BackgroundMultiple sclerosis (MS) is one of the world’s most common neurologic disorders. Fatigue is one of most common symptoms that persons with MS experience, having significant impact on their quality of life and limiting their activity levels. Self-management strategies are used to support them in the care of their health. Mobile health (mHealth) solutions are a way to offer persons with chronic conditions tools to successfully manage their symptoms and problems. Gamification is a current trend among mHealth apps used to create engaging user experiences and is suggested to be effective for behavioral change. To be effective, mHealth solutions need to be designed to specifically meet the intended audience needs. User-centered design (UCD) is a design philosophy that proposes placing end users’ needs and characteristics in the center of design and development, involving users early in the different phases of the software life cycle. There is a current gap in mHealth apps for persons with MS, which presents an interesting area to explore.ObjectiveThe purpose of this study was to describe the design and evaluation process of a gamified mHealth solution for behavioral change in persons with MS using UCD.MethodsBuilding on previous work of our team where we identified needs, barriers, and facilitators for mHealth apps for persons with MS, we followed UCD to design and evaluate a mobile app prototype aimed to help persons with MS self-manage their fatigue. Design decisions were evidence-driven and guided by behavioral change models (BCM). Usability was assessed through inspection methods using Nielsen’s heuristic evaluation.ResultsThe mHealth solution More Stamina was designed. It is a task organization tool designed to help persons with MS manage their energy to minimize the impact of fatigue in their day-to-day life. The tool acts as a to-do list where users can input tasks in a simple manner and assign Stamina Credits, a representation of perceived effort, to the task to help energy management and energy profiling. The app also features personalization and positive feedback. The design process gave way to relevant lessons to the design of a gamified behavioral change mHealth app such as the importance of metaphors in concept design, negotiate requirements with the BCM constructs, and tailoring of gamified experiences among others. Several usability problems were discovered during heuristic evaluation and guided the iterative design of our solution.ConclusionsIn this paper, we designed an app targeted for helping persons with MS in their fatigue management needs. We illustrate how UCD can help in designing mHealth apps and the benefits and challenges that designers might face when using this approach. This paper provides insight into the design process of gamified behavioral change mHealth apps and the negotiation process implied in it.
Social comparison as an aspect of social influence has an effect on health behavior, and technology can be used to support desired behavior change. However, no concrete guidelines exist on how to design social comparison features. This paper examines how designers have actually designed social comparison in IT artifacts supporting individuals in a behavior change process. We apply qualitative evidence synthesis review method and analyze twelve studies reporting experiences of designing social comparison features. As a result, we present six design dimensions for social comparison features emerging from the literature, and several alternative design options for each dimension. The dimensions can be used as a guide for designers and as a repository for researchers to design and evaluate social comparison features for technologies targeting behavior change in different contexts. Shows the current relation between the users (suggested for ad-hoc feedback). Shows the relation between the users in time/the users' progress. Use visual cues (i.e. color, size) to show different comparison types. Combination of visual cues' to represent many user's relations. Attitudes promoted-What design attitudes will be promoted? Competition Cooperation Usually, used together with gamified or metaphorical representations. Rewarding users based on their individual progress. Motivating them to be the best. May demotivate users who dislike competition. Promote team-spirit. Can be combined with coopetition. May promote accountability to the team-members.
The foreseen growth of Head and Neck cancer (HNC) incidents will require future rehabilitation services to meet the needs of a wider population. This study reports the empirical findings of a case study conducted at a cancer rehabilitation center in Copenhagen, aiming to elicit the needs of HNC patients, informal caregivers and healthcare professionals (HCPs). Our results point out that patients and stakeholders' needs are interrelated, as they faced common challenges pertinent to provision and distribution of information. This study, though preliminary, underlines the importance of inclusion of all actors in the design of future interventions. BACKGROUNDGlobally, Head and Neck cancer (HNC) results in more than 550,000 new cases and 380,000 deaths annually [25], and the number of cases is rising [14]. In Europe, there were approximately 250,000 cases and 63,500 deaths in 2012 [27]. Primary risk factors leading to the development of HNC include tobacco use, alcohol consumption, human papillomavirus infection, and Epstein-Barr virus infection [25], while the most common types of HNC are in pharynx, larynx and oral cavity [55]. HNC rehabilitation is accompanied with high morbidity compromising vital functions, such as swallowing, respiration and speech. These functions are directly related to the quality Permission to make digital
BackgroundThe incidents of Head and Neck Cancer (HNC) are rising worldwide, suggesting that this type of cancer is becoming more common. The foreseen growth of incidents signifies that future rehabilitation services will have to meet the needs of a wider population.ObjectiveThe aim of this paper is to explore the needs of patients, caregivers and healthcare professionals during HNC rehabilitation.MethodsThis paper reports the empirical findings from a case study that was conducted in a cancer rehabilitation center in Copenhagen to elicit the needs of HNC cancer patients, informal caregivers and healthcare professionals.ResultsFour areas of needs during the rehabilitation process were identified: service delivery, emotional, social and physical needs. Service delivery needs and emotional needs have been identified as the most prevalent.ConclusionsStakeholders’ needs during the rehabilitation process were found to be interrelated. All stakeholders faced service delivery challenges in the form of provision and distribution of information, including responsibilities allocation between municipalities, hospitals and rehabilitation services. Emotional and social needs have been reported by HNC patients and informal caregivers, underlining the importance of inclusion of all actors in the design of future healthcare interventions. Connected Health (CH) solutions could be valuable in provision and distribution of information.
Background: Multiple sclerosis (MS) is one of the world's most common neurologic disorders. Fatigue is one of most common symptoms that persons with MS experience, having significant impact on their quality of life and limiting their activity levels. Self-management strategies are used to support them in the care of their health. Mobile health (mHealth) solutions are a way to offer persons with chronic conditions tools to successfully manage their symptoms and problems. Gamification is a current trend among mHealth apps used to create engaging user experiences and is suggested to be effective for behavioral change. To be effective, mHealth solutions need to be designed to specifically meet the intended audience needs. User-centered design (UCD) is a design philosophy that proposes placing end users' needs and characteristics in the center of design and development, involving users early in the different phases of the software life cycle. There is a current gap in mHealth apps for persons with MS, which presents an interesting area to explore. Objective: The purpose of this study was to describe the design and evaluation process of a gamified mHealth solution for behavioral change in persons with MS using UCD. Methods: Building on previous work of our team where we identified needs, barriers, and facilitators for mHealth apps for persons with MS, we followed UCD to design and evaluate a mobile app prototype aimed to help persons with MS self-manage their fatigue. Design decisions were evidence-driven and guided by behavioral change models (BCM). Usability was assessed through inspection methods using Nielsen's heuristic evaluation. Results: The mHealth solution More Stamina was designed. It is a task organization tool designed to help persons with MS manage their energy to minimize the impact of fatigue in their day-today life. The tool acts as a to-do list where users can input tasks in a simple manner and assign Stamina Credits, a representation of perceived effort, to the task to help energy management and energy profiling. The app also features personalization and positive feedback. The design process gave way to relevant lessons to the design of a gamified behavioral change mHealth app such as the importance of metaphors in concept design, negotiate requirements with the BCM constructs, and tailoring of gamified experiences among others. Several usability problems were discovered during heuristic evaluation and guided the iterative design of our solution. Conclusions: In this paper, we designed an app targeted for helping persons with MS in their fatigue management needs. We illustrate how UCD can help in designing mHealth apps and the benefits and challenges that designers might face when using this approach. This paper provides insight into the design process of gamified behavioral change mHealth apps and the negotiation process implied in it.
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