Department of Intelligent Systems, Delft University of Technology, Delft, The Netherlands.
Department of Perceptual and Cognitive Systems, Nederlandse Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek (TNO), Soesterberg, The Netherlands.
PeerJ. 2022 Aug 19;10:e13824. doi: 10.7717/peerj.13824. eCollection 2022.
Despite their increasing prevalence and potential, eHealth applications for behavior change suffer from a lack of adherence and from dropout. Advances in virtual coach technology provide new opportunities to improve this. However, these applications still do not always offer what people need. We, therefore, need a better understanding of people's needs and how to address these, based on both actual experiences of users and their reflections on envisioned scenarios.
We conducted a longitudinal study in which 671 smokers interacted with a virtual coach in five sessions. The virtual coach assigned them a new preparatory activity for quitting smoking or increasing physical activity in each session. Participants provided feedback on the activity in the next session. After the five sessions, participants were asked to describe barriers and motivators for doing their activities. In addition, they provided their views on videos of scenarios such as receiving motivational messages. To understand users' needs, we took a mixed-methods approach. This approach triangulated findings from qualitative data, quantitative data, and the literature.
We identified 14 main themes that describe people's views of their current and future behaviors concerning an eHealth application. These themes relate to the behaviors themselves, the users, other parties involved in a behavior, and the environment. The most prevalent theme was the perceived usefulness of behaviors, especially whether they were informative, helpful, motivating, or encouraging. The timing and intensity of behaviors also mattered. With regards to the users, their perceived importance of and motivation to change, autonomy, and personal characteristics were major themes. Another important role was played by other parties that may be involved in a behavior, such as general practitioners or virtual coaches. Here, the themes of companionableness, accountability, and nature of the other party (., human AI) were relevant. The last set of main themes was related to the environment in which a behavior is performed. Prevalent themes were the availability of sufficient time, the presence of prompts and triggers, support from one's social environment, and the diversity of other environmental factors. We provide recommendations for addressing each theme.
The integrated method of experience-based and envisioning-based needs acquisition with a triangulate analysis provided a comprehensive needs classification (empirically and theoretically grounded). We expect that our themes and recommendations for addressing them will be helpful for designing applications for health behavior change that meet people's needs. Designers should especially focus on the perceived usefulness of application components. To aid future work, we publish our dataset with user characteristics and 5,074 free-text responses from 671 people.
尽管电子健康应用程序在行为改变方面的应用越来越普遍，且具有潜在的优势，但它们仍然存在着缺乏依从性和脱落的问题。虚拟教练技术的进步为此提供了新的机会。然而，这些应用程序仍然不能满足人们的需求。因此，我们需要更好地了解人们的需求以及如何满足这些需求，这需要基于用户的实际体验以及他们对设想场景的反思。
我们进行了一项纵向研究，共有 671 名吸烟者与虚拟教练进行了五次互动。虚拟教练在每次会话中为他们分配一项新的戒烟或增加体育活动的预备活动。参与者在下一次会议上对活动进行反馈。五次会议结束后，参与者被要求描述进行活动的障碍和动机。此外，他们还对收到激励信息等场景的视频发表了看法。为了了解用户的需求，我们采用了混合方法。这种方法将定性数据、定量数据和文献的研究结果进行了三角分析。
我们确定了 14 个主要主题，这些主题描述了人们对电子健康应用程序中当前和未来行为的看法。这些主题涉及行为本身、用户、涉及行为的其他各方以及环境。最常见的主题是行为的感知有用性，特别是它们是否具有信息性、帮助性、激励性或鼓励性。行为的时间和强度也很重要。关于用户，他们对改变的重要性和动机、自主性以及个人特点等方面的看法是主要主题。其他可能涉及行为的各方的角色也很重要，例如全科医生或虚拟教练。在这里，同伴关系、问责制以及对方的性质（例如，人 AI）等主题是相关的。最后一组主要主题与行为执行的环境有关。普遍存在的主题是有足够的时间、存在提示和触发因素、得到社会环境的支持以及其他环境因素的多样性。我们提供了针对每个主题的建议。
基于经验和设想的需求获取方法与三角分析相结合的综合方法提供了全面的需求分类（基于经验和理论）。我们预计，我们的主题和满足人们需求的应用程序设计建议将对健康行为改变的应用程序设计有所帮助。设计者尤其应关注应用程序组件的感知有用性。为了帮助未来的工作，我们发布了包含用户特征和 671 人提供的 5074 条自由文本回复的数据集。
