scholarly journals Persuasive System Design Principles and Behavior Change Techniques to Stimulate Motivation and Adherence in Electronic Health Interventions to Support Weight Loss Maintenance: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Rikke Aune Asbjørnsen ◽  
Mirjam Lien Smedsrød ◽  
Lise Solberg Nes ◽  
Jobke Wentzel ◽  
Cecilie Varsi ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behavior Change ◽  
Goal Setting ◽  
Weight Loss Maintenance ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Support Weight ◽  
And Behavior ◽  
Weight Loss Interventions

BACKGROUND Maintaining weight after weight loss is a major health challenge, and eHealth (electronic health) solutions may be a way to meet this challenge. Application of behavior change techniques (BCTs) and persuasive system design (PSD) principles in eHealth development may contribute to the design of technologies that positively influence behavior and motivation to support the sustainable health behavior change needed. OBJECTIVE This review aimed to identify BCTs and PSD principles applied in eHealth interventions to support weight loss and weight loss maintenance, as well as techniques and principles applied to stimulate motivation and adherence for long-term weight loss maintenance. METHODS A systematic literature search was conducted in PsycINFO, Ovid MEDLINE (including PubMed), EMBASE, Scopus, Web of Science, and AMED, from January 1, 2007 to June 30, 2018. Arksey and O’Malley’s scoping review methodology was applied. Publications on eHealth interventions were included if focusing on weight loss or weight loss maintenance, in combination with motivation or adherence and behavior change. RESULTS The search identified 317 publications, of which 45 met the inclusion criteria. Of the 45 publications, 11 (24%) focused on weight loss maintenance, and 34 (76%) focused on weight loss. Mobile phones were the most frequently used technology (28/45, 62%). Frequently used wearables were activity trackers (14/45, 31%), as well as other monitoring technologies such as wireless or digital scales (8/45, 18%). All included publications were anchored in behavior change theories. Feedback and monitoring and goals and planning were core behavior change technique clusters applied in the majority of included publications. Social support and associations through prompts and cues to support and maintain new habits were more frequently used in weight loss maintenance than weight loss interventions. In both types of interventions, frequently applied persuasive principles were self-monitoring, goal setting, and feedback. Tailoring, reminders, personalization, and rewards were additional principles frequently applied in weight loss maintenance interventions. Results did not reveal an ideal combination of techniques or principles to stimulate motivation, adherence, and weight loss maintenance. However, the most frequently mentioned individual techniques and principles applied to stimulate motivation were, personalization, simulation, praise, and feedback, whereas associations were frequently mentioned to stimulate adherence. eHealth interventions that found significant effects for weight loss maintenance all applied self-monitoring, feedback, goal setting, and shaping knowledge, combined with a human social support component to support healthy behaviors. CONCLUSIONS To our knowledge, this is the first review examining key BCTs and PSD principles applied in weight loss maintenance interventions compared with those of weight loss interventions. This review identified several techniques and principles applied to stimulate motivation and adherence. Future research should aim to examine which eHealth design combinations can be the most effective in support of long-term behavior change and weight loss maintenance.

scholarly journals Identifying Persuasive Design Principles and Behavior Change Techniques Supporting End User Values and Needs in eHealth Interventions for Long-Term Weight Loss Maintenance: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Rikke Aune Asbjørnsen ◽  
Jobke Wentzel ◽  
Mirjam Lien Smedsrød ◽  
Jøran Hjelmesæth ◽  
Matthew M Clark ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behavior Change ◽  
Weight Loss Maintenance ◽  
End User ◽  
Behavior Change Techniques ◽  
Design Elements ◽  
Healthy Behaviors ◽  
Key Stakeholders ◽  
And Behavior

BACKGROUND An increasing number of eHealth interventions aim to support healthy behaviors that facilitate weight loss. However, there is limited evidence of the effectiveness of the interventions and little focus on weight loss maintenance. Knowledge about end user values and needs is essential to create meaningful and effective eHealth interventions, and to identify persuasive system design (PSD) principles and behavior change techniques (BCTs) that may contribute to the behavior change required for successful long-term weight loss maintenance. OBJECTIVE This study aimed to provide insight into the design of eHealth interventions supporting behavior change for long-term weight maintenance. The study sought to identify the values and needs of people with obesity aiming to maintain weight after weight loss, and to identify PSD principles, BCTs, and design requirements that potentially enable an eHealth intervention to meet end user values and needs. METHODS This study presents the concept of integrating PSD principles and BCTs into the design process of eHealth interventions to meet user values and needs. In this study, individual interviews and focus groups were conducted with people with obesity (n=23) and other key stakeholders (n=27) to explore end user values and needs related to weight loss maintenance. Design thinking methods were applied during the focus group sessions to identify design elements and to explore how eHealth solutions can support the needs to achieve sustainable weight loss maintenance. The PSD model and behavior change taxonomy by Michie were used to identify PSD principles and BCT clusters to meet end user values and needs. RESULTS A total of 8 key end user values were identified, reflecting user needs for weight loss maintenance support: <i>self-management</i>, <i>personalized care</i>, <i>autonomy</i>, <i>feel supported</i>, <i>positive self-image</i>, <i>motivation</i>, <i>happiness</i>, and <i>health</i>. <i>Goals and planning</i>, <i>feedback and monitoring</i>, <i>repetition and substitution</i>, <i>shaping knowledge</i>, <i>social support</i>, <i>identity</i>, and <i>self-belief</i> were some of the BCT clusters identified to address these concepts, together with PSD principles such as <i>personalization</i>, <i>tailoring</i>, <i>self-monitoring</i>, <i>praise</i>, and <i>suggestions</i>. CONCLUSIONS The process of translating end user values and needs into design elements or features of eHealth technologies is an important part of the design process. To our knowledge, this is the first study to explore how PSD principles and BCTs can be integrated when designing eHealth self-management interventions for long-term weight loss maintenance. End users and other key stakeholders highlighted important factors to be considered in the design of eHealth interventions supporting sustained behavior change. The PSD principles and BCTs identified provide insights and suggestions about design elements and features to include for supporting weight loss maintenance. The findings indicate that a combination of BCTs and PSD principles may be needed in evidence-based eHealth interventions to stimulate motivation and adherence to support healthy behaviors and sustained weight loss maintenance. CLINICALTRIAL ClinicalTrials.gov NCT04537988; https://clinicaltrials.gov/ct2/show/NCT04537988

scholarly journals Identifying Persuasive Design Principles and Behavior Change Techniques Supporting End User Values and Needs in eHealth Interventions for Long-Term Weight Loss Maintenance: Qualitative Study

10.2196/22598 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e22598
Author(s):  
Rikke Aune Asbjørnsen ◽  
Jobke Wentzel ◽  
Mirjam Lien Smedsrød ◽  
Jøran Hjelmesæth ◽  
Matthew M Clark ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behavior Change ◽  
Weight Loss Maintenance ◽  
End User ◽  
Behavior Change Techniques ◽  
Design Elements ◽  
Healthy Behaviors ◽  
Key Stakeholders ◽  
And Behavior

Background An increasing number of eHealth interventions aim to support healthy behaviors that facilitate weight loss. However, there is limited evidence of the effectiveness of the interventions and little focus on weight loss maintenance. Knowledge about end user values and needs is essential to create meaningful and effective eHealth interventions, and to identify persuasive system design (PSD) principles and behavior change techniques (BCTs) that may contribute to the behavior change required for successful long-term weight loss maintenance. Objective This study aimed to provide insight into the design of eHealth interventions supporting behavior change for long-term weight maintenance. The study sought to identify the values and needs of people with obesity aiming to maintain weight after weight loss, and to identify PSD principles, BCTs, and design requirements that potentially enable an eHealth intervention to meet end user values and needs. Methods This study presents the concept of integrating PSD principles and BCTs into the design process of eHealth interventions to meet user values and needs. In this study, individual interviews and focus groups were conducted with people with obesity (n=23) and other key stakeholders (n=27) to explore end user values and needs related to weight loss maintenance. Design thinking methods were applied during the focus group sessions to identify design elements and to explore how eHealth solutions can support the needs to achieve sustainable weight loss maintenance. The PSD model and behavior change taxonomy by Michie were used to identify PSD principles and BCT clusters to meet end user values and needs. Results A total of 8 key end user values were identified, reflecting user needs for weight loss maintenance support: self-management, personalized care, autonomy, feel supported, positive self-image, motivation, happiness, and health. Goals and planning, feedback and monitoring, repetition and substitution, shaping knowledge, social support, identity, and self-belief were some of the BCT clusters identified to address these concepts, together with PSD principles such as personalization, tailoring, self-monitoring, praise, and suggestions. Conclusions The process of translating end user values and needs into design elements or features of eHealth technologies is an important part of the design process. To our knowledge, this is the first study to explore how PSD principles and BCTs can be integrated when designing eHealth self-management interventions for long-term weight loss maintenance. End users and other key stakeholders highlighted important factors to be considered in the design of eHealth interventions supporting sustained behavior change. The PSD principles and BCTs identified provide insights and suggestions about design elements and features to include for supporting weight loss maintenance. The findings indicate that a combination of BCTs and PSD principles may be needed in evidence-based eHealth interventions to stimulate motivation and adherence to support healthy behaviors and sustained weight loss maintenance. Trial Registration ClinicalTrials.gov NCT04537988; https://clinicaltrials.gov/ct2/show/NCT04537988

scholarly journals A Conceptual Model of Long-Term Weight Loss Maintenance: The Importance of Cognitive, Empirical and Computational Approaches

2021 ◽  
Vol 18 (2) ◽  
pp. 635
Author(s):  
Darren Haywood ◽  
Blake J. Lawrence ◽  
Frank D. Baughman ◽  
Barbara A. Mullan
Keyword(s):  
Weight Loss ◽  
Weight Loss Maintenance ◽  
Computational Approaches ◽  
Healthy Habits ◽  
Health Related ◽  
The One ◽  
Major Factors ◽  
Positive Social Support ◽  
Weight Loss Interventions

Living with obesity is related to numerous negative health outcomes, including various cancers, type II diabetes, and cardiovascular disease. Although much is known about the factors associated with obesity, and a range of weight loss interventions have been established, changing health-related behaviours to positively affect obesity outcomes has proven difficult. In this paper, we first draw together major factors that have emerged within the literature on weight loss to describe a new conceptual framework of long-term weight loss maintenance. Key to this framework is the suggestion that increased positive social support influences a reduction in psychosocial stress, and that this has the effect of promoting better executive functioning which in turn facilitates the development of healthy habits and the breaking of unhealthy habits, leading to improved ongoing maintenance of weight loss. We then outline how the use of computational approaches are an essential next step, to more rigorously test conceptual frameworks, such as the one we propose, and the benefits that a mixture of conceptual, empirical and computational approaches offer to the field of health psychology.

scholarly journals Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men: A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project)

2015 ◽  
Vol 11 (4) ◽  
pp. 1096-1123 ◽  
Author(s):  
Clare Robertson ◽  
Alison Avenell ◽  
Fiona Stewart ◽  
Daryll Archibald ◽  
Flora Douglas ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Weight Loss ◽  
Confidence Interval ◽  
Behavior Change ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Behavior Change Techniques ◽  
Randomized Controlled ◽  
And Behavior

Men are underrepresented in obesity services, suggesting current weight loss service provision is suboptimal. This systematic review evaluated evidence-based strategies for treating obesity in men. Eight bibliographic databases and four clinical trials’ registers were searched to identify randomized controlled trials (RCTs) of weight loss interventions in men only, with mean/median body mass index of ≥30 kg/m2 (or ≥28 kg/m2 with cardiac risk factors), with a minimum mean/median duration of ≥52 weeks. Interventions included diet, physical activity, behavior change techniques, orlistat, or combinations of these; compared against each other, placebo, or a no intervention control group; in any setting. Twenty-one reports from 14 RCTs were identified. Reducing diets produced more favorable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise program −3.2 kg, 95% confidence interval −4.8 to −1.6 kg, reported p < .01). The most effective interventions combined reducing diets, exercise, and behavior change techniques (mean difference in weight at 1 year compared with no intervention was −4.9 kg, 95% confidence interval −5.9 to −4.0, reported p < .0001). Group interventions produced favorable weight loss results. The average reported participant retention rate was 78.2%, ranging from 44% to 100% retention, indicating that, once engaged, men remained committed to a weight loss intervention. Weight loss for men is best achieved and maintained with the combination of a reducing diet, increased physical activity, and behavior change techniques. Strategies to increase engagement of men with weight loss services to improve the reach of interventions are needed.

scholarly journals Behavior Change Techniques in Wrist-Worn Wearables to Promote Physical Activity: Content Analysis (Preprint)

2020 ◽  
Author(s):  
Peter Düking ◽  
Marie Tafler ◽  
Birgit Wallmann-Sperlich ◽  
Billy Sperlich ◽  
Sonja Kleih
Keyword(s):  
Physical Activity ◽  
Content Analysis ◽  
Behavior Change ◽  
Goal Setting ◽  
Wearable Sensors ◽  
Action Planning ◽  
Noncommunicable Diseases ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Current Behavior

BACKGROUND Decreasing levels of physical activity (PA) increase the incidences of noncommunicable diseases, obesity, and mortality. To counteract these developments, interventions aiming to increase PA are urgently needed. Mobile health (mHealth) solutions such as wearable sensors (wearables) may assist with an improvement in PA. OBJECTIVE The aim of this study is to examine which behavior change techniques (BCTs) are incorporated in currently available commercial high-end wearables that target users’ PA behavior. METHODS The BCTs incorporated in 5 different high-end wearables (Apple Watch Series 3, Garmin Vívoactive 3, Fitbit Versa, Xiaomi Amazfit Stratos 2, and Polar M600) were assessed by 2 researchers using the BCT Taxonomy version 1 (BCTTv1). Effectiveness of the incorporated BCTs in promoting PA behavior was assessed by a content analysis of the existing literature. RESULTS The most common BCTs were goal setting (behavior), action planning, review behavior goal(s), discrepancy between current behavior and goal, feedback on behavior, self-monitoring of behavior, and biofeedback. Fitbit Versa, Garmin Vívoactive 3, Apple Watch Series 3, Polar M600, and Xiaomi Amazfit Stratos 2 incorporated 17, 16, 12, 11, and 11 BCTs, respectively, which are proven to effectively promote PA. CONCLUSIONS Wearables employ different numbers and combinations of BCTs, which might impact their effectiveness in improving PA. To promote PA by employing wearables, we encourage researchers to develop a taxonomy specifically designed to assess BCTs incorporated in wearables. We also encourage manufacturers to customize BCTs based on the targeted populations.

scholarly journals Behavior change techniques in mobile applications for sedentary behavior

2018 ◽  
Vol 4 ◽  
pp. 205520761878579 ◽  
Author(s):  
Emily E Dunn ◽  
Heather L Gainforth ◽  
Jennifer E Robertson-Wilson
Keyword(s):  
Physical Activity ◽  
Behavior Change ◽  
Sedentary Behavior ◽  
Mobile Applications ◽  
Health Behavior Change ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Behavior Change Interventions ◽  
And Behavior ◽  
Keyword Searches

Objective Mobile applications (apps) are increasingly being utilized in health behavior change interventions. To determine the presence of underlying behavior change mechanisms, apps for physical activity have been coded for behavior change techniques (BCTs). However, apps for sedentary behavior have yet to be assessed for BCTs. Thus, the purpose of the present study was to review apps designed to decrease sedentary time and determine the presence of BCTs. Methods Systematic searches of the iTunes App and Google Play stores were completed using keyword searches. Two reviewers independently coded free ( n = 36) and paid ( n = 14) app descriptions using a taxonomy of 93 BCTs (December 2016–January 2017). A subsample ( n = 4) of free apps were trialed for one week by the reviewers and coded for the presence of BCTs (February 2017). Results In the free and paid app descriptions, only 10 of 93 BCTs were present with a mean of 2.42 BCTs (range 0–6) per app. The BCTs coded most frequently were “prompts/cues” ( n = 43), “information about health consequences” ( n = 31), and “self-monitoring of behavior” ( n = 17). For the four free apps that were trialed, three additional BCTs were coded that were not coded in the descriptions: “graded tasks,” “focus on past successes,” and “behavior substitution.” Conclusions These sedentary behavior apps have fewer BCTs compared with physical activity apps and traditional (i.e., non-app) physical activity and healthy eating interventions. The present study sheds light on the behavior change potential of sedentary behavior apps and provides practical insight about coding for BCTs in apps.

scholarly journals Participants’ enactment of behavior change techniques: A call for increased focus on what people do to manage their motivation and behaviour

2018 ◽  
Author(s):  
Nelli Hankonen
Keyword(s):  
Behavior Change ◽  
Intervention Effectiveness ◽  
Intervention Participant ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Intervention Delivery ◽  
Change Behavior ◽  
Starting Point ◽  
Trial Outcomes ◽  
And Behavior

Intervention effectiveness does not only depend on fidelity of intervention delivery, but also the enactment, or use, of behavior change techniques (BCTs) by the participants. For example, it is not sufficient that intervention provider prompts an intervention participant to self-monitor their physical activity, but crucially, the participant enacts self-monitoring. Theoretical and conceptual work integrating various strands of research into ‘what a person can do for oneself’ to change behavior is needed. This paper argues how this would aid in designing for, assessing, and promoting the use individuals’ self-management techniques, and ultimately, our understanding of sustained behavior change. The recently published, integrative compendium of self-enactable techniques to change and self-manage motivation and behavior can act as a useful starting point for this work. An increased focus on the enactment of BCTs would help clarify intervention processes, help explain trial outcomes, and potentially enhance intervention effectiveness.

scholarly journals Evaluación de aplicaciones para la deshabituación tabáquica con elementos de gamificación: elaboración y aplicación de un check-list = Evaluation of gamification apps in smoking cessation: development and application of a check-list

2018 ◽  
Vol 9 (2) ◽  
pp. 152
Author(s):  
Rubén Andújar-Espinosa ◽  
Lourdes Salinero-González ◽  
Manuel Castilla-Martínez ◽  
Carlos Castillo-Quintanilla ◽  
Rocío Ibañez-Meléndez ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Behavior Change ◽  
Check List ◽  
Tobacco Use Cessation ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Pubmed Search ◽  
And Behavior ◽  
Access Policies

Resumen: Introducción. El uso de la gamificación en salud es una herramienta útil para incrementar la motivación cuan­do se aplica a salud. Los objetivos fueron realizar una revisión sobre evidencias científicas de aplicaciones con elementos de gamificación en salud, identificar características de calidad, elaborar un check-list y aplicarlo a apli­caciones para la deshabituación tabáquica con elementos de gamificación. Métodos. Se realizó una búsqueda bibliográfica en Pubmed sobre gamificación en salud y una búsqueda de apps de cese tabáquico con elementos de gamificación. Se elaboró un check-list para evaluar la calidad, elementos de gamificación y técnicas de cambio de comportamiento utilizados, posteriormente se aplicó a las apps seleccionadas. Resultados. Se incluyeron 14 apps sobre gamificación en deshabituación tabáquica. Solo 4 (28,6%) identificaron fuentes de información fiables y solo 2 (14,3%) informaron sobre políticas de acceso y tratamiento de datos. Las técnicas de cambio de comportamiento identificadas fueron retroalimentación en todas las apps, automonitorización en 12 (85,7%) y cambios basados en los éxitos pasados en 13 (92,9%). Conclusiones. Existen pocos estudios sobre aplica­ciones para la deshabituación tabáquica con elementos de gamificación, con gran variabilidad en metodología, variables medidas y escasas evidencias. La creación de un check-list sobre calidad de las aplicaciones podría disminuir esta variabilidad y mejorar la calidad de los estudios futuros. Son necesarios nuevos estudios.Palabras clave: Deshabituación tabáquica; Aplicaciones móviles; Terapia de comportamiento; Cese tabáquico.Abstract: Introduction. The use of health gamification has proven to be a useful tool to increase motivation and com­mitment when applied to health. The objectives were to review the scientific evidences of health gamification applications, to identify the quality characteristics, to develop a check list to evaluate it and to apply it to the appli­cations in smoking cessation. Methodology. PubMed search on health gamification and a search for smoking cessation apps with gamification elements in the most important application stores. A checklist was developed to evaluate the quality, gamification elements and behavior change techniques used, and was applied to the selected apps. Results. We included 14 apps on gamification in smoking cessation. Only 4 (28.6%) identified reliable sou­rces of information and only 2 (14.3%) reported on access policies and data processing. Behavior change techni­ques identified were feedback in all apps, self-monitoring in 12 (85.7%) and changes based on past successes 13 (92.9%). Conclusions. There are few studies on gamification applications in smoking cessation, with a high variabi­lity in the methodology, measured variables and with little evidence. Creating a checklist on the quality of smoking cessation apps could decrease this variability and improve the quality of future studies. Further studies are needed.Keywords: Tobacco Use Cessation; Mobile Applications; Behavior Therapy; Smoking Cessation.

Sign in / Sign up

Export Citation Format

Share Document