Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.
Research and Innovation Department, Vestfold Hospital Trust, Tønsberg, Norway.
J Med Internet Res. 2020 Nov 30;22(11):e22598. doi: 10.2196/22598.
BACKGROUND: An increasing number of eHealth interventions aim to support healthy behaviors that facilitate weight loss. However, there is limited evidence of the effectiveness of the interventions and little focus on weight loss maintenance. Knowledge about end user values and needs is essential to create meaningful and effective eHealth interventions, and to identify persuasive system design (PSD) principles and behavior change techniques (BCTs) that may contribute to the behavior change required for successful long-term weight loss maintenance. OBJECTIVE: This study aimed to provide insight into the design of eHealth interventions supporting behavior change for long-term weight maintenance. The study sought to identify the values and needs of people with obesity aiming to maintain weight after weight loss, and to identify PSD principles, BCTs, and design requirements that potentially enable an eHealth intervention to meet end user values and needs. METHODS: This study presents the concept of integrating PSD principles and BCTs into the design process of eHealth interventions to meet user values and needs. In this study, individual interviews and focus groups were conducted with people with obesity (n=23) and other key stakeholders (n=27) to explore end user values and needs related to weight loss maintenance. Design thinking methods were applied during the focus group sessions to identify design elements and to explore how eHealth solutions can support the needs to achieve sustainable weight loss maintenance. The PSD model and behavior change taxonomy by Michie were used to identify PSD principles and BCT clusters to meet end user values and needs. RESULTS: A total of 8 key end user values were identified, reflecting user needs for weight loss maintenance support: self-management, personalized care, autonomy, feel supported, positive self-image, motivation, happiness, and health. Goals and planning, feedback and monitoring, repetition and substitution, shaping knowledge, social support, identity, and self-belief were some of the BCT clusters identified to address these concepts, together with PSD principles such as personalization, tailoring, self-monitoring, praise, and suggestions. CONCLUSIONS: The process of translating end user values and needs into design elements or features of eHealth technologies is an important part of the design process. To our knowledge, this is the first study to explore how PSD principles and BCTs can be integrated when designing eHealth self-management interventions for long-term weight loss maintenance. End users and other key stakeholders highlighted important factors to be considered in the design of eHealth interventions supporting sustained behavior change. The PSD principles and BCTs identified provide insights and suggestions about design elements and features to include for supporting weight loss maintenance. The findings indicate that a combination of BCTs and PSD principles may be needed in evidence-based eHealth interventions to stimulate motivation and adherence to support healthy behaviors and sustained weight loss maintenance. TRIAL REGISTRATION: ClinicalTrials.gov NCT04537988; https://clinicaltrials.gov/ct2/show/NCT04537988.
背景:越来越多的电子健康干预措施旨在支持促进减肥的健康行为。然而,这些干预措施的有效性证据有限,而且很少关注体重维持。了解最终用户的价值观和需求对于创建有意义和有效的电子健康干预措施至关重要,并有助于确定可能有助于成功实现长期体重维持所需的行为改变的有说服力的系统设计 (PSD) 原则和行为改变技术 (BCT)。
目的:本研究旨在深入了解支持长期体重维持的行为改变的电子健康干预措施的设计。该研究旨在确定减肥后希望维持体重的肥胖人群的价值观和需求,并确定可能使电子健康干预措施满足最终用户价值观和需求的 PSD 原则、BCT 和设计要求。
方法:本研究提出了将 PSD 原则和 BCT 整合到电子健康干预措施设计过程中的概念,以满足用户的价值观和需求。在这项研究中,对 23 名肥胖患者和 27 名其他利益相关者进行了个人访谈和焦点小组讨论,以探讨与体重维持相关的最终用户价值观和需求。在焦点小组会议期间应用设计思维方法来确定设计要素,并探讨电子健康解决方案如何支持实现可持续体重维持的需求。使用 Michie 的 PSD 模型和行为改变分类学来确定满足最终用户价值观和需求的 PSD 原则和 BCT 群集。
结果:确定了 8 个关键的最终用户价值观,反映了用户对体重维持支持的需求:自我管理、个性化护理、自主权、得到支持、积极的自我形象、动机、幸福和健康。目标和计划、反馈和监测、重复和替代、塑造知识、社会支持、身份和自我信念是为解决这些问题而确定的 BCT 群集之一,以及个性化、定制、自我监测、表扬和建议等 PSD 原则。
结论:将最终用户的价值观和需求转化为电子健康技术的设计要素或功能的过程是设计过程的重要组成部分。据我们所知,这是第一项探讨如何在设计用于长期减肥维持的电子健康自我管理干预措施时整合 PSD 原则和 BCT 的研究。最终用户和其他利益相关者强调了在支持持续行为改变的电子健康干预措施设计中需要考虑的重要因素。确定的 PSD 原则和 BCT 提供了有关支持体重维持的设计要素和功能的见解和建议。研究结果表明,基于证据的电子健康干预措施可能需要结合 BCT 和 PSD 原则,以激发动机和坚持,从而支持健康行为和持续的体重维持。
试验注册:ClinicalTrials.gov NCT04537988;https://clinicaltrials.gov/ct2/show/NCT04537988。
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