Identifying Mobile Health Engagement Stages: Interviews and Observations for Developing Brief Message Content.

BACKGROUND: Interest in mobile health (mHealth) has increased recently, and research suggests that mHealth devices can enhance end-user engagement, especially when used in conjunction with brief message content. OBJECTIVE: This research aims to explore the stages of engagement framework for mHealth devices and develop a method to generate brief message content to promote sustained user engagement. This study uses the framework by O'Brien and Toms as a point of departure, where engagement is defined as the uptake or the use of an mHealth device. The framework is a linear repeatable process, including point of engagement, period of engagement, disengagement, and re-engagement. Each stage is characterized by attributes related to a person's technology experience. Although the literature has identified stages of engagement for health-related technology, few studies explore mHealth engagement. Furthermore, little research has determined a method for creating brief message content at each stage in this engagement journey. METHODS: Interviews and observations from 19 participants who used mHealth technologies (apps, devices, or wellness websites) in a solo capacity were recruited for sample group 1. In sample group 2, interviews, and observations from 25 participants using mHealth technologies in a group capacity through the Global Corporate Challenge were used. These samples were investigated at 3 time points in both research contexts. The results underwent deductive-inductive thematic analysis for the engagement stages' framework and attributes. RESULTS: In addition to the 4 stages identified by O'Brien and Toms, 2 additional stages, self-management and limited engagement, were identified. Self-management captures where users had disengaged from their technology but were still engaged with their health activity. Limited engagement captures where group mHealth users had minimal interaction with their mHealth technology but continued to engage in a group fitness activity. The results revealed that mHealth engagement stages were nonlinear and embedded in a wider engagement context and that each stage was characterized by a combination of 49 attributes that could be organized into 8 themes. Themes documented the total user experience and included technology usability, technology features, technology aesthetics, use motivations, health awareness, goal setting, social support, and interruptions. Different themes were found to have more relevance at different engagement stages. Knowing themes and attributes at all engagement stages allows technology developers and health care professionals to generate relevant brief message content informed by a person-centered approach. CONCLUSIONS: This research extends an existing engagement stages framework and identifies attributes and themes relevant to mHealth technology users' total user experience and incorporates concepts derived from health, business studies, and information systems literature. In addition, we offer a practical 5-step process based on a person-centered approach to develop mHealth technology brief message content for sustained engagement.

A Multisensorial Storytelling Design Strategy to Build Empathy and a Culture of Inclusion.

The Wondrous Goggles project is a multisensorial storytelling design strategy to explore the experiential world of people who are blind or have low vision, with the aim of raising awareness about inclusive places for work and play. The need for this exploratory storytelling design strategy is predominantly educational, as a tool to inform designers, policy makers, and technology developers of how people with blindness or low vision experience public spaces. The Wondrous Googles are specifically designed to facilitate an understanding of the navigational and spatial perception of people with low vision. During use, the Wondrous Goggles enable the user to gain a sense of limited vision and provide a vehicle for the wearer to embark upon a process of feeling, sensing, and reflecting while listening to the narration of someone who has navigated the space with low vision. Unlike other technologies that create virtual reality, or an augmented reality based on vision alone, the Wondrous Goggles create a multisensorial storytelling experience through the lived experience of a person with low vision, to gain an understanding of people's lived experiences in navigating public spaces, in order to create cultures of inclusion.

Co-creation through non-dyadic service experiences using service design.

Scant empirical research has examined non-dyadic multi-actor service experiences within the food industry. Drawing from the theories of multi-actor co-creation, service dominant logic and service experience, this paper investigates the meal-kit industry and its role in enhanced food well-being among consumers. Specifically, it answers the following research questions; 1) which stages are there in food preparation and consumption routine when using meal-kits and 2), how do these relate to the components of FWB. This exploratory study used service design tools including mind maps, prompt cards, cultural probes, and a cognitive mapping activity with interviews, to examine the food experience of participants within the meal-kit industry over the period of a week. The findings indicate five stages of food preparation and consumption that through multi-actor interactions, even when deviant to the intended purpose, lead to food experiences that can enable the co-creation of emotional, social, and cognitive benefits specifically contributing to Food Socialisation, Food Availability and Food Literacy from the FWB framework. The investigation into contextual influences and interactions with the resources within the consumer's network across all phases of food consumption, reflects the consumer's changing food experiences over time and the consumer's improved relationship with food, helping in turn to predict their food well-being. This research provides insights as to how consumer interactions with service offerings and actors within their network develop new applications of a service's value propositions based on one's specific needs and situational context.

Self-efficacy and trust in consumers' use of health-technologies devices for sports.

The commercial market for wearable health technology is growing but the value these technologies provide for consumers is debatable, as many technologies lack formal validation and are being abandoned at a high rate. The enabling of self-efficacy mechanisms in the design of health technologies, through the factors identified by self-determination theory and the Technology Acceptance Model, could increase the uptake and continued use of these devices. The aim of this research was to investigate how and why people use wearable health technology, and to evaluate their experiences from the perspective of perceptions of autonomy, safety, information security, information accuracy and willingness for continued use. Forty-eight sport enthusiasts or athletes, age range 18-65 and over, completed an online survey with 46 questions. A statistical analysis that included a Mann-Whitney U Test and a Person's Correlation analysis indicated that participants who were confident in their use of a health technology showed satisfaction with previous uses and a sense of autonomy leading to an overall positive experience. Issues around data and personal information security were identified, aligning with extant literature. Findings suggest that: (i) past experience play a role in people's perception of self-efficacy, (ii) the tracking of activities enables of autonomy and confidence, (iii) autonomy influences personal willingness to use health technologies, (iv) strong interest in personal health technologies motivates sustained engagement, and that (v) reliability and validity of data impacts on confidence in health technologies. A conceptual model is proposed for consideration when designing and evaluating health technologies, based on the factors supporting self-efficacy and trust in health technologies. Further research is required to develop this model with the aim of informing designers and developers about how to translate these factors into design features for the development of more effective personal health technology.

Factors influencing the journey to work for young people with physical and/or neurological conditions.

PURPOSE: This study examined the challenges young people with a physical and/or neurological condition experience in their journey to work. This includes both their physical commute to work and transition to the workforce. MATERIALS AND METHODS: Insight was established through the development and testing of a model which extended the model of goal directed behavior. A survey was distributed to 200 young people with a physical and/or neurological condition. PLS-SEM analysis was conducted to identify factors which influence a young person with a physical and/or neurological disability's journey to work. RESULTS: The results suggest subjective norms, attitudes, anticipated negative emotions, and risk aversion underpin a young person's desire to journey to work (both physical commute to work and transition to workforce). This desire then encourages an individual's intentions to travel independently. Past behavior and perceived behavioral support are seen to encourage intentions, while employer support and social support lead to increased perceived behavioral control directly and intentions indirectly. CONCLUSIONS: The study highlights the importance of mental preparedness, having support available from employers, friends, and families, and access to transport that supports independence in encouraging and facilitating the journey to work for young adults with a neurological and/or physical disability.IMPLICATIONS FOR REHABILITATIONfPositive attitude, risk aversion, and expected negative emotions are key factors in the decision to commute to work independently for a young person with a physical and/or neurological disability.The more support a young person with a physical and/or neurological disability feels from their employer and social circle, the more likely they feel in control of their actions and to plan to journey to work independently.Encouraging social norms are likely to impact the desire and intention to journey to work independently for young people with a physical and/or neurological disability.Feeling in control and having successful previous transport experiences is likely to help predict whether young people with a physical and/or neurological disability will plan on commuting to work independently in the future.

Encouraging young adults with a disability to be independent in their journey to work: A segmentation and application of Theory of Planned Behaviour approach.

This study investigates how young adults with disabilities can be encouraged to be independent in their travel to work and thus, transition more smoothly into the workforce. Using cluster analysis, we identify three segment groups of young adults with physical disabilities. The Theory of Planned Behaviour is then applied to examine differences and identify strategies that could provide assistance and support to these groups of workers in their travel to work. This study is the first to segment this group of workers and identify strategies to mitigate the often-unique challenges they face in their physical journey to work.

Using technology to enhance and encourage dance-based exercise.

This study investigated the role of Self-Service Technologies (SSTs) in dance-based exercise in order to begin exploring the motivations behind the use (or not) of SSTs by ordinary men and women in this context. The research approach employed interviews to gain insights into participants' use of SSTs and their exercise practices, in order to start establishing ways in which dance can be re/incorporated into people's lives through the design of appropriate SSTs. Findings from this study highlight the significant opportunity to further explore how the properties of music and dance can be integrated into the design of new SSTs. Literature suggests dance could be a beneficial exercise format for many people and self-service technology abounds for exercise but is often not used consistently. Our interviews asked participants about dance-based exercise and SSTs for exercise and showed that there is an opportunity to design SSTs to help people access dance-based exercise. SSTs should help people learn dance, build confidence, and dance alone or with others. SSTs could facilitate movement and increase engagement with physical activity whilst addressing issues around logistics, confidence and dance knowledge and experience.

Seating in aged care: Physical fit, independence and comfort.

OBJECTIVES: This research was intended to provide a greater understanding of the context and needs of aged care seating, specifically:To conduct an audit of typical chairs used in aged care facilities;To collect data about resident and staff experiences and behaviour around chairs in order to gain a deeper understanding of the exact issues that residents and staff have with the chairs they use at aged care facilities;To identify positive and negative issues influencing use of chairs in aged care facilities;To deliver evidence-based recommendations for the design of chairs for aged care facilities. METHODS: Methods included a chair dimension audit, interviews with residents, experts and carers and observations of aged care residents getting into chairs, sitting in them and getting out. RESULTS: Results showed that residents, experts and carers all prefer chairs which are above the recommended height for older people so that they will be able to get out of them more easily. Armrests were essential for ease of entry and egress. However, many residents struggled with chairs which were also too deep in the seat pan so that they could not easily touch the floor or sit comfortably and were forced to slump. Most residents used cushions and pillows to relieve discomfort where possible. CONCLUSION: The implications of these issues for chair design and selection are discussed. Variable height chairs, a range of chairs of different heights in each space and footrests could all address the height problem. Chair designers need to address the seat depth problem by reducing depth in most aged care specific chairs, even when they are higher. Armrests must be provided but could be made easier to grip. Addressing these issues would increase access to comfortable yet easy-to-use chairs for a wider range of the aged care population.

Human experience and product usability: principles to assist the design of user-product interactions.

This paper introduces research that investigates how human experience influences people's understandings of product usability. It describes an experiment that employs visual representation of concepts to elicit participants' ideas of a product's use. Results from the experiment lead to the identification of relationships between human experience, knowledge, and context-of-use--relationships that influence designers' and users' concepts of product usability. These relationships are translated into design principles that inform the design activity with respect to the aspects of experience that trigger people's understanding of a product's use. A design tool (ECEDT) is devised to aid designers in the application of these principles. This tool is then trialled in the context of a design task in order to verify applicability of the findings.