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.

Why confidence leads to swifter tertiary education choices: A qualitative study of the international tertiary education industry of Australia.

This paper investigates international students' confidence as a base for imminent tertiary education decisions. International students are a highly sought-after commodity, particularly during and after a global pandemic when the income streams of tertiary education providers are limited. In-depth interviews were conducted with students who sought guidance towards an international study experience to explore the guiding research questions, (1) how does confidence impact tertiary education decisions of international students and (2) what is the relationship between confidence and time to make a tertiary education decision? Set within the context of the international tertiary education industry of Australia, the original contribution stems from identifying that guidance towards an international study experience is affected by confidence in; guidance counselors, the brand name of the university, and the tertiary education decision itself. The identified confidence characteristics in this study have an inverse relationship with the length of time taken for the students' decision-making process. This leads to swifter finalizations of tertiary education decisions by students increasing returns on education providers' admission activities.

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.