Health, behaviour change & technology : a snapshot - May 2013

Jacqueline (Jax) Wechsler
Jacqueline (Jax) WechslerHuman-centred Designer, Researcher & Strategist
Health, behaviour 
change & technology 
trends, a snapshot.
Many Consumer Health Apps
Consumer Health Apps Examples 
AZUMIO offers 
biofeedback health apps - 
this one checks your 
stress levels. 
SAMSUNG S-HEALTH A health tracker native on 
your phone with synched accessories. Monitors 
weight, blood sugar and graphs it all. Demo-ed for 
the first time March 14th, 2013
Patient Behaviours Drive Health 
• Rehabilitation exercises! 
• Medication compliance! 
• Progress measurement! 
• Nutrition plan! 
• Correcting bad habits! 
Patients are responsible for most of their own treatment.
7 Guidelines: Motivating Behaviour 
Change with Mobile 
! 
• Remind people of who they want to be! 
• Foster an alliance! 
• Apply social influence! 
• Show people what they could lose! 
• Put the message where the action is! 
• Raise emotional awareness! 
• Reframe Challenges 
http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- 
change-with-mobile.pdf
7 Guidelines: Motivating Behaviour 
Change with Mobile 
REMIND PEOPLE OF WHO THEY WANT TO BE 
! 
Health messaging should reference relationships 
and other powerful incentives for making difficult 
lifestyle changes to remind people of their values 
and previously set intentions.! 
! 
+ E.g. Images are pushed to the phone at the time 
individuals take medication to convey that 
adherence will enable them to pursue favorite 
activities, such as gardening.! 
! 
http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- 
change-with-mobile.pdf
7 Guidelines: Motivating Behaviour 
Change with Mobile 
FOSTER AN ALLIANCE (between patient & device) 
Dialogue such as “Let’s figure out what might be causing the rise in your 
blood pressure” is preferable to “Your blood pressure is high; answer the 
questions below.”! 
! 
+ CONNECT can assist to form an alliance between health practitioners and 
patients as well. 
”Insight and confidence in one’s ability to change results from a strong 
therapeutic alliance. A therapist’s interpretations that describe the patient’s 
main conflict in the contexts of her current situation, her personal history, and 
the dynamics within the therapeutic relationship are catalysts for insight.”! 
! 
! 
! 
http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- 
change-with-mobile.pdf
7 Guidelines: Motivating Behaviour 
Change with Mobile 
Behaviour change requires support between feedback and recording 
! 
http://www.slideshare.net/frogdesign/iln-behaviors-mechanics1
7 Guidelines: Motivating Behaviour 
Change with Mobile 
APPLY SOCIAL INFLUENCE 
Social comparison has been used to influence behavior in many contexts 
! 
+ To motivate change, the statements must accurately reference desirable behavior, 
rather than unfortunate behavioral trends and their deleterious effects 
“You exercised once last week. Eighty percent of women your age exercise daily.” ! 
+ Detailed narratives or videos depicting the successful strategies of others can 
provide role modeling and thereby foster self-efficacy! 
! 
+ Set a referee for behaviour change commitments so patient feels supported by a 
friend 
! 
http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- 
change-with-mobile.pdf
7 Guidelines: Motivating Behaviour 
Change with Mobile 
SHOW PEOPLE WHAT THEY COULD LOSE 
People need help understanding 
the health losses they could 
experience as a result of poor self-care. 
! 
http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- 
change-with-mobile.pdf 
! 
! 
It can be hard for patients to link 
short term decisions with long-term 
consequences.!
7 Guidelines: Motivating Behaviour 
Change with Mobile 
PUT THE MESSAGE WHERE THE ACTION IS - CONTEXTUAL PROMPTING 
The closer to the time and place of the target activity that a reminder occurs, 
the more effective it will be. A wide range of health choices, from immediate 
meal decisions to enrollment in exercise classes, can be guided and simplified 
through contextual prompting.! 
! 
e.g. Set reminders such as “Prepare healthy vegetable snacks for work 
tomorrow” at dinner time. 
“Is it time for your lunch-time walk” set as an alert at lunch-time.! 
! 
Delivering messaging within the right context can trigger behaviour. 
! 
http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- 
change-with-mobile.pdf
7 Guidelines: Motivating Behaviour 
Change with Mobile 
RAISE EMOTIONAL AWARENESS 
Emotional dynamics play a strong role in motivation, with negative moods 
associated with impaired negotiating skills and consequent lapses from health goals. ! 
! 
By “checking in” with their current mood and emotional patterns, individuals can 
understand their vulnerabilities to such lapses and develop alternative coping 
strategies.! 
Emerging mobile applications and on-the-body sensors allow individuals to reflect on 
emotional, physiological, and behavioral patterns.! 
We should consider emotional dynamics and fluctuations in our platform.! 
! 
! 
http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- 
change-with-mobile.pdf
7 Guidelines: Motivating Behaviour 
Change with Mobile 
REFRAME CHALLENGES 
Examining one’s immediate interpretations of daily events and considering 
alternatives helps people respond to challenging situations in more constructive 
ways.! 
! 
An example of this reframing is attributing a dietary lapse, such as eating fast 
food, not to a lack of willpower but to unpreparedness for a long car ride. The 
latter interpretation generates practical solutions, such as packing snacks, 
rather than self-recrimination. Self-monitoring, cognitive reappraisal, and 
development of alternative coping strategies are well evidenced elements of 
cognitive behavioral therapy (CBT).! 
! 
http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- 
change-with-mobile.pdf
Trends Relating to Health Tools 
• Wearable Technology! 
• Platforms! 
• Visualisation! 
• Gamification! 
• Social
Wearable Technology 
WVISEUAARALIBSLAET TIOECNH
Biometric Measurement
Fitness Data Tracking 
Viiiiva Fitness Gadget 
Unveiled at CES International 2013, 
this monitor lets ANT+ devices 
communicate with an iPhone or iPod 
touch in real-time without using an 
adapter to sync information. This 
means that you can jog, bike, 
kickbox (or whatever your workout) 
while monitoring stats like heart rate 
or calories burned on your iPhone.
Health Data Tracking
PLATFORMS
Product Service Systems
Microsoft Health Vault
Microsoft Health Vault
Others offering BIG DATA platforms 
Health institutions are partnering with these and other suppliers
VISUALISATION
Annual Reports Project 
Nicholas Felton & the Felton Report!
Daytum.com 
Visualising Life 
DIY Platform for Visuslising Personal Statistics!
Visualising Health 
Track & Share Glucose Levels! 
http:/baotapp.com
Visualising Health 
This can help patients to better visualise their conditions ! 
where it has no symptoms. 
Progress can be visualised in order to function as a motivator.
http://www.slideshare.net/frogdesign/healthcare-innovation-now-3-themes-and-10-insights
GAMIFICATION
Gamification 
“Gamification is the use of game thinking and game mechanics in 
a non-game context in order to engage users and solve problems. ! 
! 
Gamification is used in applications and processes to improve user 
engagement, ROI, data quality, timeliness, and learning.” 
SRC: http://en.wikipedia.org/wiki/Gamification
Health Games 
Good health games successfully apply game mechanics that 
make games fun to play. They shift the mentality of difficulty and 
undesirable tasks into something that patients actually look 
forward to doing.
Gamification can assist to.... 
• get people engaged! 
• make health management more fun! 
• get people to do challenging stuff! 
• and keep them engaged.
Basic Game Mechanics 
1.Lottery - e.g. choosing a card in Trivial Pursuit! 
2.Countdown - e.g. the timer in Pictionary! 
3.Team Competition - e.g. sports! 
4.Narrative - e.g. Dungeons and Dragons! 
5.Leader Board - e.g. Scrabble! 
6.Progression Dynamic - e.g. Treasure hunt game! 
7.Meta-game - e.g. Nintendo Brain Games! 
8.Status - e.g. Farmville! 
9.Achievement - e.g. Foursquare badges for visiting places 
SRC for mechanics only: http://www.slideshare.net/frogdesign/iln-behaviors-mechanics1
Gaming for Health 
Switch 2 Health! 
http://www.s2h.com! 
Wearable technology device that monitors health achievements & provides incentives 
through a web platform. Positive behaviour is rewarded by a code from the device that users 
can enter on the site to get rewards/prizes.
Gaming for Health 
Nike +, Adidas mCoach! 
IT platforms integrate with wearable devices that try to provide motivation for people that 
exercise alone. The platforms use a social dimension to connect people as well as record 
metrics to track progress on an individual level.
Gaming Dynamics of Nike + 
SRC: http://www.slideshare.net/frogdesign/iln-behaviors-mechanics1
Gaming Dynamics of Nike + 
SRC: http://www.slideshare.net/frogdesign/iln-behaviors-mechanics1
Gaming Dynamics of Nike + 
SRC: http://designmind.com 
SRC: http://www.slideshare.net/frogdesign/iln-behaviors-mechanics1
SOCIAL
Social and health apps 
There is evidence to suggest that social elements can 
help people to stay motivated and supported in their 
health improvement journeys. Social elements can 
manifest in very different ways on sites ranging from “like” 
buttons to full-blown social networks.! 
There are many online support communities for diabetics, 
cancer patients, MS & HIV patients, asthma sufferers etc.! 
The social network model relies on on-going support and 
funding. These sites are usually funded by not for profits, 
pharmaceutical companies, government and health 
groups etc.
Patients Like Me
Patients Like Me
Patients Like Me
Health, behaviour change & technology : a snapshot - May 2013
Health, behaviour change & technology : a snapshot - May 2013
Health, behaviour change & technology : a snapshot - May 2013
Health, behaviour change & technology : a snapshot - May 2013
Connected Care Solution 
by Frog Design 
• A care plan - vitals (weight, BMI, waist circumference, blood pressure), Lifestyle 
(physical activity), Medications & Supplements (different drugs)! 
• Health monitoring - synching with biometric feedback devices the tool recognises 
outliers and health professionals can check in on the patients progress at anytime. 
Visualisation and sharing of data.! 
• Virtual Coach - reminders to take metrics, medication and exercise. Setting of 
progressive targets for activity. Gives feedback about results and actionable 
suggestions.! 
• Cheerleaders - Share your progress with friends and 
family and get gentle nudges from them along the way.! 
NB Developed with cardio-vascular ! 
patients in mind
jax@stickydesignstudio.com.au! 
http://stickydesignstudio.com.au
1 of 50

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Health, behaviour change & technology : a snapshot - May 2013

  • 1. Health, behaviour change & technology trends, a snapshot.
  • 3. Consumer Health Apps Examples AZUMIO offers biofeedback health apps - this one checks your stress levels. SAMSUNG S-HEALTH A health tracker native on your phone with synched accessories. Monitors weight, blood sugar and graphs it all. Demo-ed for the first time March 14th, 2013
  • 4. Patient Behaviours Drive Health • Rehabilitation exercises! • Medication compliance! • Progress measurement! • Nutrition plan! • Correcting bad habits! Patients are responsible for most of their own treatment.
  • 5. 7 Guidelines: Motivating Behaviour Change with Mobile ! • Remind people of who they want to be! • Foster an alliance! • Apply social influence! • Show people what they could lose! • Put the message where the action is! • Raise emotional awareness! • Reframe Challenges http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- change-with-mobile.pdf
  • 6. 7 Guidelines: Motivating Behaviour Change with Mobile REMIND PEOPLE OF WHO THEY WANT TO BE ! Health messaging should reference relationships and other powerful incentives for making difficult lifestyle changes to remind people of their values and previously set intentions.! ! + E.g. Images are pushed to the phone at the time individuals take medication to convey that adherence will enable them to pursue favorite activities, such as gardening.! ! http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- change-with-mobile.pdf
  • 7. 7 Guidelines: Motivating Behaviour Change with Mobile FOSTER AN ALLIANCE (between patient & device) Dialogue such as “Let’s figure out what might be causing the rise in your blood pressure” is preferable to “Your blood pressure is high; answer the questions below.”! ! + CONNECT can assist to form an alliance between health practitioners and patients as well. ”Insight and confidence in one’s ability to change results from a strong therapeutic alliance. A therapist’s interpretations that describe the patient’s main conflict in the contexts of her current situation, her personal history, and the dynamics within the therapeutic relationship are catalysts for insight.”! ! ! ! http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- change-with-mobile.pdf
  • 8. 7 Guidelines: Motivating Behaviour Change with Mobile Behaviour change requires support between feedback and recording ! http://www.slideshare.net/frogdesign/iln-behaviors-mechanics1
  • 9. 7 Guidelines: Motivating Behaviour Change with Mobile APPLY SOCIAL INFLUENCE Social comparison has been used to influence behavior in many contexts ! + To motivate change, the statements must accurately reference desirable behavior, rather than unfortunate behavioral trends and their deleterious effects “You exercised once last week. Eighty percent of women your age exercise daily.” ! + Detailed narratives or videos depicting the successful strategies of others can provide role modeling and thereby foster self-efficacy! ! + Set a referee for behaviour change commitments so patient feels supported by a friend ! http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- change-with-mobile.pdf
  • 10. 7 Guidelines: Motivating Behaviour Change with Mobile SHOW PEOPLE WHAT THEY COULD LOSE People need help understanding the health losses they could experience as a result of poor self-care. ! http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- change-with-mobile.pdf ! ! It can be hard for patients to link short term decisions with long-term consequences.!
  • 11. 7 Guidelines: Motivating Behaviour Change with Mobile PUT THE MESSAGE WHERE THE ACTION IS - CONTEXTUAL PROMPTING The closer to the time and place of the target activity that a reminder occurs, the more effective it will be. A wide range of health choices, from immediate meal decisions to enrollment in exercise classes, can be guided and simplified through contextual prompting.! ! e.g. Set reminders such as “Prepare healthy vegetable snacks for work tomorrow” at dinner time. “Is it time for your lunch-time walk” set as an alert at lunch-time.! ! Delivering messaging within the right context can trigger behaviour. ! http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- change-with-mobile.pdf
  • 12. 7 Guidelines: Motivating Behaviour Change with Mobile RAISE EMOTIONAL AWARENESS Emotional dynamics play a strong role in motivation, with negative moods associated with impaired negotiating skills and consequent lapses from health goals. ! ! By “checking in” with their current mood and emotional patterns, individuals can understand their vulnerabilities to such lapses and develop alternative coping strategies.! Emerging mobile applications and on-the-body sensors allow individuals to reflect on emotional, physiological, and behavioral patterns.! We should consider emotional dynamics and fluctuations in our platform.! ! ! http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- change-with-mobile.pdf
  • 13. 7 Guidelines: Motivating Behaviour Change with Mobile REFRAME CHALLENGES Examining one’s immediate interpretations of daily events and considering alternatives helps people respond to challenging situations in more constructive ways.! ! An example of this reframing is attributing a dietary lapse, such as eating fast food, not to a lack of willpower but to unpreparedness for a long car ride. The latter interpretation generates practical solutions, such as packing snacks, rather than self-recrimination. Self-monitoring, cognitive reappraisal, and development of alternative coping strategies are well evidenced elements of cognitive behavioral therapy (CBT).! ! http://www.intel.com/content/dam/www/public/us/en/documents/articles/margie-morris-motivating- change-with-mobile.pdf
  • 14. Trends Relating to Health Tools • Wearable Technology! • Platforms! • Visualisation! • Gamification! • Social
  • 17. Fitness Data Tracking Viiiiva Fitness Gadget Unveiled at CES International 2013, this monitor lets ANT+ devices communicate with an iPhone or iPod touch in real-time without using an adapter to sync information. This means that you can jog, bike, kickbox (or whatever your workout) while monitoring stats like heart rate or calories burned on your iPhone.
  • 23. Others offering BIG DATA platforms Health institutions are partnering with these and other suppliers
  • 25. Annual Reports Project Nicholas Felton & the Felton Report!
  • 26. Daytum.com Visualising Life DIY Platform for Visuslising Personal Statistics!
  • 27. Visualising Health Track & Share Glucose Levels! http:/baotapp.com
  • 28. Visualising Health This can help patients to better visualise their conditions ! where it has no symptoms. Progress can be visualised in order to function as a motivator.
  • 31. Gamification “Gamification is the use of game thinking and game mechanics in a non-game context in order to engage users and solve problems. ! ! Gamification is used in applications and processes to improve user engagement, ROI, data quality, timeliness, and learning.” SRC: http://en.wikipedia.org/wiki/Gamification
  • 32. Health Games Good health games successfully apply game mechanics that make games fun to play. They shift the mentality of difficulty and undesirable tasks into something that patients actually look forward to doing.
  • 33. Gamification can assist to.... • get people engaged! • make health management more fun! • get people to do challenging stuff! • and keep them engaged.
  • 34. Basic Game Mechanics 1.Lottery - e.g. choosing a card in Trivial Pursuit! 2.Countdown - e.g. the timer in Pictionary! 3.Team Competition - e.g. sports! 4.Narrative - e.g. Dungeons and Dragons! 5.Leader Board - e.g. Scrabble! 6.Progression Dynamic - e.g. Treasure hunt game! 7.Meta-game - e.g. Nintendo Brain Games! 8.Status - e.g. Farmville! 9.Achievement - e.g. Foursquare badges for visiting places SRC for mechanics only: http://www.slideshare.net/frogdesign/iln-behaviors-mechanics1
  • 35. Gaming for Health Switch 2 Health! http://www.s2h.com! Wearable technology device that monitors health achievements & provides incentives through a web platform. Positive behaviour is rewarded by a code from the device that users can enter on the site to get rewards/prizes.
  • 36. Gaming for Health Nike +, Adidas mCoach! IT platforms integrate with wearable devices that try to provide motivation for people that exercise alone. The platforms use a social dimension to connect people as well as record metrics to track progress on an individual level.
  • 37. Gaming Dynamics of Nike + SRC: http://www.slideshare.net/frogdesign/iln-behaviors-mechanics1
  • 38. Gaming Dynamics of Nike + SRC: http://www.slideshare.net/frogdesign/iln-behaviors-mechanics1
  • 39. Gaming Dynamics of Nike + SRC: http://designmind.com SRC: http://www.slideshare.net/frogdesign/iln-behaviors-mechanics1
  • 41. Social and health apps There is evidence to suggest that social elements can help people to stay motivated and supported in their health improvement journeys. Social elements can manifest in very different ways on sites ranging from “like” buttons to full-blown social networks.! There are many online support communities for diabetics, cancer patients, MS & HIV patients, asthma sufferers etc.! The social network model relies on on-going support and funding. These sites are usually funded by not for profits, pharmaceutical companies, government and health groups etc.
  • 49. Connected Care Solution by Frog Design • A care plan - vitals (weight, BMI, waist circumference, blood pressure), Lifestyle (physical activity), Medications & Supplements (different drugs)! • Health monitoring - synching with biometric feedback devices the tool recognises outliers and health professionals can check in on the patients progress at anytime. Visualisation and sharing of data.! • Virtual Coach - reminders to take metrics, medication and exercise. Setting of progressive targets for activity. Gives feedback about results and actionable suggestions.! • Cheerleaders - Share your progress with friends and family and get gentle nudges from them along the way.! NB Developed with cardio-vascular ! patients in mind