BackgroundSeniors with chronic diseases are often called on to self-manage their conditions. Mobile health (mHealth) tools may be a useful strategy to help seniors access health information at the point of decision-making, receive real-time feedback and coaching, and monitor health conditions. However, developing successful mHealth interventions for seniors presents many challenges. One of the key challenges is to ensure the scope of possible research questions includes the diverse views of seniors, experts and the stakeholder groups who support seniors as they manage chronic disease.ObjectiveOur primary objective was to present a case-study of a collaborative research approach to the development of an interdisciplinary research agenda. Our secondary objectives were to report on the results of a nominal group technique (NGT) approach used generate research questions and to assess the success of including non-academic researchers to enrich the scope, priority, and total number of possible research questions.MethodsWe invited researchers and stakeholders to participate in a full day meeting that included rapid-style presentations by researchers, health care professionals, technology experts, patients and community groups followed by group discussions. An NGT was used to establish group consensus on the following question: In your opinion, what research needs to be done to better understand the effectiveness, usability and design of mobile health apps and devices for older adults?ResultsOverall, the collaborative approach was a very successful strategy to bring together a diverse group of participants with the same end goal. The 32 participants generated 119 items in total. The top three research questions that emerged from the NGT were related to adoption, the need for high quality tools and the digital divide. Strong sub-themes included privacy and security, engagement and design. The NGT also helped us include the perspectives information from non-academic researchers that would not have been captured if the process had been limited to the research team.ConclusionsDeveloping ways for patients and other stakeholders to have a voice when it comes to developing patient awareness as related to mHealth may guide future research into engagement, ownership, usability and design. It is our intention that our paper be used and adapted by other researchers to engage small or vulnerable populations often excluded from mHealth research and design.
When developing patient self-management applications, designs must motivate patients to engage with the intervention so as to increase their medical adherence. This paper hypothesizes that for the analysis and design of these technologies, a Cognitive Work Analysis (CWA) approach would benefit from the additional insight provided by a Persuasive Design (PD) framework. The results of this combined approach are shown to be valuable in informing an Ecological Interface Design (EID) of self-management systems. Benefits come in two ways: First, by improving patients' understanding of their disease and how to manage it, and second by increasing their motivation to self-monitor. The next step of this research will be to devise a set of design guidelines that can be used to create effective patient self-management systems.
Cognitive Work Analysis (CWA) and Persuasive Design (PD) can be complementary approaches for designing behavior change systems. CWA can provide insights into persuasive context, identify ineffective behavior paths and suggest more effective behaviors. However, PD can contribute design ideas to create that behavior change. These methods, and how they can be used together, are discussed. The example of blood pressure management is used to show how new behavior change paths can be identified and encouraged.
This paper describes the first of three experiments conducted to investigate the efficacy of a proposed persuasive mHealth messaging intervention that motivates individuals to become more physically active. In order to develop a set of persuasive health messages that can be used in the principal experiment, which examines a particular message-tailoring strategy, we conducted an online survey through Amazon Mechanical Turk. In this online study participants rated a series of health messages to indicate each message’s level of persuasiveness, as well as the message’s focus. This study was essential, as disagreements exist on how to frame persuasive health messages in the context of promoting physical activity. Among the proposed 57 messages, 14 messages rated as the most persuasive were selected for the principal experiment.
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