Persuasive Technology. Design for Health and Safety

Frontmatter

Determining the Determinants of Health Behaviour Change through an Online Social Network

Abstract

The ABC framework provides determinants for leveraging the motivational power of online social networks with the determinants for promoting health behaviour changes. We designed VivoSpace, a medium fidelity prototype of an online social network to promote healthy behaviour changes based on the guidelines for incorporating these determinants. We evaluated the determinants of appeal, belonging and commitment using both direct and indirect methods with 36 adult subjects. Indirect evaluation methods included a helping game experiment, adopted from experimental behavioural economics to measure indirect reciprocity evoked by VivoSpace, which is an important factor in developing belonging. Similarly, an in-group experiment was adopted to evaluate group commitment. Our results show that VivoSpace’s design based on the ABC framework result in a strong degree of agreement with the appeal determinants with evidence for the promotion of belonging and commitment. Thus, we have evidence for the effectiveness of design elements for evoking behaviour change to improve health using an online social network.

Noreen Kamal, Sidney Fels

Empowering Independent Living for People with Autism: Designing Supportive, Low-Cost, Interactive E-Health Environments

Abstract

An investigation of the Caregiver Autism Residential E-health (CARE) system, a low-cost, end-user deployable smart home technology, has been evaluated for its potential as an empowering assistive technology for adults living with autism. It allows adults living with autism and their caregivers to create personalized smart home interventions that provide motivational support for activities of daily living, social relationships, and safer behaviors. This is achieved through the use of a ubiquitous computing system composed of off-the-shelf consumer electronic technologies. The Environmental Rating Scale (ERS), designed to assess residential interventions for people living with autism, guided the development and evaluation of CARE/ERS heuristics and interaction scenarios. The contributions of this investigation, advanced through an iterative design process involving expert reviewers, caregivers, and end-users in a patient centered approach for the design of actualizing e-health interventions, can be readily applied to a broad range of residential circumstances that improve quality of life.

Winslow Burleson, Naomi Newman, Ryan Brotman

Persuasive Sensing: A Novel In-Home Monitoring Technology to Assist Elderly Adult Diabetic Patients

Abstract

Diabetes mellitus is a common but serious chronic disease that kills thousands of patients worldwide each year. While there are several useful regimens that can be followed to manage the disease, elderly adult patients have particular difficulties in self-managing the disease. In this paper we present a novel approach to self-management – persuasive sensing – that uses environmental and body-wearable sensors that continuously detects activities and physiological parameters. Our system sends persuasive text messages and a weekly health newsletter aimed to alter the subject’s behavior. We present the findings from an in-home monitoring implementation. The results obtained are quite encouraging. We discuss the challenges and lessons learned from such a field experiment and how we can improve upon the technology.

Samir Chatterjee, Jongbok Byun, Akshay Pottathil, Miles N. Moore, Kaushik Dutta, Harry (Qi) Xie

Turning the Classic Snake Mobile Game into a Location–Based Exergame that Encourages Walking

Abstract

Exergames (video games that combine exercise and play) could encourage physical activity by making it more enjoyable. Mobile devices are an interesting platform for exergames because they can support outdoors activities such as walking and running. Different mobile exergames have been proposed in the literature, and typically evaluated with informal interviews and ad–hoc questionnaires. The research we present in this paper had two main goals. First, we wanted to design a fun and easy-to-use mobile exergame to encourage walking. To this purpose, we propose a location–based version of the classic Snake mobile game, in which users can control the snake by walking. Second, we wanted to introduce important measures (such as users’ attitude towards walking) in the evaluation of exergames, by adopting validated questionnaires employed in the medical literature. The results of the study presented in this paper shed light on how differences in users’ lifestyle can be related to exergame enjoyment and to attitude change fostered by the exergame.

Luca Chittaro, Riccardo Sioni

Phone Row: A Smartphone Game Designed to Persuade People to Engage in Moderate-Intensity Physical Activity

Abstract

Few people reach the recommended levels of moderate-intensity physical activity (MIPA). This study examines whether persuasive technology, in the form of a smartphone game, can help people engage more in MIPA. A smartphone boat racing game was developed that requires users to make rowing movements and therefore engage in MIPA to play it successfully. With these rowing movements, users can control the movement of a virtual boat across a virtual track on an external screen. Users were fond of the concept of the game. However, a sub-optimal implementation resulted in users not wanting to replay the game and thus not developing a habit involving performance of MIPA. The implementation of the concept was inadequate for testing the hypothesis that a smartphone game can help people engage more in MIPA.

Matthijs Jan Zwinderman, Azadeh Shirzad, Xinyu Ma, Prina Bajracharya, Hans Sandberg, Maurits Clemens Kaptein

Developing Persuasive Technology for ASD Challenged Teenagers

Abstract

The HANDS project suggests the use of Mobile Persuasion in order to support teenagers with an autism diagnosis and normal or high IQ. The paper offers a description of the HANDS toolset and its potential. The HANDS toolset has been evaluated at four schools for teenagers with autism over a period of 7 months. The paper presents the main conclusions from this evaluation and some perspectives of the use of systems like HANDS are discussed.

Morten Aagaard, Peter Øhrstrøm

Talk to Act: How Internet Use Empowers Users to Participate in Collective Actions Offline

Abstract

This study examines how Internet use can empower users to carry out collective actions for an environmentalism movement organization. More precisely, we focused on the impact of online interactivity, i.e., the fact that users can share content online and receive feedback on it from others. The participatory Internet fulfills thereby two preconditions of a sense of psychological empowerment: a) receiving information about the goals and performance of an organization and b) experiencing an effective reward system. Using an experimental design, our results showed that users’ sense of empowerment was indeed increased by online interactivity. Higher sense of empowerment led to stronger willingness to participate in a panel discussion and demonstration for the environmentalist organization. In addition, when users were identifiable with their name and photo as compared to being anonymous while making their contributions, the likelihood to get engaged was higher, mediated by an increased sense of empowerment. The importance of intra-individual processes when studying the impact of Internet use on behavior is discussed, as well as the role of identifiability online.

Sandy Schumann, Olivier Klein, Karen Douglas

The Illusion of Agency: The Influence of the Agency of an Artificial Agent on Its Persuasive Power

Abstract

Artificial social agents can influence people. However, artificial social agents are not real humans, and people may ascribe less agency to them. Would the persuasive power of a social robot diminish when people ascribe only little agency to it? To investigate this question, we performed an experiment in which participants performed tasks on a washing machine and received feedback from a robot about their energy consumption (e.g., “Your energy consumption is too high”), or factual, non-social feedback. This robot was introduced to participants as (a) an avatar (that was controlled a human in all its feedback actions; high agency), or as (b) an autonomous robot (that controlled its own feedback actions; moderate agency), or as (c) a robot that produced only random feedback; low agency). Results indicated that participants consumed less energy when a robotic social agent gave them feedback than when they received non-social feedback. This behavioral effect was independent of the level of robotic agency. In contrast, a perceived agency measure indicated that the random feedback robot was ascribed the lowest agency rating. These results suggest that the persuasive power of robot behavior is independent of the extent to which the persuadee explicitly ascribes agency to the agent.

Cees Midden, Jaap Ham

Tailoring Feedback to Users’ Actions in a Persuasive Game for Household Electricity Conservation

Abstract

Recent work has begun to focus on the use of games as a platform for energy awareness and eco-feedback research. While technical advancements (wireless sensors, fingerprinting) make timely and tailored feedback an objective within easy reach, we argue that taking into account the users’ own personal consumption behavior and tailoring feedback accordingly is a key requirement and a harder challenge. We present a first attempt in this direction, EnergyLife, which is designed to support the users’ actions and embeds contextualized feedback triggered by specific actions of the user, called ‘smart advice’. We conclude by showing the results of a four-month trial with four households that returned promising results on the effectiveness and acceptance of this feature.

Luciano Gamberini, Anna Spagnolli, Nicola Corradi, Giulio Jacucci, Giovanni Tusa, Topi Mikkola, Luca Zamboni, Eve Hoggan

Motivational Technologies: A Theoretical Framework for Designing Preventive Health Applications

Abstract

Every day, millions of people seek health information online, but we still do not know how to create websites or mobile applications that could motivate them to change their health-related behaviors in a proactive manner. There is a big difference between learning about one’s health status and doing something about it. In order to bridge this gap, we provide a theoretical framework for designing Motivational Technologies. We discuss how three affordances of modern media interfaces—navigability, interactivity, and customization—could be used to enhance individuals’ intrinsic motivation for preventive health, based on self-determination theory. Empirical evidence and design guidelines discussed here could lead to significant advances in health information systems aimed at promoting preventive health behaviors.

S. Shyam Sundar, Saraswathi Bellur, Haiyan Jia

The Voluntariness of Persuasive Technology

Abstract

The most important ethical question regarding PTs is the voluntariness of changes they bring about. Coercive technologies control its users by application of direct force or credible threat. Manipulative technologies control their users by influencing them in ways of which the users are not aware and cannot control. As a result, both violate the voluntariness condition of the standard definition of PTs. Any voluntariness assessment needs to consider whether there are external controlling influences and whether the user acts intentionally.

Jilles Smids

Persuasion and Reflective Learning: Closing the Feedback Loop

Abstract

Reflecting about past experiences can lead to new insights and changes in behavior that are similar to the goals of persuasive technology. This paper compares both research directions by examining the underlying feedback loops. Persuasive technology aims at reinforcing clearly defined behaviors to achieve measurable goals and therefore focuses on the optimal form of feedback to the user. Reflective learning aims at establishing goals and insights. Hence, the design of tools is mainly concerned with providing the right data to trigger a reflection process. In summary, both approaches differ mainly in the amount of guidance and this opens up a design space between reflective learning and persuasive computing. Both approaches may learn from each other and can use common capturing technologies. However, tools for reflective learning require additional concepts and cues to account for the unpredictability of relevance of captured data.

Lars Müller, Verónica Rivera-Pelayo, Stephan Heuer

Normative Social Influence in Persuasive Technology: Intensity versus Effectiveness

Abstract

It has been established that normative social influence can be used effectively in persuasive technology. However, it is unknown whether the application of more social pressure makes it more effective. To test this hypothesis, a quantitative experiment was conducted on the online social network Facebook. Although evidence to support the hypothesis was found, it cannot be concluded from this experiment that more intense persuasion is more effective, when utilizing normative social influence in persuasive technology.

Thijs Waardenburg, Robbert Winkel, Maarten H. Lamers

Exploring Perceived Persuasiveness of a Behavior Change Support System: A Structural Model

Abstract

There is no healthcare system in the world that has the capacity or resources to provide every person in need of help and support of changing lifestyle behaviors. Consequently, there is a need to design health information systems that enable individuals to manage their health and maintain a healthier lifestyle. However, there is limited knowledge about how individuals perceive these behavior change support systems and how individuals’ perceptions affect the use of such systems. In the present study, we tested a persuasive systems design model that had a significant impact on perceived persuasiveness and system usage. Also, there appears to be some local gender differences in the strength of the relationships between factors (perceived persuasiveness and intention, and unobtrusiveness and intention). We discuss future developments of the model and health as a social and personal responsibility.

Filip Drozd, Tuomas Lehto, Harri Oinas-Kukkonen

Biometric Monitoring as a Persuasive Technology: Ensuring Patients Visit Health Centers in India’s Slums

Abstract

Managing chronic disease is particularly challenging in the developing world, because every trip to a health center can translate to lost time and wages on the part of the patient. This problem is especially acute for tuberculosis patients, who in India are required to visit a center over 40 times in the course of a six-month treatment period. In this paper, we explore the role of a biometric attendance terminal in persuading patients to complete follow-up health visits in slum communities of New Delhi, India. The terminal, which enrolled over 2,300 patients across 25 centers during our 2 years of observation, uses biometric fingerprint scanning to ensure that tuberculosis patients receive and take medications on the right schedule. We evaluate the perceived impact of the terminal via interviews with 8 health workers, 4 center owners, and 23 patients. Our findings suggest that the biometric terminal helps to draw patients to the center, both by incentivizing health workers to convince patients to come, and by persuading patients that in-person visits are important.

Nupur Bhatnagar, Abhishek Sinha, Navkar Samdaria, Aakar Gupta, Shelly Batra, Manish Bhardwaj, William Thies

The Neural Persuasion Model: Aligning Neural Readiness, Perceived Need, and Intervention Strategies

Abstract

An increasing body of information is being assembled to understand how persuasive technology can be applied to develop successful persuasive health systems. Both technology and human issues contribute to reduced success of some persuasive systems. Neuroscience research has opened the door to improved understanding of how humans process information during attitude formation, attitude change, and during persuasion attempts. This article presents the Neural Persuasion Model, which delves more deeply into the human component of persuasion. The model draws on current neuroscience research and theories of neural readiness and neural organization to suggest ways in which understanding the neural activity of the brain might close the gap between persuasive technology design and behavioral outcomes, particularly for addiction recovery and other circumstances where neural disorder exists.

Susan Ferebee, James Davis

Analyzing the Persuasion Context of the Persuasive Systems Design Model with the 3D-RAB Model

Abstract

Research into design methodology is one of the most challenging issues in the field of persuasive technology. However, the introduction of the Persuasive Systems Design model, and the consideration of the 3-Dimensional Relationship between Attitude and Behavior, offer to make persuasive technologies more practically viable. In this paper we demonstrate how the 3-Dimensional Relationship between Attitude and Behavior guides the analysis of the persuasion context in the Persuasive System Design model. As a result, we propose a modification of the persuasion context and assert that the technology should be analyzed as part of strategy instead of event.

Isaac Wiafe, Muna M. Alhammad, Keiichi Nakata, Stephen R. Gulliver

Towards a Data-Driven Approach to Intervention Design: A Predictive Path Model of Healthy Eating Determinants

Abstract

Dietary behavior and attitude play major roles in the worldwide prevalence of obesity, as weight is gained when energy intake exceeds energy expenditure. Although research has focused on designing technological interventions for healthy eating behavior, recent reviews have identified a gap in the knowledge base regarding the variables/determinants of healthy eating and the interactions between them. We developed a model of some determinants and their impact on healthy eating as a basis for designing technological interventions to promote healthy eating behavior within a target community. The main goal of this work is to understand how people adopt a healthy eating attitude, the variables influencing such attitudes, the interactions between these variables, and the degree of influence each variable exerts on healthy eating attitudes. We use fast food-related eating behavior as our case study. Our model shows that weight concern, nutrition knowledge, concern for diseases, social influence, and food choice motives predicts 65% of the variance in healthy eating attitudes, showing the suitability of the model for use in predicting healthy eating attitude. This result will inform decisions on the most effective persuasive strategy for designing interventions to promote healthy eating behavior.

Rita Orji, Regan L. Mandryk, Julita Vassileva

Passengers’ Safety in Aircraft Evacuations: Employing Serious Games to Educate and Persuade

Abstract

The field of persuasive technology has only recently started to investigate how virtual experiences of risk can be used to change people’s attitudes and behaviors with respect to personal safety. In this paper, we aim at advancing the investigation in different directions. First, we extend the study to self-efficacy, which has been shown to be a predictor of future performance as well as an important factor for persuasion attempts which show negative consequences on people’s health. Second, we increase the interactivity of the virtual experience, by designing and implementing a full serious game, in which the user can acquire knowledge about several aspects of her personal safety, and we investigate also effects of the virtual experience on user’s knowledge. Third, we focus on an important problem to which serious games and persuasive technology have never been applied before, i.e. educating passengers about personal safety in aircraft evacuations. The experiment presented in the paper shows how just playing the serious game for a few minutes results in significant increases in user’s knowledge and self-efficacy.

Luca Chittaro

Towards Persuasive Technology for Software Development Environments: An Empirical Study

Abstract

This paper describes an empirical study of a developed persuasive software tool (PerSoDeMetrics) and its effects on the software engineering area. The duration of the study was ten months. The persuasive tool was introduced for a small development team in the real-world. The study tries to analyze the effect of this tool being applied by software developers. The major goal was to persuade software developers to focus on the improvement of their software components. Based on this challenge we developed a plug-in which includes persuasive technology mechanisms. The persuasive software tool is a plug-in/extension in the development environment for Visual Studio 2010. It calculates the software metrics and provides recommendations as how developers can improve the quality of their software components.

Ingo Pribik, Alexander Felfernig

Persuasive Technology Considered Harmful? An Exploration of Design Concerns through the TV Companion

Abstract

Persuasive Technology has great potential to positively influence users in a wide variety of areas such as health, well-being and environmental sustainability. However, concerns have been raised regarding issues such as surveillance, lack of autonomy and coercion that might be involved with the application of such technologies. This paper articulates a set of design concerns around these themes and presents a study of the TV Companion, an instance of a behavior change system that takes into account these concerns. The TV Companion is an application aimed to address the societal issue of prolonged TV consumption with its related potential negative effects and aims to foster more reflective TV viewing among children and their parents. To explore the application of these design approaches in a real world setting we report the findings of a field study of the TV companion in three families with pre-school children and reflect on how the design concerns shaped the experience and use of the TV companion.

Wolfgang Reitberger, Florian Güldenpfennig, Geraldine Fitzpatrick

Bridging the Gap between the Home and the Lab: A Qualitative Study of Acceptance of an Avatar Feedback System

Abstract

The current study provides a first step in the design and development of a persuasive agent in the natural context of the household. We developed two persuasive probe studies: one paper-based probe and one email-based probe on the use, experience, and effectiveness of persuasive agents. Participants had used these prototypes for a week, after which their experiences were explored in depth interviews and a focus group. Results indicated that a persuasive agent in the household is experienced as fairly pleasant, but important issues need to be solved before it can effectively influence behavior.

Peter A. M. Ruijten, Yvonne A. W. de Kort, Petr Kosnar

Less Fizzy Drinks: A Multi-method Study of Persuasive Reminders

Abstract

In this paper, we present initial outcomes from our multi-method study that explored the impact of reminders on effectiveness of information systems that aim to facilitate behaviour change. Our study explicitly focused on reminders as a key persuasive software feature that should be employed to support behaviour change. We designed a prototype aiming to encourage people to gradually reduce soda/fizzy drinks consumption. A multi-method 14-day pilot study was conducted, composed of statistical analysis followed by a qualitative focus group. Statistical analysis shows that participants consumed less fizzy drinks in the second half of the study, and feedback from the focus group study indicates that reminders successfully persuaded participants to keep a log of their fizzy drink consumption. Our study supports the claim that persuasive reminders have extraordinary potential for helping people change their behaviours.

Sitwat Langrial, Harri Oinas-Kukkonen

Plotting to Persuade – Exploring the Theoretical Cross Field between Persuasion and Learning

Abstract

This paper presents a few of the initial reflections related to ongoing research on the notion of Persuasive Learning. In addition the paper briefly comments upon some of the benefits and challenges related to the cross field between persuasive technologies and learning objects, and between persuasion and learning in general.

Sandra Burri Gram-Hansen, Henrik Schärfe, Jens Vilhelm Dinesen

Does a Hyperlink Function as an Endorsement?

Abstract

Websites often provide hyperlinks to other sites featuring related content. Does this imply an endorsement of the content presented on those linked sites? We answered this question with a 2 x 2 between-subjects factorial experiment in which we systematically varied source credibility (high vs. low) and source sequence (linking vs. linked). All study participants (N = 572) read a dubious story questioning the value of sunscreen, with a link at the bottom to a related story with the same claim. Results show that user perceptions of interest value (i.e., appeal) do transfer over from the linking site to the linked site. However, the source signal is quite salient when it comes to evaluations of newsworthiness and trustworthiness, with users taking note of the differences in credibility. Design implications of these findings for persuasive communications are discussed.

Eric DiMuzio, S. Shyam Sundar

Comparative Analysis of Recognition and Competition as Features of Social Influence Using Twitter

Abstract

This paper studies how and to what extent social influence design principles can persuade people to participate in sharing their feedback. For this reason, a Twitter-based system was designed with persuasive software features of social influence at its core. The effects of recognition and competition features were tested in a pilot study in two computer rooms simultaneously. Their effects on the behavior of simulated airline travelers were compared. The main result of this study provides evidence of several positive effects, especially regarding the persuasive powers of recognition in a system’s design.

Agnis Stibe, Harri Oinas-Kukkonen

Backmatter