Engaging Users in the Behavior Change Process With Digitalized Motivational Interviewing and Gamification : Development and Feasibility Testing of the Precious App

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Nurmi , J , Knittle , K , Ginchev , T , Khattak , F , Helf , C , Zwickl , P , Castellano-Tejedor , C , Lusilla-Palacios , P , Costa-Requena , J , Ravaja , N & Haukkala , A 2020 , ' Engaging Users in the Behavior Change Process With Digitalized Motivational Interviewing and Gamification : Development and Feasibility Testing of the Precious App ' , JMIR mhealth and uhealth , vol. 8 , no. 1 , 12884 . https://doi.org/10.2196/12884

Title: Engaging Users in the Behavior Change Process With Digitalized Motivational Interviewing and Gamification : Development and Feasibility Testing of the Precious App
Author: Nurmi, Johanna; Knittle, Keegan; Ginchev, Todor; Khattak, Fida; Helf, Christopher; Zwickl, Patrick; Castellano-Tejedor, Carmina; Lusilla-Palacios, Pilar; Costa-Requena, Jose; Ravaja, Niklas; Haukkala, Ari
Contributor organization: Research group of Ari Haukkala
Center for Population, Health and Society
Social Psychology
Faculty Common Matters (Faculty of Social Sciences)
Research Group of Nelli Hankonen
Department of Psychology and Logopedics
Helsinki Institute for Information Technology
Helsinki Collegium for Advanced Studies
Helsinki Inequality Initiative (INEQ)
Date: 2020-01-30
Language: eng
Number of pages: 30
Belongs to series: JMIR mhealth and uhealth
ISSN: 2291-5222
DOI: https://doi.org/10.2196/12884
URI: http://hdl.handle.net/10138/313215
Abstract: Background: Most adults do not engage in sufficient physical activity to maintain good health. Smartphone apps are increasingly used to support physical activity but typically focus on tracking behaviors with no support for the complex process of behavior change. Tracking features do not engage all users, and apps could better reach their targets by engaging users in reflecting their reasons, capabilities, and opportunities to change. Motivational interviewing supports this active engagement in self-reflection and self-regulation by fostering psychological needs proposed by the self-determination theory (ie, autonomy, competence, and relatedness). However, it is unknown whether digitalized motivational interviewing in a smartphone app engages users in this process. Objective: This study aimed to describe the theory- and evidence-based development of the Precious app and to examine how digitalized motivational interviewing using a smartphone app engages users in the behavior change process. Specifically, we aimed to determine if use of the Precious app elicits change talk in participants and how they perceive autonomy support in the app. Methods: A multidisciplinary team built the Precious app to support engagement in the behavior change process. The Precious app targets reflective processes with motivational interviewing and spontaneous processes with gamified tools, and builds on the principles of self-determination theory and control theory by using 7 relational techniques and 12 behavior change techniques. The feasibility of the app was tested among 12 adults, who were asked to interact with the prototype and think aloud. Semistructured interviews allowed participants to extend their statements. Participants’ interactions with the app were video recorded, transcribed, and analyzed with deductive thematic analysis to identify the theoretical themes related to autonomy support and change talk. Results: Participants valued the autonomy supportive features in the Precious app (eg, freedom to pursue personally relevant goals and receive tailored feedback). We identified the following five themes based on the theory-based theme autonomy support: valuing the chance to choose, concern about lack of autonomy, expecting controlling features, autonomous goals, and autonomy supportive feedback. The motivational interviewing features actively engaged participants in reflecting their outcome goals and reasons for activity, producing several types of change talk and very little sustain talk. The types of change talk identified were desire, need, reasons, ability, commitment, and taking steps toward change. Conclusions: The Precious app takes a unique approach to engage users in the behavior change process by targeting both reflective and spontaneous processes. It allows motivational interviewing in a mobile form, supports psychological needs with relational techniques, and targets intrinsic motivation with gamified elements. The motivational interviewing approach shows promise, but the impact of its interactive features and tailored feedback needs to be studied over time. The Precious app is undergoing testing in a series of n-of-1 randomized controlled trials. KEYWORDS health app; mHealth; human-computer interaction; prevention; service design; usability design; intrinsic motivation; reflective processes; spontaneous processes; engagement; self-determination theory; autonomous motivation; gamification; physical activity
autonomous motivation
health app
human-computer interaction
intrinsic motivation
physical activity
reflective processes
self-determination theory
service design
spontaneous processes
usability design
515 Psychology
5144 Social psychology
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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