Changing behaviours via self-tracking:exploring the effect of psychological differences on system evaluations

Abstract Self-tracking devices are promising tools for delivering support for behavioural changes. They present a mix of behaviourally relevant, theory-driven features and functionalities. The effectiveness of digital tools lies in their ability to scale solutions to individuals with diverse characteristics. However, the same solution will probably not deliver results for all needs. Some challenges could be overcome by commercial off-the-shelf systems designed to solve health behaviour problems, such as a lack of physical activity. Although digital systems to support health behaviour changes have progressed remarkably, there is still room for new endeavours to understand why some turn into solutions and why many do not work as expected. Accordingly, this thesis explores the intersection of theories and techniques of behaviour change and the current design of commercial self-tracking systems. The work is based on subjective user evaluations and built on the persuasive systems design (PSD) model. Themes include reflection, the susceptibility to social influence strategies, the need for cognition, an exerciser’s self-schema and goal focus. This thesis comprises five studies. The quantitative data for the thesis were collected using structured survey questionnaires in 2015 and 2019. Surveys targeted those who had used their self-selected systems to monitor physical activity. Theory-based research models were analysed using structural equation modelling. The studies report differences in user evaluations in each studied theoretical theme and highlight heterogeneity in the real-life context of physical activity monitoring. Findings suggest that even the most basic mechanisms might not work for all users or systems. Users also choose systems to match their preferences and motivations, and tailoring approaches might not always be feasible. This work also contributes to perceptions of effectiveness, often neglected in discussions of evidence and theory. The thesis presents design insights from the intersection of evidence-based strategies and subjective user experiences and aims to advance the designs of future systems by embracing the subjective nature of behaviour change experiences.Tiivistelmä Ihmisen käyttäytymistä seuraavat itsemittausjärjestelmät ovat lupaavia apuvälineitä käyttäytymisen muutosten tukemiseen. Yleensä niistä on tunnistettavissa monia käyttäytymisen muutoksen teorioihin pohjautuvia toiminnallisuuksia. Digitaalisten lähestymistapojen vahvuutena pidetään skaalautumista laajalle käyttäjäjoukolle ja monenlaisille käyttäjille, mutta samat ratkaisut eivät kuitenkaan vastaa kaikkien käyttäjien tarpeisiin. Joihinkin terveyskäyttäytymisen osa-alueisiin, kuten fyysisen aktiivisuuden lisäämiseen, itsemittausjärjestelmät vaikuttavat jossain määrin vastaavan. Vaikka fyysisen aktiivisuuden lisäämiseen tarkoitetut itsemittausjärjestelmät ovat kehittyneet huimasti viime vuosina, ei vielä täysin ymmärretä, miksi jotkut järjestelmät pystyvät auttamaan muutosten tekemisessä ja toiset eivät toimi toivotulla tavalla. Tässä väitöskirjassa tutkittiin teoreettisten muutostekniikoiden ja kaupallisten itsemittausjärjestelmien suunnittelun välistä rajapintaa. Työ pohjautuu oikeiden käyttäjien subjektiivisiin arviointeihin ja Persuasive System Design -malliin (PSD). Työssä tutkittiin muutosta tukevia suunnitteluratkaisuja reklektiotarpeen, sosiaalisten vaikutusmekanismien, kognitiotarpeen ja liikkujan minäkuvan kautta. Työ koostuu viidestä osajulkaisusta. Määrällinen aineisto kerättiin kyselytutkimuksella vuosina 2015 ja 2019. Vastaajina olivat kaupallisia itsemittausjärjestelmiä omavalintaisesti ja vapaaehtoisesti käyttävät ihmiset. PSD-malliin ja käyttäytymismuutoskirjallisuuden hyödyntämiin teorioihin pohjautuvia teoreettisia malleja analysoitiin rakenneyhtälömallinnuksella. Tulosten perusteella käyttäjäarvioinnit eroavat toisistaan kaikkien tutkittujen ominaisuuksien osalta, mikä korostaa käyttäjädiversiteetin laajuutta. Löydösten mukaan jopa kaikkein oleellisimmat ominaisuudet voivat toimia eri tavalla eri käyttäjille. Käyttäjät myös valitsevat järjestelmiä eri tavoin, jolloin käyttöönoton jälkeen tapahtuva räätälöinti ei toimi. Työ kuvaa käyttäjien subjektiivista kokemusta itsemittausjärjestelmän vaikuttavuudesta, mikä on usein sivuroolissa. Tulosten pohjalta väitöskirja kuvaa käyttäytymissuunnittelun mallin ja suunnittelustrategioita, joiden avulla itsemittausjärjestelmiä voidaan kehittää huomioimaan paremmin erilaisia käyttäjätarpeita ja tukemaan käyttäytymisen muutoksen subjektiivista luonnetta

Need for cognition among users of self-monitoring systems for physical activity:survey study

Abstract Background: Need for cognition (NFC) is among the most studied personality traits in psychology. Despite its apparent relevance for engaging with technology and the use of information, it has not been studied in the context of self-monitoring systems and wearables for health. This study is the first to explore the relationship between NFC and commercial self-monitoring systems among healthy users. Objective: This study aims to explore the effect of NFC levels on the selection of self-monitoring systems and evaluation of system features of self-monitoring and feedback, as well as perceived credibility and perceived persuasiveness. We also assessed perceived behavior change in the form of self-reported activity after adopting the system. Methods: Survey data were collected in October 2019 among university students and personnel. The invitation to respond to the questionnaire was addressed to those who had used a digital system to monitor their physical activity for at least two months. The web-based questionnaire comprised the following 3 parts: details of system use, partially randomly ordered theoretical measurement items, and user demographics. The data were analyzed using structural equation modeling. The effect of NFC was assessed both as 3 groups (low, moderate, and high) and as a continuous moderator variable. Results: In all, 238 valid responses to the questionnaire were obtained. Individuals with high NFC reported all tested system features with statistically significantly higher scores. The NFC also had some effect on system selection. Hypothesized relationships with perceived credibility gained support in a different way for individuals with low and high NFC; for those with low NFC, credibility increased the persuasiveness of the system, but this effect was absent among individuals with high NFC. For users with high NFC, credibility was related to feedback and self-monitoring and perhaps continuously evaluated during prolonged use instead of being a static system property. Furthermore, the relationship between perceived persuasiveness and self-reported activity after adopting the system had a large effect size (Cohen f²=0.355) for individuals with high NFC, a small effect size for individuals with moderate NFC (Cohen f²=0.107), and a nonsignificant path (P=.16) for those with low NFC. We also detected a moderating effect of NFC in two paths on perceived persuasiveness but only among women. Our research model explained 59.2%, 63.9%, and 47.3% of the variance in perceived persuasiveness of the system among individuals with low, moderate, and high NFC, respectively. Conclusions: The system choices of individuals seem to reflect their intrinsic motivations to engage with rich data, and commercial systems might themselves be a tailoring strategy. Important characteristics of the system, such as perceived credibility, have different roles depending on the NFC levels. Our data demonstrate that NFC as a trait that differentiates information processing has several implications for the selection, design, and tailoring of self-monitoring systems

Susceptibility to social influence strategies and persuasive system design:exploring the relationship

Abstract Cialdini’s six principles of influence are commercially used but less common to encourage healthy behaviors. This study examines how these influence strategies relate to the persuasive systems design (PSD) model constructs implemented in commercial mobile fitness applications. Our research questions address whether susceptibility to influence strategies strengthen the relationships between persuasive constructs and, if so, which strategies and software features are promising to leverage the persuasive effects of systems designed to change health behaviors. This study presents results from a survey of system users (N=147) and their self-reported susceptibility to the six principles. All PSD model constructs showed significantly unequal distribution for some influence strategy, indicating that susceptibility to these strategies affects how users evaluate systems. The commitment principle correlated positively with all persuasive constructs, while reciprocation, scarcity and liking all significantly affected system evaluations. Susceptibility to influence strategies also moderated the relationships between PSD model constructs, but the moderation was often negative with small effect sizes. Our preliminary results indicate that practitioners could benefit from utilizing these influence strategies, especially susceptibility to commitment and reciprocation, which are stable and often high. However, the interaction between these strategies and persuasive systems is not straightforward and would benefit from further research

Persuading to reflect:role of reflection and insight in persuasive systems design for physical health

Abstract Mobile applications and self-tracking devices help us to maintain health and support our goals in changing our behaviors. Most of these tools aim to increase our self-knowledge by providing information upon which to reflect. However, merely spending time reflecting does not always lead to insightful outcomes. In this study surveying users of mobile health and fitness applications (N = 147), we have used structural equation modeling to explore the need for and roles of reflection and insight in the persuasive systems design model. The findings suggest that both dialogue support and primary task support features influence the need for reflection, paving the way to personal insight. The perceived credibility of the system played different roles for women and men and seemed to originate from different sources. In addition, we found significant roles for the attitude and unobtrusiveness of the system. This article contributes to positioning the reflective capabilities of a system in the design framework of persuasive systems and makes preliminary suggestions regarding how to transform the need for reflection into insights. It also exemplifies how to evaluate behavior change technologies by assessing the psychological outcomes of the intervention

Supporting and understanding reflection on persuasive technology through a reflection schema

Abstract Literature on persuasive technology acknowledges the importance of promoting reflection within design research and practice. This paper takes up a reflection framework suggested in previous research as assisting the reasoning of researchers, designers or other stakeholders concerning values, goals, actions, and their consequences in a project. It contributes to this research by demonstrating additional evidence for the applicability of the reflection framework by applying it to a published case. This work can guide researchers and practitioners by means of issues to be considered while reflecting on as well as communicating value-related aspects in a project, so that significant value choices and the rationale for actions taken to promote them are clear

Recovering from work-related strain and stress with the help of a persuasive mobile application:interview-based thematic analysis of micro-entrepreneurs

Abstract People often have long-term personal goals regarding health behavior change. Recently, the processes for achieving these goals have begun to be supported through behavior change support systems and especially through their persuasive software features. In a multidisciplinary research project focused on helping micro-entrepreneurs to recover from work-related strain and stress, a persuasive mobile application was developed. For gaining insights about the workings of the system and its persuasive features, we conducted 29 interviews with the system users. We used thematic analysis method with a deductive emphasis for analyzing the interviews. For some, concurrent usage of wearables or other applications led to discarding our application. Users thought that the application was relatively persuasive, but technical issues reduced its persuasiveness noticeably. When functioning properly, self-monitoring and reminders were found to be supportive for users to achieve their goals. Unobtrusiveness was found to increase the persuasiveness of reminders, while self-monitoring always seems to be dependent on the user’s personal needs

Reflection through gaming:reinforcing health message response through gamified rehearsal

Abstract Reflection is generally considered an effective means of achieving behavior change. A gamified approach to promoting rehearsal and reflection in a healthy eating context was studied. The game was based on the principles of the Implicit Attitude Test: by categorizing food items under positive or negative associations the players would gain points according to how fast they categorized foods under positive or negative associations. Game scores constituted feedback for reflection, and repeated playing constituted rehearsal of target responses. Experiment participants (N = 58) played the game over a five-day period. Constructs of Rehearsal (REH), self-reported questionnaire responses on Reflection (REFL) and Perceived Persuasiveness (PEPE), and self-reported Perceived Health Behavior Change (PHBC) were analyzed using PLS-SEM. The results show that PLAY moderates the REFL-PEPE relationship, and there are also significant relationships between REH and PEPE, PEPE and PHBC, and REFL and PHBC