To improve people’s lives, human-computer interaction researchers are increasingly designing technological solutions based on behavior change theory, such as social comparison theory (SCT). However, how researchers operationalize such a theory as a design remains largely unclear. One way to clarify this methodological step is to clearly state which functional elements of a design are aimed at operationalizing a specific behavior change theory construct to evaluate if such aims were successful. In this article, we investigate how the operationalization of functional elements of theories and designs can be more easily conveyed. First, we present a scoping review of the literature to determine the state of operationalizations of SCT as behavior change designs. Second, we introduce a new tool to facilitate the operationalization process. We term the tool blueprints. A blueprint explicates essential functional elements of a behavior change theory by describing it in relation to necessary and sufficient building blocks incorporated in a design. We describe the process of developing a blueprint for SCT. Last, we illustrate how the blueprint can be used during the design refinement and reflection process.
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Behavior change is a topic that is of great interest to many people. People can use apps to exercise more, eat healthier, or learn a new skill, but and digital interventions and games are also used by policy makers and companies to create a safe environment for the general public or to increase sales. Given this interest in behavior change, it is not surprising that this topic has seen a lot of interest from the scientific community. This has resulted in a wide range of theories and techniques to bring about behavior change. However, maintaining behavior change is rarely addressed, and as a result poorly understood. In this paper, we take a first step in the design of digital interventions for long-term behavior change by placing a range of behavior change techniques on a long-term behavior change timeline.
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Background Movement behaviors (i.e., physical activity levels, sedentary behavior) in people with stroke are not self-contained but cluster in patterns. Recent research identified three commonly distinct movement behavior patterns in people with stroke. However, it remains unknown if movement behavior patterns remain stable and if individuals change in movement behavior pattern over time. Objectives 1) To investigate the stability of the composition of movement behavior patterns over time, and 2) determine if individuals change their movement behavior resulting in allocation to another movement behavior pattern within the first two years after discharge to home in people with a first-ever stroke. Methods Accelerometer data of 200 people with stroke of the RISE-cohort study were analyzed. Ten movement behavior variables were compressed using Principal Componence Analysis and K-means clustering was used to identify movement behavior patterns at three weeks, six months, one year, and two years after home discharge. The stability of the components within movement behavior patterns was investigated. Frequencies of individuals’ movement behavior pattern and changes in movement behavior pattern allocation were objectified. Results The composition of the movement behavior patterns at discharge did not change over time. At baseline, there were 22% sedentary exercisers (active/sedentary), 45% sedentary movers (inactive/sedentary) and 33% sedentary prolongers (inactive/highly sedentary). Thirty-five percent of the stroke survivors allocated to another movement behavior pattern within the first two years, of whom 63% deteriorated to a movement behavior pattern with higher health risks. After two years there were, 19% sedentary exercisers, 42% sedentary movers, and 39% sedentary prolongers. Conclusions The composition of movement behavior patterns remains stable over time. However, individuals change their movement behavior. Significantly more people allocated to a movement behavior pattern with higher health risks. The increase of people allocated to sedentary movers and sedentary prolongers is of great concern. It underlines the importance of improving or maintaining healthy movement behavior to prevent future health risks after stroke.
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Abstract: Combined lifestyle interventions (CLI) are focused on guiding clients with weight-related health risks into a healthy lifestyle. CLIs are most often delivered through face-to-face sessions with limited use of eHealth technologies. To integrate eHealth into existing CLIs, it is important to identify how behavior change techniques are being used by health professionals in the online and offline treatment of overweight clients. Therefore, we conducted online semi-structured interviews with providers of online and offline lifestyle interventions. Data were analyzed using an inductive thematic approach. Thirty-eight professionals with (n = 23) and without (n = 15) eHealth experience were interviewed. Professionals indicate that goal setting and action planning, providing feedback and monitoring, facilitating social support, and shaping knowledge are of high value to improve physical activity and eating behaviors. These findings suggest that it may be beneficial to use monitoring devices combined with video consultations to provide just-in-time feedback based on the client’s actual performance. In addition, it can be useful to incorporate specific social support functions allowing CLI clients to interact with each other. Lastly, our results indicate that online modules can be used to enhance knowledge about health consequences of unhealthy behavior in clients with weight-related health risks.
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Habitual behavior is often hard to change because of a lack of self-monitoring skills. Digital technologies offer an unprecedented chance to facilitate self-monitoring by delivering feedback on undesired habitual behavior. This review analyzed the results of 72 studies in which feedback from digital technology attempted to disrupt and change undesired habits. A vast majority of these studies found that feedback through digital technology is an effective way to disrupt habits, regardless of target behavior or feedback technology used.
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Introduction Physical activity levels of children with disabilities are low, as these children and their parents face a wide variety of both personal and environmental barriers. Behavior change techniques support pediatric physical therapists to address these barriers together with parents and children. We developed the What Moves You?! intervention Toolkit (WMY Toolkit) filled with behavioral change tools for use in pediatric physical therapy practice. Objective To evaluate the feasibility of using the WMY Toolkit in daily pediatric physical therapy practice. Methods We conducted a feasibility study with a qualitative approach using semi-structured interviews with pediatric physical therapists (n = 11). After one day of training, the pediatric physical therapists used the WMY Toolkit for a period of 9 weeks, when facilitating physical activity in children with disabilities. We analyzed the transcripts using an inductive thematic analysis followed by a deductive analysis using a feasibility framework. Results For acceptability, pediatric physical therapists found that the toolkit facilitated conversation about physical activity in a creative and playful manner. The working mechanisms identified were in line with the intended working mechanisms during development of the WMY Toolkit, such as focusing on problem solving, self-efficacy and independence. For demand, the pediatric physical therapists mentioned that they were able to use the WMY Toolkit in children with and without disabilities with a broad range of physical activity goals. For implementation, education is important as pediatric physical therapists expressed the need to have sufficient knowledge and to feel confident using the toolkit. For practicality, pediatric physical therapists were positive about the ease of which tools could be adapted for individual children. Some of the design and materials of the toolkit needed attention due to fragility and hygiene. Conclusion The WMY Toolkit is a promising and innovative way to integrate behavior change techniques into pediatric physical therapy practice.
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The hospitality industry contributes significantly to global climate change through its high resource consumption and emissions due to travel. As public pressure for hotels to develop sustainability initiatives to mitigate their footprint grows, a lack of understanding of green behavior and consumption of hotel guests hinders the adoption of effective programs. Most tourism research thus far has focused on the ecotourism segment, rather than the general population of travelers, and while research in consumer behavior shows that locus of control (LOC) and guilt can influence guests’ environmental behavior, those factors have not been tested with consideration of the subjective norm to measure their interaction and effect on recycling behavior. This study first examines the importance of internal and external LOC on factors for selecting hotel accommodation and the extent of agreement about hotel practices and, second, examines the differences in recycling behavior among guests with internal versus external LOC under levels of positive versus negative subjective norms and feelings of low versus high guilt.
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Behaviour change design has much to gain with the integration of insights from the behavioural sciences in the design process. However, this integration needs to be done without hampering the creative process. In two rich design cases aimed at health and safety behaviour change, we describe our efforts to develop a method for theory driven design based on the Double Diamond. Our method attempts to integrate insights from the Persuasive by Design-model (PbD) for behaviour change into the entire design process. Our case studies demonstrate that our method indeed augments the integration of theory and evidence in our designs, but only if the Double Diamond process model is complemented with an evaluation phase, and insights from the PbD-model are derived using rich, well developed tools.
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Blended behavior change interventions combine therapeutic guidance with online care. This new way of delivering health care is supposed to stimulate patients with chronic somatic disorders in taking an active role in their disease management. However, knowledge about the effectiveness of blended behavior change interventions and how they should be composed is scattered. This comprehensive systematic review aimed to provide an overview of characteristics and effectiveness of blended behavior change interventions for patients with chronic somatic disorders.
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Past research on designing for behavioural change mostly concerned linear design processes, whereas in practice, Agile design methods are increasingly popular. This paper evaluates the possibilities and limitations of using Agile design methods in theory-driven design for behavioural change. We performed a design case study, consisting of a student design team working on improving waiting experiences at Schiphol Airport security and check-in. Our study showed that Agile design methods are usable when designing for behavioural change. Moreover, the Behavioural Lenses toolkit used in the design process is beneficial in facilitating theory-driven Agile design. The combination of an Agile design process and tools to evidentially inform the design enabled the design team to formulate viable and interesting concepts for improving waiting-line experiences. However, limitations also occurred: a mismatch between the rate at which the Scream method proceeded and the time and momentum needed to conduct in-depth research.
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