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BackgroundPersuasive design, in which the aim is to change attitudes and behaviors by means of technology, is an important aspect of electronic health (eHealth) design. However, selecting the right persuasive feature for an individual is a delicate task and is likely to depend on individual characteristics. Personalization of the persuasive strategy in an eHealth intervention therefore seems to be a promising approach.ObjectiveThis study aimed to develop a method that allows us to model motivation in older adults with respect to leading a healthy life and a strategy for personalizing the persuasive strategy of an eHealth intervention, based on this user model.MethodsWe deployed a Web-based survey among older adults (aged >60 years) in the Netherlands. In the first part, we administered an adapted version of the revised Sports Motivation Scale (SMS-II) as input for the user models. Then, we provided each participant with a selection of 5 randomly chosen mock-ups (out of a total of 11), each depicting a different persuasive strategy. After showing each strategy, we asked participants how much they appreciated it. The survey was concluded by addressing demographics.ResultsA total of 212 older adults completed the Web-based survey, with a mean age of 68.35 years (SD 5.27 years). Of 212 adults, 45.3% were males (96/212) and 54.7% were female (116/212). Factor analysis did not allow us to replicate the 5-factor structure for motivation, as targeted by the SMS-II. Instead, a 3-factor structure emerged with a total explained variance of 62.79%. These 3 factors are intrinsic motivation, acting to derive satisfaction from the behavior itself (5 items; Cronbach alpha=.90); external regulation, acting because of externally controlled rewards or punishments (4 items; Cronbach alpha=.83); and a-motivation, a situation where there is a lack of intention to act (2 items; r=0.50; P<.001). Persuasive strategies were appreciated differently, depending on the type of personal motivation. In some cases, demographics played a role.ConclusionsThe personal type of motivation of older adults (intrinsic, externally regulated, and/or a-motivation), combined with their educational level or living situation, affects an individual’s like or dislike for a persuasive eHealth feature. We provide a practical approach for profiling older adults as well as an overview of which persuasive features should or should not be provided to each profile. Future research should take into account the coexistence of multiple types of motivation within an individual and the presence of a-motivation.

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Independent living of older adults is one of the main challenges linked to the ageing population. Especially those living with diseases like COPD, MCI or frailty, need more Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation support in everyday life and this is by itself a big societal challenge with impact in multiple sectors. In this paper we present eWALL, an innovative open-source eHealth platform that aims to address these challenges by means of an advanced cloud-based infrastructure. eWALL is designed in an innovative manner and achieved technical breakthroughs in eHealth platforms, while prioritizing user and market needs that are often abandoned and are the major reason for technically sound solutions that fail. We consider this as an opportunity and we aim to change the eHealth systems' experience for older adults and break the barriers for the penetration of ICT solutions.

Embodied conversational agents may be used to engage users in adopting eHealth applications. The aim of this research is to investigate which design features establish a positive first impression of an agent in this context. A set of eight static agent images, different in age, gender and role, were subjected to testing in an online questionnaire. Respondents (n = 155) selected their preferred design and rated the characteristicsfriendliness, expertise, reliability, involvement and authorityand the likeliness of following the agent's advice for all designs. In addition, focus groups (n = 13) were conducted for detailed understandings supporting these impressions. Our results show that, for both a general and elderly population, (1) people seem to prefer images of young, female agents over old, male agents, (2) the (a) age, (b) gender and (c) role of the agent image affect the perception of the agent's characteristics and the likeliness of following the agent's advice, and that (3) both the general and elderly population prefer an agent image that is similar in (a) age and (b) gender. A next step would be to investigate how the characteristics of the agent designs are perceived after interaction with the agent.