Persuasive Systems Design: Key Issues, Process Model, and System Features

A growing number of information technology systems and services are being developed to change users’ attitudes or behavior or both. Despite the fact that attitudinal theories from social psychology have been quite extensively applied to the study of user intentions and behavior, these theories have been developed for predicting user acceptance of the information technology rather than for providing systematic analysis and design methods for developing persuasive software solutions. This article is conceptual and theory-creating by its nature, suggesting a framework for Persuasive Systems Design (PSD). It discusses the process of designing and evaluating persuasive systems and describes what kind of content and software functionality may be found in the final product. It also highlights seven underlying postulates behind persuasive systems and ways to analyze the persuasion context (the intent, the event, and the strategy). The article further lists 28 design principles for persuasive system content and functionality, describing example software requirements and implementations. Some of the design principles are novel. Moreover, a new categorization of these principles is proposed, consisting of the primary task, dialogue, system credibility, and social support categories

Native Mobile Applications For Personal Well-Being: A Persuasive Systems Design Evaluation

Smartphone applications have shown promise in supporting people to adopt healthy lifestyles. Hence, it is critical to understand persuasive design strategies incorporated in native mobile applications that facilitate behavior change. The aim of our study was to identify distinct persuasive software features assimilated in twelve selected applications using Persuasive Systems Design (PSD) model and provide a methodical framework for systems developers and IS researchers to extract and evaluate such features. Further, this study aimed to provide deeper comprehension of persuasive design and strategies by learning from practice. Exhaustive evaluations were performed by four researchers specializing in persuasive information systems simulating users walking through the applications step-by-step performing regular tasks. The results disclose the need for improvement in designing and incorporating persuasive techniques in personal well-being applications. While self-monitoring and personalization were moderately exploited, tailoring, a key persuasive feature, was not identified among the evaluated applications. In addition, evaluated applications lacked features that could augment human-computer dialogue as well as social support. The contribution of this paper is two-fold: while it exposes weakness in persuasive design of native mobile applications for personal well-being, it provides a methodical approach for enhancing general persuasiveness of such applications for instance, through enhanced dialogue support. We propose that designers and IS researchers perform rigorous evaluations of persuasive features incorporated in personal well-being applications

Tekemällä oppii – kokeilukulttuurista vauhtia sosiaali- ja terveyspalveluiden uudistamiseen

Selvitystyön perimmäisenä tavoitteena oli selvittää, miten ketterillä kokeiluilla voidaan edistää sähköisten palvelujen käyttöä, uusien palveluiden tuottamismalleja ja toiminnan muutosta sosiaali- ja terveyspalveluissa. Selvitystyön toteutti VTT:n monitieteinen projektiryhmä ja se perustuu kirjalliseen taustamateriaaliin sekä asiantuntija- ja kansalaishaastatteluihin. ”Kokeilukulttuuri muuttuvassa sosiaali- ja terveydenhuollossa – sähköiset innovaatiot hyötykäyttöön” -hanke ehdottaa ratkaisuksi kokeilukulttuuria, joka kokoaa eri osapuolet yhteisen asian äärelle sähköisten palveluiden kehittämisen eri vaiheissa. Esitetyssä kokeilukulttuurin mallissa on kolme tasoa; kansallinen taso, organisaatiotaso sekä yksilötaso. Kokeilukulttuurin käyttöönotto edellyttää toimenpiteitä kaikilla kolmella tasolla. Kansallinen taso vastaa tarvittavasta lainsäädännöstä, ohjeistuksesta ja teknisestä infrastruktuurista. Sopiva kansallinen ohjaus ja tuki eivät rajoita kokeiluja vaan toimivat tukipilarina ja hyvien ratkaisujen levittäjinä. Kansallisen ohjauksen ja infrastruktuurin pohjalta varsinaiset palvelut toteutetaan ja tuotetaan SOTE-organisaatioissa, joiden henkilökunta on vastuussa kokeilujen läpiviennistä. Uusien palvelujen käyttöönotossa ja kokeilujen onnistumisessa avainasemassa ovat kansalaiset, joilta edellytetään aikaisempaa merkittävämpää vastuunottoa omasta hyvinvoinnistaan ja siten myös aktiivista osallistumista palvelujen kehittämiseen mm. kokeiluihin osallistumalla. Haastatteluiden pohjalta tunnistettiin useita kokeilukulttuuria edistäviä ja estäviä tekijöitä kaikilla kolmella eri tasolla. Kokeiluihin liitettyjä ominaisuuksia olivat muun muassa keveys ja ketteryys, vaikuttavuus ja innovatiivisuus. Tutkimuksen keskeisenä tuloksena esitetään suosituksia kokeilukulttuuriin siirtymiseksi sosiaali- ja terveyspalveluissa

Short-term effects of a digital patient journey solution on patient-reported outcomes and health care utilization in arthroplasty : a pragmatic randomized controlled trial

Mobile health solutions for patient support have been proposed as promising and safe alternatives to usual care in adults undergoing primary total hip and knee arthroplasty. Studies of such applications, however, have produced conflicting results and only moderate- to low-quality evidence. This study aims to evaluate the short-term effects of a digital patient journey solution on patient-reported outcomes and health care utilization in patients undergoing total hip and knee arthroplasty using a pragmatic randomized controlled trial design. Randomly allocated patients in the control arm (n = 35, 64 ± 9 years) received usual care, while patients in the intervention arm (n = 34, 62 ± 11 years) received the digital patient journey solution in addition to usual care. The primary outcome was health-related quality of life as measured by the EuroQol EQ-5D-5L scale. Secondary outcomes included functional recovery, pain, self-efficacy, patient experience, adherence to fast-track protocol, and health care utilization. Participants were followed from a preoperative surgical visit until a postoperative follow-up visit at 6–12 weeks. The health-related quality of life, functional recovery, pain, patient experience, adherence to the fast-track protocol, and health care utilization did not differ between the arms. During the study, however, the self-efficacy to use digital health services (p=0.027) increased in the intervention arm. The use of the digital patient journey solution was not superior to usual care in terms of patient-reported outcomes and health care utilization. However, the solution improved the self-efficacy of patients to use digital health services, which may lead to greater demand for similar digital offerings as patient become more familiar with mobile health solutions.Peer reviewe

Digitaalisten palvelujen vaikutukset sosiaali- ja terveydenhuollossa

Selvityksen tavoitteena oli luoda ajantasainen kuva digipalvelujen vaikutuksista sosiaali- ja terveydenhuollossa eri toimijoiden näkökulmista. Digipalveluja hyödynnetään etenkin terveydenhuollossa, erityisesti avosairaanhoidossa asiakaspolun eri vaiheissa. Myös kotihoidossa digipalveluita hyödynnetään runsaasti. Muissa sosiaalihuollon palveluissa digipalveluja havaittiin vähemmän, erityisesti vammais- ja hoivapalveluissa. Sosiaalihuollon digipalvelut ovat myös enemmän pistemäisiä; sähköisiä hakemuksia ja lomakkeita. Digipalvelujen käyttäjät ovat pääosin tyytyväisiä palveluihin. Asiakkaille kriittistä on digipalvelujen saavutettavuus ja integraatio, etenkin jos henkilöllä on useita pitkäaikaisia sairauksia, vammoja tai toiminnanvajausta. Ammattilaisten kokemukset digipalveluista ovat osin positiivisia, mutta huolia työmäärän lisääntymisestä esiintyy. Käyttöönotoissa tulisi tehdä enemmän työtä digipalvelujen viimekätisten hyötyjen ja vaikutusten saavuttamiseksi. Palvelujärjestelmän johto kokee, että digipalvelujen vaikutusten ja vaikuttavuuden arviointia tulisi lisätä, mutta mittaaminen on haasteellista. Yksi ratkaisu on sitoa mittaaminen voimakkaammin tavoitteisiin, mikä edellyttäisi selkeämpää tavoiteasetantaa. Digipalvelujen vaikuttavuus ei juurikaan näy lainsäädännössä, ja lainsäädännössä on useita kehittämistarpeita. Lain tulkinnat aiheuttavat haasteita digipalvelujen käytölle.Tämä julkaisu on toteutettu osana valtioneuvoston selvitys- ja tutkimussuunnitelman toimeenpanoa. (tietokayttoon.fi) Julkaisun sisällöstä vastaavat tiedon tuottajat, eikä tekstisisältö välttämättä edusta valtioneuvoston näkemystä

Enhanced Eating Competence Is Associated with Improved Diet Quality and Cardiometabolic Profile in Finnish Adults with Increased Risk of Type 2 Diabetes

Eating competence (EC) is characterized by positive attitudes towards food and eating, having regular meals, eating a variety of foods, and internally regulated eating. We investigated the associations of changes in EC with changes in lifestyle, anthropometrics and biomarkers of glucose and lipid metabolism in 2291 adults at increased risk of type 2 diabetes as part of the StopDia study conducted in primary healthcare. EC and diet quality were assessed with validated digital questionnaires. During the intervention, the participants received either (1) the digital lifestyle intervention, (2) the combined digital and face-to-face group-based lifestyle intervention, or (3) standard care. EC increased among the participants independent of the intervention type. Increase in EC was associated with an increase in diet quality, high-density lipoprotein (HDL) cholesterol, and with a decrease in body mass index and waist circumference, regardless of baseline EC. Of the subdomains of EC, the contextual skills, food acceptance and eating attitudes were associated with various of these changes. Our results thus suggest that EC could be a potential target in lifestyle interventions aiming to improve the cardiometabolic health of people at type 2 diabetes risk.publishedVersionPeer reviewe

Long-term Randomized Controlled Trial

Funding Information: The authors thank Sarah E Scott for her valuable contributions as the trial manager and in the user experience evaluation, and Susana Cunha for her contribution in conducting and reporting the focus groups. This project has received funding from the European Union?s Horizon 2020 research and innovation program under grant agreement number 643309. The material presented and views expressed here are the responsibility of the authors only. The European Union Commission does not take responsibility for any use made of the information set out.Background: Digital behavior change interventions (DBCIs) offer a promising channel for providing health promotion services. However, user experience largely determines whether they are used, which is a precondition for effectiveness. Objective: The primary aim of this study is to evaluate user experiences with the NoHoW Toolkit (TK)—a DBCI that targets weight loss maintenance—over a 12-month period by using a mixed methods approach and to identify the main strengths and weaknesses of the TK and the external factors affecting its adoption. The secondary aim is to objectively describe the measured use of the TK and its association with user experience. Methods: An 18-month, 2×2 factorial randomized controlled trial was conducted. The trial included 3 intervention arms receiving an 18-week active intervention and a control arm. The user experience of the TK was assessed quantitatively through electronic questionnaires after 1, 3, 6, and 12 months of use. The questionnaires also included open-ended items that were thematically analyzed. Focus group interviews were conducted after 6 months of use and thematically analyzed to gain deeper insight into the user experience. Log files of the TK were used to evaluate the number of visits to the TK, the total duration of time spent in the TK, and information on intervention completion. Results: The usability level of the TK was rated as satisfactory. User acceptance was rated as modest; this declined during the trial in all the arms, as did the objectively measured use of the TK. The most appreciated features were weekly emails, graphs, goal setting, and interactive exercises. The following 4 themes were identified in the qualitative data: engagement with features, decline in use, external factors affecting user experience, and suggestions for improvements. Conclusions: The long-term user experience of the TK highlighted the need to optimize the technical functioning, appearance, and content of the DBCI before and during the trial, similar to how a commercial app would be optimized. In a trial setting, the users should be made aware of how to use the intervention and what its requirements are, especially when there is more intensive intervention content.publishersversionpublishe

Digitally Supported Lifestyle Intervention to Prevent Type 2 Diabetes Through Healthy Habits : Secondary Analysis of Long-Term User Engagement Trajectories in a Randomized Controlled Trial

Background: Digital health interventions may offer a scalable way to prevent type 2 diabetes (T2D) with minimal burden on health care systems by providing early support for healthy behaviors among adults at increased risk for T2D. However, ensuring continued engagement with digital solutions is a challenge impacting the expected effectiveness. Objective: We aimed to investigate the longitudinal usage patterns of a digital healthy habit formation intervention, BitHabit, and the associations with changes in T2D risk factors. Methods: This is a secondary analysis of the StopDia (Stop Diabetes) study, an unblinded parallel 1-year randomized controlled trial evaluating the effectiveness of the BitHabit app alone or together with face-to-face group coaching in comparison with routine care in Finland in 2017-2019 among community-dwelling adults (aged 18 to 74 years) at an increased risk of T2D. We used longitudinal data on usage from 1926 participants randomized to the digital intervention arms. Latent class growth models were applied to identify user engagement trajectories with the app during the study. Predictors for trajectory membership were examined with multinomial logistic regression models. Analysis of covariance was used to investigate the association between trajectories and 12-month changes in T2D risk factors. Results: More than half (1022/1926, 53.1%) of the participants continued to use the app throughout the 12-month intervention. The following 4 user engagement trajectories were identified: Terminated usage (904/1926, 46.9%), weekly usage (731/1926, 38.0%), twice weekly usage (208/1926, 10.8%), and daily usage (83/1926, 4.3%). Active app use during the first month, higher net promoter score after the first 1 to 2 months of use, older age, and better quality of diet at baseline increased the odds of belonging to the continued usage trajectories. Compared with other trajectories, daily usage was associated with a higher increase in diet quality and a more pronounced decrease in BMI and waist circumference at 12 months. Conclusions: Distinct long-term usage trajectories of the BitHabit app were identified, and individual predictors for belonging to different trajectory groups were found. These findings highlight the need for being able to identify individuals likely to disengage from interventions early on, and could be used to inform the development of future adaptive interventions.publishedVersionPeer reviewe