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Theory-based design strategies & lessons learned from previous studies

Theory-based design strategies for active lifestyle

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Page 1: Theory-based design strategies for active lifestyle

Theory-based design strategies

& lessons learned from previous studies

Page 2: Theory-based design strategies for active lifestyle

Theory-Driven Design Strategies for Technologies that Support Behavior Change in Everyday Life(Consolvo, McDonald, & Landay, 2009)

Design strategies based on psychological, social and cognitive theories, previous studies and other persuasive technologies

People want to be fit, but still: physical inactivity and poor eating habits

Psychological theories can be used to design technologies to promote an active life

Technologies should be persuasive, effective, without being invasive; support behavioral change AND fundamental

social needs

Page 3: Theory-based design strategies for active lifestyle

Goal-Setting theory (see later) how people respond to different types of goals

and which is more motivating. The goal must be:

important to the user decided by the user (or with the help of an

expert), not assigned without rationale challenging but realistically achievable it should be easy to monitor the progresses toward

the goal feedbacks and incentives must be provided as

progress is made (and not solely at goal achievement)

Page 4: Theory-based design strategies for active lifestyle

Transtheoretical Model of Behavior Change 5 stages in the intentional modification of behavior

precontemplation: no intention to change.

contemplation: seriously considering changing, but no action and no commitment yet.

preparation: intention to take actions in the next months but no successful action in the past year.

action: has performed the behavior consistently for less than six months.

maintenance: has performed the behavior consistently for more than six months.

Persuasive actioneducationovercoming barriers + rewards

rewards (even when the behavior is inconsistent) + increasing awareness of behavioral patterns to encourage consistencykeeping track of progresses to maintain consistency + social influencecoping strategies for problems + awareness: “I'm becoming the kind of person I want to be”

Stage

Page 5: Theory-based design strategies for active lifestyle

Presentation of Self in Everyday Life Novel application to persuasive technology Daily social interactions, and how individuals

attempt to manage the impressions they want others to have of them: Theatre metaphor

The individual performs for an audience

Backstage: no audience allowed – secret consumption

Page 6: Theory-based design strategies for active lifestyle

Presentation of Self in Everyday Life

In the front stage:

In the backstage:

secret consumption(need to conceal these

behaviors)

Page 7: Theory-based design strategies for active lifestyle

Presentation of Self in Everyday Life: Implications for technology Support impression management needs:

the user must be able to control the information we collect (e.g. what to share, with whom); to disguise something; to misrepresent something, for example to support secret consumption

technology aiming at representing the “perfect information” (i.e. weight, height, scores of the initial test as well as every activity session in detail, km run, speed, etc.) do not support individuals' needs to control the backstage

enable the user to perform differently for different audiences (or the user will perceive a privacy violation; e.g. Google+)

Page 8: Theory-based design strategies for active lifestyle

Cognitive Dissonance Theory Novel application to persuasive technology what happens when behaviors and attitudes

are inconsistent An individual realizes that:

attitudes behavior

inconsistent

Cognitive dissonance

(psychologically

uncomfortable)

Page 9: Theory-based design strategies for active lifestyle

Cognitive Dissonance Theory She will try to reduce the dissonance. How?

Change behavior: healthy lifestyle “I will train more”

Change knowledge (attitude): stop believing that I should have a healthier lifestyle “I’m not that fat/sedentary”

Reduce the importance of the dissonance: seeking information about worse things, avoiding information/situations which could reinforce the dissonance “having diabetes is worse”, avoid gyms, not going to the beach

Page 10: Theory-based design strategies for active lifestyle

Cognitive Dissonance Theory: Implications for technology

Change behavior (“I will train more): Address the factors preventing the individual to change Help to remain focused Awareness system should be persistently available and

easy to access but also subtle to support occasional needs for information/situation avoidance.

Change knowledge (“I’m not that inactive”): Awareness

Reduce the importance of the dissonance (“having diabetes is worse”):

Education, information, examples

Page 11: Theory-based design strategies for active lifestyle

Strategies used in recent persuasive technology research

Breakaway: to encourage users to take a break while working.

It provides peripheral awareness. Participants appreciate the possibility to ignore it in busy times. Abstract: the feedback is given in the form of abstract information,

not raw sensor data collected from the user Non-intrusive: the data are available all the time Public: data are presented in an appropriate way to be presented in

public), Aesthetic: the device should be interesting over time

Page 12: Theory-based design strategies for active lifestyle

Strategies used in recent persuasive technology research

Fish'nSteps: to make users taking more steps.

step count affects: growth of the fish (more steps, larger fish), facial expression (happy for sufficient, angry for near-sufficient, sad

for insufficient), water (clean for sufficient, murky with no decoration for

insufficient). Motivated participants increased their daily step count. But:

they ignored the display when they had an insufficient step count (bad decision to use punishment).

Page 13: Theory-based design strategies for active lifestyle

Strategies used in recent persuasive technology research

Houston: to make users taking more steps. Users share step count and performance Add notes, send messages and see trending

information Receive congratulations and stars (*) when

they achieve goal

Most participants increased awareness But: they complained that the pedometer

did not register other activities (e.g. cycling, etc.): they pointed out that receiving credit for all activities is critical.

Page 14: Theory-based design strategies for active lifestyle

New design strategies based on theories and previous studies

1. Abstract & reflective2. Unobtrusive3. Public4. Aesthetic5. Positive6. Controllable7. Trending & historical8. Comprehensive

Page 15: Theory-based design strategies for active lifestyle

1. Abstract & reflective People in their social relationships need to

conceal something, sometimes (Presentation of Self theory).

Abstract data are flexible. Flexibility and ambiguity allow people to create different interpretations of the data, to disguise and manage them

Both Breakaway and Fish'nSteps use abstract information.

Page 16: Theory-based design strategies for active lifestyle

2. Unobtrusive

Data should be available to the user, but without interrupting or calling her attention.

Apps for mobile phones are appropriate.

Technology should support the occasional need to ignore the dissonance (Cognitive Dissonance Theory - see the user's comments in the Breakaway study)

Page 17: Theory-based design strategies for active lifestyle

3. Public The data (personal) should be presented in an

appropriate way to be shown in public. The user should be comfortable with the fact

that others will see it never make the user feel uncomfortable

In Breakaway the sculpture was public but did not draw unwanted attention to the user (thanks to data abstraction)

In Houston the technology was on mobile phones, and users were discrete in its use

Page 18: Theory-based design strategies for active lifestyle

4. Aesthetic The technology should be inquisitive, comfortable,

attractive and maintain attention. The aesthetic aspect deals with the front stage

(Presentation of Self) and should reflect the user's personal style provide different displays for males/females?

It should convey credibility: people judge the credibility of an object on the basis of some surface features (B. J. Fogg)

In Fish'nSteps users where satisfied with the aspect of the happy fish (when they walked enough), and at the same time complained about the ugliness of the pedometer

Page 19: Theory-based design strategies for active lifestyle

5. Positive Positive reinforcement and rewards When the user does not perform the behavior: nor

rewards or punishments, but her interest should be sustained.

In the long-periods the user could get sick or injured, need a break or secret consumption: sustain the user's interest without making her feeling bad

Houston: stars (*) and congratulations as rewards; Fish'nSteps: happy fish, tank decoratins, clean water.

Users appreciated the rewards (motivating). The use of punishment (Fish'nSteps angry fish, murky water, removal of decorations) resulted in system abandonment

Page 20: Theory-based design strategies for active lifestyle

6. Controllable Controllability over data overcomes the problem inaccurate

data and respects users social needs Always able to decide what to share and with whom, to

modify the data (add, delete, edit, manipulate), both when the information is manually entered or automatically detected.

Automatic detection of data: inaccuracy is particularly problematic and leads to loss of credibility (failure of technology): users will be upset when they are not given credit for something

they did (e.g. Houston participants complained about missed steps → important to include all possible activities) → system abandonment

users will be frustrated when they receive credit for something they did not do (e.g. based on the technology feedback they should have lost weight but they haven't

Page 21: Theory-based design strategies for active lifestyle

7. Trending & historical Information about patterns of behaviors in relation to the user's

goals. The presentation of data should be accommodated as the goals

change, and support portability across devices. The user usually don't focus on patterns of behaviors, but on

single decisions

Awareness on patterns of behaviors Information/situation avoidance (Cognitive Dissonance Theory)

is more difficult if the user reflects on her past behavior in relation to her goal

Page 22: Theory-based design strategies for active lifestyle

8. Comprehensive Account for a wide range of healthy behaviors

(→ as many activities as possible + letting users add their own activities, e.g. housework).

In Houston and Fish'nSteps: only walking (pedometer)

Participants complained and were discouraged to do other activities This resulted in users doing less healthy activities (e.g. they did not run, just walk).

For contemplators, preparators and action stagers (Transtheoretical Model) this kills motivation, inhibiting progress and reverting users to a previous stage.

Page 23: Theory-based design strategies for active lifestyle

UbiFit Garden System

Small butterflies, big butterfly, different flowers

Page 24: Theory-based design strategies for active lifestyle

UbiFit Garden System: Demographics 28 participants for 3 months

15 females, general public, 25-54 years old 17 participants were employed full-time, 8 part-time, 2

homemakers, 1 full-time student a range of occupations:

real estate agent, personal care assistant, public relations specialist, retail manager, psychologist, event laborer, project manager, human resources specialist, teacher, business developer, and comedian

education: 4 college, 19 bachelor, 1 course work at master, 3

master degree, 1 phd 12 normal weight, 9 overweight, 7 obese

Page 25: Theory-based design strategies for active lifestyle

UbiFit Garden System1. Abstract & reflective: the garden is a methaphor; frequent

reflections; feedback at a glance.2. Unobtrusive: the garden is on the mobile phone wallpaper3. Public: If someone unintentionally sees the wallpaper she could

explain it in several ways.4. Aesthetic (not for males…)5. Positive: rewards are flowers and butterflies; flowers don't die;

Every week the user starts over with an empty garden, so even if she was not active the previous week she can concentrate of the current week.

6. Controllable: the user can always add comments, add, delete, modify activities both when they are manually or automatically entered.

7. Trending & historical: through weekly patterns there are feedbacks up to a month; the interactive app goes far back in the past (no website here)

8. Comprehensive: the MSP (Mobile Sensing Platforms) records walking, running, cycling, elliptical and stair machine; activities that are not registered can be manually entered by the users.

Page 26: Theory-based design strategies for active lifestyle

UbiFit Garden System Experimental conditions

Interactive application + accelerometer (no garden) Interactive application + display (no msp) Full system

Goal setting Weekly goal At least 1 session cardio 10 min, walking 10 min,

strength or fexibility <n° sessions> <activity> <minimum duration> per

week 2 cardio sessions > 30 min/session 4 walking sessions > 15 min/session 3 flexibility sessions (no min duration)

Page 27: Theory-based design strategies for active lifestyle

UbiFit Garden System: Lessons learned(Klasnja, Consolvo, McDonald, Landay, & Pratt, 2009)

Supportare nel tempo l'attivazione cognitiva degli obiettivi persistent visual

Differenza significativa fra chi aveva il display e chi no: chi aveva il display (condizioni “no msp” e “full system”) ha

mantenuto l'attività fisica nei 3 mesi nonostante l'inverno. Chi non aveva il display ha diminuito l'attività fisica.

Future directions: il display di Ubifit ricorda costantemente l'impegno a fare attività fisica e allo stesso tempo fornisce feedback sui risultati. In futuro si potrebbe vedere se il primo metodo è efficace senza l'altro.

+ >

Page 28: Theory-based design strategies for active lifestyle

UbiFit Garden System: Lessons learned Incoraggiare un ampio range di comportamenti

salutari includere quante più attività possibili, altrimenti rischio che l'utente si focalizzi solo sulle attività supportate dal sistema tralasciandone altre importanti es. il pedometro è frustrante (es. “my main source of

exercise [rock climbing] doesn’t register”). Se il sistema non considera certi tipi di attività, molti

partecipanti semplicemente scelgono di non farla (the pedometer did not “care whether you went up and down hills or whether you walk on flats, so why kill yourself?”).

In UbiFit gli utenti registrano tutte le loro attività: 26 tipi di attività cardiovascolari (including skiing, cardio classes, dancing, swimming, and ice skating.)

Page 29: Theory-based design strategies for active lifestyle

UbiFit Garden System: Lessons learned

InUbiFit users did 1853 activities (almost every day) only 35-40% of them were automatically detected

by the MSP All the others were manually entered by users,

who recorded a broad range of activities (e.g. 26 types of cardio activities alone).

So, no one refrained from doing an activity because it was not tracked by the system.

Page 30: Theory-based design strategies for active lifestyle

UbiFit Garden System: Lessons learned Puntare su pattern di attività a lungo termine rappresentare nel display il

progresso su obiettivi settimanali o mensili

Le persone tendono a focalizzarsi su singole decisioni e non sui pattern

E' necessario rappresentare nel display il progresso su obiettivi settimanali o mensili per permettere alle persone di focalizzarsi su pattern di comportamenti es. “quanto mi sono allenato questa settimana e quanto mi manca per raggiungere

l'obiettivo?” e non sulle singole sessioni di allenamento “devo fare movimento oggi?” In questo modo non ci si scoraggia dopo un paio di giorni di sedentarietà perché si può

ancora recuperare. Vedere i progressi sulla settimana aumenta la consapevolezza della propria inattività,

cosa che di solito sorprende.

Page 31: Theory-based design strategies for active lifestyle

UbiFit Garden System: Lessons learned Future directions:

aumentare la consapevolezza dei propri pattern di comportamento

e dei fattori che li influenzano Es. fornire analisi di correlazione tra pattern di attività

fisica e specifiche situazioni giorno lavorativo/feriale, fasce orarie, quando si va

all'università / al lavoro / si resta a casa a studiare; quando nelle vicinanze ci sono amici o piste ciclabili; che tipo di attività fisica si predilige;

il passo successivo potrebbe essere dare consigli mirati sulla base di questi dati

Page 32: Theory-based design strategies for active lifestyle

UbiFit Garden System: Lessons learned Utilizzare il supporto sociale come incentivo

opzionale, non primario il supporto sociale non va usato come incentivo primario, va data la possibilità di scegliere cosa, come, quanto condividere e con chi. arma a doppio taglio: funziona e aumenta la

motivazione quando i partecipanti sono già attivi e motivati, ma è controproducente quando sono poco attivi e se percepiscono troppa competizione.

Houston: i partecipanti potevano decidere quando e cosa condividere, e lo facevano quando erano attivi e motivati, altrimenti non si sentivano a proprio agio

Page 33: Theory-based design strategies for active lifestyle

Goal-setting considerations for persuasive technologies that encourage physical activityConsolvo, Klasnja, McDonald, & Landay, 2009

How people respond to different types of goals and how to set them to motivate them

The goal should be difficult & specific (unambiguous): people give the highest effort and reach the highest

performance for specific, difficult goals. too general goals (“do your best”) have too many

levels of acceptable performance and it is difficult to say if the goal was reached → the goal should be specific (unambiguous) and difficult.

FitCity: the goal assigned now in UniFit is quite ambiguous

Page 34: Theory-based design strategies for active lifestyle

Goal-setting considerations for persuasive technologies that encourage physical activity

Commitment: 2 factors Importance of the goal: how to increase it?

Public commitment (e.g. share online) Incentive: throughout the whole process, not only at goal achievement.

Feedback on single activities in relation to the overall goal. Increase the importance of the cognitive dissonance providing

information (on benefits of healthy lifestyle) Increase awareness (e.g. WiiFit age?)

Self-efficacy: the individual must believe she can reach the goal Overcome barriers (e.g. lack of time, children, workload; tips to organize

better)

Page 35: Theory-based design strategies for active lifestyle

Goal sources: who sets the goal? Interviews after UbiFit

Assigned: significantly lower performance By national recommendations,

fitness expert, medical expert

Group-set (not preferred; users with similar abilities/goals) Strangers (slightly preferred) Social network, friends/family

Pros: accountability & motivation (for difficult weeks)

Cons: when exercise is not a priority (work deadlines, illness); don’t like the responsibility

Page 36: Theory-based design strategies for active lifestyle

Goal sources: who sets the goal? Interviews after UbiFit

Self-set (preferred) Self-efficacy When preferred it was because of the cost of a personal

trainer

Participatory (preferred) Fitness expert (*) or medical expert (not preferred)

Guided (preferred) Fitness expert (*) or medical expert

Self-efficacy, accountability, motivation Possible to modify the goal without notifying the trainer? Keep the trainer goal as primary and define an alternate

secondary goal Important on-going relationship with the trainer

Page 37: Theory-based design strategies for active lifestyle

Goal sources: who sets the goal? Interviews after UbiFit

However: not enough literature to support a type of goal source as most effective

Past studies only found that setting goals leads to better performances than not to

Page 38: Theory-based design strategies for active lifestyle

Goal timeframes: time periods to each the goal Interviews after UbiFit

UbiFit: weekly goals (national recommendations). Options: Rolling week: 7-days timeframe showing the user's last 7

days which never resets for users who tended to be more active at the end of the week

Fixed calendar: the goal resets at the end of the week, with a fixed start day

Customizable week (preferred): the goal resets at the end of the week, but the user decides when the week starts. Preferred days: Monday (1st) & Sunday (2nd) Users liked having a deadline and a fresh start every week

Page 39: Theory-based design strategies for active lifestyle

Goal-Setting strategies applied What has been done

Houston: small groups of women from pre-existing social networks shared step count and progress toward a daily goal via mobile phone. Goal was assigned (derived from the step count

detected during a baseline period)

Fish'nSteps: weekly goal assigned (derived from a baseline period), which became progressively more challenging (exponential function)

Page 40: Theory-based design strategies for active lifestyle

Goal-Setting strategies applied What has been done Gasser et al., 2006: every participant has the

same daily assigned goal: “to earn at least 7 lifestyle points”. Each point: 10

min activity or by eating one serving of fruit or vegetables.

At least 4 points must come from fruit/vegetables. Bickmore et al., 2005:

daily participatory goal (on step count) negotiated with the virtual agent Laura. The goal takes into account

the current's day step count and the step count history

Page 41: Theory-based design strategies for active lifestyle

So far, goal design strategies: FitCity Goal defined in a participatory/guided way

with the fitness expert (real or virtual) with this regard, the possibility to leverage fitness experts knowledge designing a virtual guide sounds particularly promising

Overall long-term goal (to be reached by the re-test): e.g. to reach the sufficient level in every physical test

At the beginning: user provide information about motivation, time

commitment, constraints (e.g. exam session, work deadlines, vacation periods, specific busy days)

Workplan made of weekly goals defined on the basis of the overall long-term goal & user's

information

Page 42: Theory-based design strategies for active lifestyle

So far, goal design strategies: FitCity Weekly goals adjusted in progress

on the basis of user's information (e.g. work deadlines, illness)

reduce the workload accordingly, without letting the user deliberately ignoring the technology (cognitive dissonance)

Default weekly timeframe: calendar week starting on Monday with the option to change the start date, and to switch to a rolling 7-days window

On “public commitment”: it increases users' motivations. Sharing options: take into account possible undesirable

effects (shame, excessive competition) leading to system abandonment

Page 43: Theory-based design strategies for active lifestyle

The Social fMRI: Measuring, Understanding, and Designing Social Mechanisms in the Real World (Aharony, Pan, Ip, Khayal, & Pentland, 2011)

130 persone di proposito < numero di Dunbar “Friends & Family”: a residential community made

of 400 young couples with friendship ties (each one with at least 1 member affiliated to the university; nearly 200 have children).

Attività fisica non meglio specificata (misurata con accelerometro che rileva l'attività per 15 sec ogni 2 min)

Page 44: Theory-based design strategies for active lifestyle

The Social fMRI 3 condizioni:

control: fino a 5$ in base alla propria attività

peer-view: A vede i progressi di 2 compagni (B e C) dello stesso gruppo (i progressi di A sono visti da D e E) + compenso fino a 5$ in base alla propria attività

peer-reward: il compenso di A è fino a 2,5$ per ogni compagno B e C

NB: il compenso minimo è 0.5$ per evitare scoraggiamento.

AB

C

D

E

solo A può guadagnare dall'attività di B o viceversa, ma non entrambi

Page 45: Theory-based design strategies for active lifestyle

The Social fMRI

Triadi: Amici Sconosciuti A + 1 amico + 1

sconosciuto

AB

C

D

E

Page 46: Theory-based design strategies for active lifestyle

The Social fMRI: Risultati In generale, “peer-reward” > “peer-view” > “control”,

ma dipende da come sono formate le triadi: amici: “peer-reward” è doppiamente efficace di “peer-

view” sconosciuti: “peer-reward” > “peer-view” misti: “peer-view” > “peer-reward”

Quindi: l'intensità del legame sociale influenza la performance sembra che mentre le performance di “control” e “peer-

view” diminuiscano nel tempo, quella di “peer-reward” cresca più lentamente all'inizio ma si mantenga nel tempo

Page 47: Theory-based design strategies for active lifestyle

69 overweight and obese people in their late 50s 12 group sessions over 6 months focusing on

nutrition, exercise and behavioral changes Half received a personal digital assistant (PDA) to

record food intake and activity (mobile group). They also had a coach who checked in with them by phone after the first month to set personalized weight loss goals

Mobile technology, in combination with an existing system of care and telephone coaching, led to more short-term weight loss than a typical weight loss program alone.

Does It Actually Work? Study Shows Mobile Technology Enhances Weight Loss http://www.medgadget.com/2012/12/does-it-actually-work-study-shows-mobile-technology-enhances-weight-loss.html

Page 48: Theory-based design strategies for active lifestyle

Mobile technology, in combination with telephone coaching (?), led to more short-term weight loss than a typical weight loss program alone

after 6 months the mobile group had lost on average 3.9 kg more than the standard treatment group.

41% of the mobile group had met the goal of losing at least 5%of their initial body weight, compared to 11% in the conventional group

the mobile group lost weight in a shorter time-frame

Does It Actually Work? Study Shows Mobile Technology Enhances Weight Loss