3MD for Chronic Conditions, a Model for Motivational mHealth Design: Embedded Case Study (Preprint)

Abstract

Chronic conditions are the leading cause of death in the world. Major improvements in acute care and diagnostics have created a tendency towards the chronification of formerly terminal conditions, requiring people with these conditions to learn how to self-manage. Mobile technologies hold promise as self-management tools due to their ubiquity and costeffectiveness.The delivery of health-related services through the use of mobile technologies (mHealth) has grown exponentially in recent years. However, only a fraction of these solutions takes into consideration the views of relevant stakeholders like healthcare professionals or even patients. The use of behavioral change models (BCM) has proven important in developing successful health solutions, yet engaging patients remains a challenge. There is a trend in mHealth solutions called gamification that attempts to use game elements to drive user behavior and increase engagement. As it stands, designers of mHealth solutions for behavioral change in chronic conditions have no clear way of deciding what factors are relevant to consider.The focus of this work is to discover factors for the design of mHealth solutions for chronic patients; to do so, negotiations between medical knowledge, BCM, and gamification were explored through an embedded case study research methodology. The data obtained was thematically analyzed to create the Model for Motivational Mobile-health Design for chronic conditions (3MD).The 3MD model guides the design of condition-oriented gamified behavioral change mHealth solutions. The main components are: 1) Condition-specific, which describe factors that need to be adjusted and adapted for each particular chronic condition; 2) Motivation-related; which are factors that address how to influence behaviors in an engaging manner; and 3) Technologybased, which are factors that are directly connected to the technical capabilities of mobile technologies. 3MD also provides a series of high level illustrative design questions for designers to use and consider during the design process.The present work addresses a recognized gap in research and practice, and proposes a unique model that could be of use in the generation of new solutions to help chronic patients.