Embedding Psychological Factors in Technology Design to Improve Adherence to Physical Activity: Literature Review and Survey (Preprint)

Abstract

BACKGROUND Physical inactivity is a main risk factor of death worldwide, and contributes to psychological and physical problems, including obesity. Physical activity (PA) is critical to preventing health deterioration. Many technological interventions designed to promote PA have limited efficacy as some critical variables affecting PA are not considered. This study aims to understand the variables affecting PA, including barriers or facilitators for doing PA to facilitate the design of effective interventions OBJECTIVE (1) To investigate the mediating non-demographic variables of physical (in)activity, with emphasis on psychological variables, (2) to study which PA variables are considered in the design of intervention technologies to promote PA, (3) to provide a tool – a questionnaire- that allows the identification of PA variables when exploring the design space, (4) to investigate the relationship of PA variables with individuals' weight and actual PA level. METHODS We conducted two literature reviews on PA barriers/facilitators, using PsycINFO and ACM Digital Libraries. The PsycINFO literature search yielded 470 articles of which 50 articles were finally selected; PA barriers/facilitators were studied from these articles and used to design the Barriers Questionnaire for PA (BQPA) with 63 items. The ACM literature search yielded 123 articles, of which 15 articles were finally selected and used to evaluate the attention given to the PA variables in the design of technologies for PA. We then conducted a survey study using the BQPA, the International Physical Activity Questionnaire and demographic questions. The survey was filled out by a representative sample of the Spanish population (N=1012), including participants from all PA and weight levels. RESULTS 38 variables were identified as PA barriers/facilitators. Few studies evaluate their relationship with the actual PA level, and most lack an actual PA measure. The same barriers are reported for the overweight/obese and the normal-weight population, but some barriers are stronger in the obese. Only 17 out of the 38 variables were considered when developing PA technologies. On the survey data, we related the item scores with the participant’s PA level and weight. We found significant correlations between PA level and 62 BQPA items (all P<=.027) and between weight group and 35 BPQA items (all P<=.049). CONCLUSIONS Our contribution is three-fold. First, the literature reviews provide an in-depth account of barriers to PA in normal-weight, overweight and obese populations, and illustrate the lack of consideration of these in the design of PA technologies. Second, we propose a novel questionnaire on barriers to PA, specifically designed to ensure consideration of factors identified in the literature review. Third, we show high correlations between many identified variables and PA participation, and demonstrate how actual PA levels and body weight must also be considered. These results can guide future work on technological interventions for PA.

SoniBand: Understanding the Effects of Metaphorical Movement Sonifications on Body Perception and Physical Activity

“…Each of these sonifications presented potential effects from previous research [18,41], with particular sound characteristics (e.g., timbre, frequency) and metaphorical qualities (e.g., "pulling the body" effect in Tone). Particular sound characteristics were chosen to ensure that the metaphorical quality would be perceived, and both were designed to address psychological barriers in the literature [29] related to negative, or distorted self-body perceptions. Table 1 briefly describes the characteristics and metaphorical qualities of each sonification, as well as how it is designed to address psychological barriers.…”

“…A physically inactive lifestyle is a serious risk factor for health problems. The World Health Organization (WHO) has reported that engaging in regular physical activity (PA) reduces the risk of health disease (e.g., diabetes), physical (e.g., obesity) and psychological (e.g., low self-stem) problems [29,52]. Effecting behavioral changes in people to become more physically active has been the target of technological interventions, such as integrating sensing devices for PA tracking (e.g., [17,50]), thus allowing self-monitoring and goals setting (e.g., [7,11,12,26]), but technological support provides very limited psychological support.…”

“…People who struggle with PA adherence benefit not only from monitoring the quantity and quality of their PA, but also from becoming more aware of, and overcoming, psychological barriers, which limit their adherence and ability to perform PA on their own [16]. Different psychological barriers to PA have been identified in prior work [29]. In this paper, we build on it and conduct two studies that center on addressing an identified group of critical psychological barriers to PA: negative or distorted body perceptions (e.g., feeling incapable or weak to perform PA) [5,20], through the use of metaphorical informed movement sonifications.…”

Designing a gesture-sound wearable system to motivate physical activity by altering body perception

“…In a recent study based on an extensive literature review and a survey study we identified significant correlations between PA participation and self-esteem, motivation and body-self relations, such as concerns about one's body appearance, and perceptions of one's muscular strength and speed/agility [17]. While current technology often uses strategies to make PA more enjoyable or finding time for PA (e.g.…”

“…The possibility of altering perceived physical appearance, physical capabilities and the overall self-concept of one's own body through sensory feedback may offer a practical way to make people feel good about their bodies [3,15]; this may facilitate healthy changes in self-esteem and confidence in one's body. The identified user needs [17], and the potential strategies to address them, are at the root of our technology design process and are summarized as Design Principles in Table 1. To cater for different users' needs, an overarching design principle is to allow tailoring the system and sensory feedback according to user needs and preferences.…”