Design for behavior change: Evaluating the effect of motivational design strategies to support physical activity among older adults

Maintenance of health and physical well-being contribute to the overall quality of life for individuals as they age. Despite the known benefits of maintaining routine levels of physical activity, many adults aged 65 and older do not meet the recommended levels of physical activity. There has been an emergence of interactive health-related technologies in the form of mobile applications and exergame systems that encourage physical activity and other health-related behaviors through monitoring, tracking, and displaying real-time information based on a user’s actions. Many of these technologies employ principles of design for behavior change in their approach to encourage a specific behavior outcome. Although there is potential for mobile health technologies to encourage physical activity, these technologies often see low and inconsistent usage rates or quick abandonment due to lack of motivational affordance and poor design consideration. This area has yet to be studied in depth for the older adult population specifically. This dissertation research defines and evaluates inclusive motivational strategies that can be implemented in the design of mobile health technologies targeting physical activity behaviors among older adults. Through qualitative interviews, psychological constructs of physical activity were explored and analyzed for relevant motivating factors that would encourage physical activity engagement. As a result, six motivational design strategies were proposed based on identified motivators such as social influence and goal support, which have been established as effective strategies in behavioral programs. In a semi-longitudinal study, these strategies were examined for effectiveness and user acceptance by deploying mobile fitness apps that implemented these individual strategies. Thirty-nine older adults were assigned a mobile fitness app to engage with for a 10-week period where their physical activity, app usage, and attitudes towards mobile health and fitness apps were assessed. Findings from this study indicate that social influence showed trends of improving participants physical activity behaviors from baseline, but was less accepted as a motivational design strategy in its current implementation. Goal support was found to be a more desired motivational design strategy. Additionally, participants expressed the desire for a more holistic approach to health and activity tracking, incorporating such metrics as sleep, hydration, and pain management. These findings informed a set of design criteria and guidelines for effective health and fitness technologies that are not only motivationally framed but that leverage universal and inclusive design principles. The design of a potential health tracking app was designed as an immediate outcome of this dissertation research.Ph.D