Software design of a health BCSS:case Onnikka

The purpose of this thesis is to study the process of designing and developing a web-based application for supporting people struggling with overweight to change their behaviour in order to prevent health risks. Obesity and its co-morbidities represent one of the major public health problems globally. To prevent health problems caused by overweight, such as the metabolic syndrome, a sustainable change in an individual’s health behavior is required. Behavior Change Support Systems (BCSSs) have been introduced as objects of study in the field of persuasive technology, defined as information systems designed to form, alter or reinforce attitudes, behaviors or an act of complying without using deception, coercion or inducements. One of the most prominent domain areas for these systems is promoting behavior change for improved health and healthier lifestyles. Despite the importance of the research domain, descriptions from the systems in most cases have been presented in too general level to be benefited from. In the scope of this thesis, we built a full-fledge BCSS within the weight loss and maintenance domain to support users lifestyle change process during a 52-week long intervention. The system design process is studied here to find re-usable conceptual designs such as software architectures and design patterns for future BCSS development and research

Flow or no flow?:a qualitative study of health behavior change support system

Abstract Recent studies about technology acceptance have highlighted the significance of hedonic values when examining consumer information systems. The flow experience is often taken as a theoretical construct to explain hedonic motivations in Web-related studies. However, regarding consumer healthcare information systems, the relevance of hedonic values has received relatively little attention. In this study Oinas-Kukkonen’s webflow model and its constructs are used to understand user experience in Behavior Change Support Systems (BCSSs) designed to prevent metabolic syndrome. Twelve participants were interviewed after using the system for ten weeks. Our findings suggest that in the area of consumer healthcare information systems, hedonic values are not as important as utilitarian values. This study demonstrates the value of the webflow model as a research framework and contributes to its further development. Methodologically, this paper contributes to a rarely used qualitative approach in studying the flow experience

Persuasive user experiences of a health Behavior Change Support System:a 12-month study for prevention of metabolic syndrome

Abstract Background: Obesity has become a severe health problem in the world. Even a moderate 5% weight loss can significantly reduce the prevalence of metabolic syndrome, which can be vital for preventing comorbidities caused by the obesity. Health Behavior Change Support Systems (hBCSS) emphasize an autogenous approach, where an individual uses the system to influence one’s own attitude or behavior to achieve his or her own goal. Regardless of promising results, such health interventions technology has often been considered merely as a tool for delivering content that has no effect or value of its own. More research on actual system features is required. Objectives: The objective of this study is to describe how users perceive persuasive software features designed and implemented into a support system. Methods: The research medium in this study is a web-based information system designed as a lifestyle intervention for participants who are at risk of developing a metabolic syndrome or who are already suffering from it. The system was designed closely following the principles of the Persuasive Systems Design (PSD) model and the Behavior Change Support Systems (BCSS) framework. A total of 43 system users were interviewed for this study during and after a 52 week intervention period. In addition, the system’s login data and subjects’ Body Mass Index (BMI) measures were used to interpret the results. Results: This study explains in detail how the users perceived using the system and its persuasive features. Self-monitoring, reminders, and tunneling were perceived as especially beneficial persuasive features. The need for social support appeared to grow along the duration of the intervention. Unobtrusiveness was found to be very important in all stages of the intervention rather than only at the beginning. Conclusions: Persuasive software features have power to affect individuals’ health behaviors. Through their systematicity the PSD model and the BCSS framework provide effective support for the design and development of technological health interventions. Designers of such systems may choose, for instance, to implement more self-monitoring tools to help individuals to adjust their personal goals with the system’s offerings better

Developing a system for prevention of metabolic syndrome

Abstract The aim of this presentation is to explain how a behaviour change support system has been developed, what were its core features, how users perceived those features and whether it succeeded to produce desired health outcomes

Opportunities and challenges of behavior change support systems for enhancing habit formation:a qualitative study

Abstract The formation of healthy habits is considered to play a fundamental role in health behavior change. A variety of studies on Health Behavior Change Support Systems (HBCSS) have been conducted recently, in which individuals use such systems to influence their own attitudes or behaviors to achieve their personal goals. However, comparatively much less research has been devoted to studying how the users of these systems form habits with the help of HBCSS, or to understanding how to design these systems to support habit formation. Objective: The objective of this article is to study HBCSS user experiences regarding habit formation through an intervention study targeted at establishing a healthier lifestyle. This study also aims to map habit formation stages, as suggested by Lally and Gardner, with the Persuasive System Design (PSD) model. The application domain is the prevention of metabolic syndrome, in which 5% weight loss can significantly reduce the prevalence of the syndrome. Methods: This study employs a web-based HBCSS named Onnikka, a lifestyle intervention designed for the prevention of metabolic syndrome for participants who are at risk of developing a metabolic syndrome or are already suffering from it. The system under investigation was designed according to the principles of the PSD model and Behavior Change Support System framework. Lally and Gardner’s research on the stages of habit formation were used to study the extent to which the Onnikka system was able to enhance the development of new habits. A total of 43 Onnikka users were interviewed for this study during and after a 52-week intervention period. The research approach employed here was hermeneutics, which leans ontologically toward the social construction of reality, gained through language, consciousness, and shared meaning. In addition, the system’s login data and participants’ weight measurements were utilized to build an interpretation of the results. Results: The findings of this study suggest that IT habits appear to have a strong linkage with use adherence, whereas lifestyle habits did not seem to be directly related to the 5% weight loss among study participants. Moreover, habit formation stages provide a possible explanation for why self-monitoring, reminders, and tunneling were perceived as especially valuable features in this study. Conclusions: For sustainable weight management, holistic e-health interventions are required, and the PSD model offers a practical approach for designing and developing them. Recognizing the stages of habit formation provides additional valuable guidance for designing systems that help shape an individual’s habits

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