at Time 1 and Time 2 (2 weeks later). Participants read (following Time 1) a gain- or loss-framed message on binging emphasizing either social or health consequences and answered engaging in or refraining from drinking attitude measures. Results: No main effects were identified. The key finding was that gain-framed messages, when used in conjunction with engage response measures (an incongruous pairing), were highly effective in reducing alcohol consumption 2 weeks later compared with the other message frame/response measure combinations. Conclusions: We suggest that for prevention behaviours, gain-framed messages, when paired with engage response measures, initiate an inconsistency resolution process. Together, our findings emphasize the importance of message frame and response type when seeking to reduce alcohol consumption using persuasive health messages

An exploration of how Generation Y demographics and point of sale marketing methods affect Generation Y’s purchasing decisions in bars

Master of ScienceDepartment of Hospitality Management and DieteticsBetsy BarrettAlcoholic beverages and on premise alcoholic beverage retailers have become important to the food and beverage industry in the past three millennia. On premise consumption of alcoholic beverages is necessary for income in bars which makes it crucial for alcoholic beverage producers and retailers to identify methods to increase sales and consumption of their products. One method used by retailers and producers is to market their product at the point of sale (POS). However, the effectiveness of various POS marketing methods can vary depending on the demographics of the consumer cohort being targeted. The Generation Y cohort is reaching legal drinking age and is quickly becoming the majority of customers patronizing bars. Because many members of Generation Y are new to the drinking and bar scene, point of sale marketing may be an effective method of introducing Generation Y to high profit beverages. Currently, 33% of all alcohol beverage marketing expenditures target customers at the point of sale. Therefore, the purpose of this study was to investigate how components of on-premise marketing methods, along with demographics, influence Generation Y’s purchasing decisions in bars. The sample was 216 members of Generation Y from across the country. Instrument development included a review of literature, three focus groups, a pilot study and a review by three industry experts. The final survey was distributed nationwide by Zoomerang.com. T-tests, ANOVA, factor analysis, and regression were used for data analysis. Results indicated that respondents patronized local bars and usually once a week, they drank regular beer, and spent an average of $23 per outing. Males, non-whites, and those who patronize bars on a weekly basis were significantly more likely to purchase alcoholic beverages based on POS logoed items at a bar. However, most respondents indicated that POS logoed items had no impact on their decisions and that assurance marketing was more important. Future studies need to be conducted focusing on either assurance marketing or logoed items. Also, demographic specific studies could be useful for local bars

Potential and effects of personalizing gameful fitness applications using behavior change intentions and Hexad user types

Personalizing gameful applications is essential to account for interpersonal differences in the perception of gameful design elements. Considering that an increasing number of people lead sedentary lifestyles, using personalized gameful applications to encourage physical activity is a particularly relevant domain. In this article, we investigate behavior change intentions and Hexad user types as factors to personalize gameful fitness applications. We first explored the potential of these two factors by analyzing differences in the perceived persuasiveness of gameful design elements using a storyboards-based online study (N=178). Our results show several significant effects regarding both factors and thus support the usefulness of them in explaining perceptual differences. Based on these findings, we implemented “Endless Universe,” a personalized gameful application encouraging physical activity on a treadmill. We used the system in a laboratory study (N=20) to study actual effects of personalization on the users’ performance, enjoyment and affective experiences. While we did not find effects on the immediate performance of users, positive effects on user experience-related measures were found. The results of this study support the relevance of behavior change intentions and Hexad user types for personalizing gameful fitness systems further

The relationship between sleep and nutrition in message framing among college students

The college years are often depicted as a time of immense change, specifically in relation to college students\u27 level of nutrition and sleep quality. However, these health concerns not only impact college students\u27 health but also their academic performance, mood, and as a result their future. The primary purpose of this study was to determine whether technologically enhanced health messages are more effective than the traditional text format for creating healthy behavioral changes amongst college students. Secondly, the study provides the opportunity to examine previous research involving message framing, specifically, regulatory focus theory and self-efficacy, in order to provide further evidence in relation to the most effective way to frame sleep hygiene and nutrition laden information. The frame of a health message refers to whether the message emphasizes the benefits of performing a behavior (gain frame) or the costs of not engaging in a specific behavior (loss frame). After reading two framed messages, one related to sleep hygiene and another related to nutrition, participants rated the extent to which they agreed with the messages as well as how persuasive they found the messages to be. Results indicated no significant findings, however, clinical and theoretical implications are discussed, as well as considerations for future research

Decision makers\u27 experience of participatory dynamic simulation modelling: Methods for public health policy

Background: Systems science methods such as dynamic simulation modelling are well suited to address questions about public health policy as they consider the complexity, context and dynamic nature of system-wide behaviours. Advances in technology have led to increased accessibility and interest in systems methods to address complex health policy issues. However, the involvement of policy decision makers in health-related simulation model development has been lacking. Where end-users have been included, there has been limited examination of their experience of the participatory modelling process and their views about the utility of the findings. This paper reports the experience of end-user decision makers, including senior public health policy makers and health service providers, who participated in three participatory simulation modelling for health policy case studies (alcohol related harm, childhood obesity prevention, diabetes in pregnancy), and their perceptions of the value and efficacy of this method in an applied health sector context. Methods: Semi-structured interviews were conducted with end-user participants from three participatory simulation modelling case studies in Australian real-world policy settings. Interviewees were employees of government agencies with jurisdiction over policy and program decisions and were purposively selected to include perspectives at different stages of model development. Results: The ‘co-production’ aspect of the participatory approach was highly valued. It was reported as an essential component of building understanding of the modelling process, and thus trust in the model and its outputs as a decision-support tool. The unique benefits of simulation modelling included its capacity to explore interactions of risk factors and combined interventions, and the impact of scaling up interventions. Participants also valued simulating new interventions prior to implementation in the real world, and the comprehensive mapping of evidence and its gaps to prioritise future research. The participatory aspect of simulation modelling was time and resource intensive and therefore most suited to high priority complex topics with contested options for intervening. Conclusion: These findings highlight the value of a participatory approach to dynamic simulation modelling to support its utility in applied health policy settings

Testimonial versus informational messages

Thesis (S.M.)--Harvard-MIT Division of Health Sciences and Technology, 2008."June 2008."Includes bibliographical references (leaves 40-47).Health communications use factual information or/and personal testimonials to inform and influence individual decisions that enhance health. Increasingly, Web and other computer-based systems are being used to communicate with patients. This study aims to test the relative effectiveness of testimonials compared to simple informational health messages presented through different modalities, and to the recipients with different levels of involvement. Results of the three independent experiments demonstrate that testimonials are more persuasive when presented through the audio mode rather than when presented through the written mode. Also, the informational messages are more persuasive when perceived by individuals characterized by high rather than low involvement and high rather than low need-for-cognition. The results are explained in terms of the Elaboration Likelihood Model (ELM). The interactive effect of transportation (Green & Brock, 2004) and involvement on persuasion is further examined. The findings help in developing the more effective ways of computer-based health communication. The highest level of efficiency can be achieved if the appropriate media modality and message format are used for recipients with certain initial involvement or need-for-cognition.by Julia Braverman.S.M