Tailoring Persuasive Electronic Health Strategies for Older Adults on the Basis of Personal Motivation: Web-Based Survey Study

Abstract

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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“…For example, they found a cook suitable for receiving recipes, but preferred discussing more sensitive issues with their children. This implies that different health topics might require ECAs in different roles, providing different types of advice (van Velsen et al 2019). However, none of the current ECA-based intervention consider different roles (Kramer et al 2020).…”

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“…When developing an ECA for eHealth we have to take into account our target users. As with many other aspects of eHealth, personalization matters (van Velsen et al, 2019;Tielman et al, 2019;Lehto & Oinas-Kukkonen, 2011;. We suggest to adapt the demographics of an ECA to the user's preferences.…”

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“…Motivation to be physically active in the frame of the Self-Determination Theory (33) differentiates between six motivation pro les: a-motivation, external, introjected, identi ed and integrated regulations, and intrinsic motivation (34). A recent study showed that the motivation to engage in healthy behaviors may in uence the preference for persuasive features included in technology-based applications (35). The study by van Velsen and colleagues showed that intrinsically motivated users appreciated all persuasive features, while externally regulated users were mostly motivated by particular persuasive features, such as showing progress, self-goal setting, rewards in the form of compliments, and health education (35).…”

“…A recent study showed that the motivation to engage in healthy behaviors may in uence the preference for persuasive features included in technology-based applications (35). The study by van Velsen and colleagues showed that intrinsically motivated users appreciated all persuasive features, while externally regulated users were mostly motivated by particular persuasive features, such as showing progress, self-goal setting, rewards in the form of compliments, and health education (35).…”