Faculty of Geosciences, Utrecht University, Utrecht, Netherlands.
Department of Applied Psychology, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.
JMIR Mhealth Uhealth. 2021 Jan 18;9(1):e16282. doi: 10.2196/16282.
It is unclear why some physical activity (PA) mobile health (mHealth) interventions successfully promote PA whereas others do not. One possible explanation is the variety in PA mHealth interventions-not only do interventions differ in the selection of persuasive strategies but also the design and implementation of persuasive strategies can vary. However, limited studies have examined the different designs and technical implementations of strategies or explored if they indeed influenced the effectiveness of the intervention.
This scoping review sets out to explore the different technical implementations and design characteristics of common and likely most effective persuasive strategies, namely, goal setting, monitoring, reminders, rewards, sharing, and social comparison. Furthermore, this review aims to explore whether previous mHealth studies examined the influence of the different design characteristics and technical operationalizations of common persuasive strategies on the effectiveness of the intervention to persuade the user to engage in PA.
An unsystematic snowball and gray literature search was performed to identify the literature that evaluated the persuasive strategies in experimental trials (eg, randomized controlled trial, pre-post test). Studies were included if they targeted adults, if they were (partly) delivered by a mobile system, if they reported PA outcomes, if they used an experimental trial, and when they specifically compared the effect of different designs or implementations of persuasive strategies. The study methods, implementations, and designs of persuasive strategies, and the study results were systematically extracted from the literature by the reviewers.
A total of 29 experimental trials were identified. We found a heterogeneity in how the strategies are being implemented and designed. Moreover, the findings indicated that the implementation and design of the strategy has an influence on the effectiveness of the PA intervention. For instance, the effectiveness of rewarding was shown to vary between types of rewards; rewarding goal achievement seems to be more effective than rewarding each step taken. Furthermore, studies comparing different ways of goal setting suggested that assigning a goal to users might appear to be more effective than letting the user set their own goal, similar to using adaptively tailored goals as opposed to static generic goals. This study further demonstrates that only a few studies have examined the influence of different technical implementations on PA behavior.
The different implementations and designs of persuasive strategies in mHealth interventions should be critically considered when developing such interventions and before drawing conclusions on the effectiveness of the strategy as a whole. Future efforts are needed to examine which implementations and designs are most effective to improve the translation of theory-based persuasive strategies into practical delivery forms.
目前尚不清楚为何某些身体活动（PA）移动健康（mHealth）干预措施能够成功促进 PA，而其他干预措施则不然。一种可能的解释是 PA mHealth 干预措施的多样性——干预措施不仅在选择有说服力的策略方面存在差异，而且在有说服力的策略的设计和实施方面也可能存在差异。然而，有限的研究已经检查了策略的不同设计和技术实现，或者探讨了它们是否确实影响了干预措施的效果。
本范围综述旨在探讨常见且可能最有效的有说服力的策略（即目标设定、监测、提醒、奖励、分享和社会比较）的不同技术实现和设计特点。此外，本综述旨在探讨之前的 mHealth 研究是否检查了常见有说服力策略的不同设计特点和技术操作化对干预措施说服用户参与 PA 的有效性的影响。
采用非系统性滚雪球和灰色文献搜索，以确定评估实验性试验（例如，随机对照试验、前后测试）中使用的有说服力策略的文献。如果研究针对成年人，如果它们部分通过移动系统提供，如果它们报告了 PA 结果，如果它们使用了实验性试验，并且当它们特别比较不同设计或实施有说服力的策略的效果时，研究就会被纳入。审查员系统地从文献中提取研究方法、有说服力策略的实施和设计以及研究结果。
共确定了 29 项实验性试验。我们发现，这些策略的实施和设计方式存在很大的差异。此外，研究结果表明，策略的实施和设计对 PA 干预的效果有影响。例如，奖励的效果因奖励类型而异；奖励目标的实现似乎比奖励每一步都更有效。此外，比较不同目标设定方式的研究表明，为用户分配目标可能比让用户设定自己的目标更有效，类似于使用自适应定制目标而不是静态通用目标。本研究进一步表明，只有少数研究检查了不同技术实现对 PA 行为的影响。
在开发此类干预措施时，以及在对整个策略的有效性得出结论之前，应仔细考虑 mHealth 干预措施中使用的有说服力的策略的不同实现和设计。需要进一步努力，以检验哪些实现和设计最有效，从而将基于理论的有说服力的策略更好地转化为实际的交付形式。
