A Grounded Approach for Applying Behavior Change Techniques in Mobile Cardiac Tele-Rehabilitation

Abstract

In mobile tele-rehabilitation applications for Coronary Artery Disease (CAD) patients, behavior change plays a central role in influencing better therapy adherence and prevention of disease recurrence. However, creating sustainable behavior change that holds a beneficial impact over a prolonged period of time remains an important challenge. In this paper we discuss various models and frameworks related to persuasion and behavior change, and investigate how to incorporate these with a multidisciplinary usercentered design approach for creating a mobile tele-rehabilitation application. By implementing different concepts that contribute to behavior change and applying a set of distinct persuasive design patterns, we were able to translate the high-level goals of behavior theory into a mobile application that explicitly incorporates behavior change techniques and also offers a good overall user experience. We evaluated our system, HeartHab, in a lab setting and show that our approach leads to a high user acceptance and willingness to use the system in daily activities. CCS Concepts

Evaluating the Impact of the HeartHab App on Motivation, Physical Activity, Quality of Life, and Risk Factors of Coronary Artery Disease Patients: Multidisciplinary Crossover Study

“…The key principle of designing persuasive systems is drawn from the Fogg Behavior Model [18], Persuasive Systems Design model [19], and the Behavior Wizard [20]. On the design level, persuasive design patterns, which are suitable in the context of CR, were derived from the above theories and integrated into visual elements presented to patients such as their risk factor thresholds, activity targets and progress, and so on [21]. On an application level, persuasion is achieved through intelligibility, personalization, and tailoring of various rehabilitation components.…”

“…Telerehabilitation approaches enable us to overcome issues in conventional rehabilitation such as distance to rehabilitation center, being restricted to fixed time and appointments, and cost per session [8,9]. However, in both conventional and telerehabilitation approaches, it has been demonstrated that effects of rehabilitation programs are not sustained after stopping the intervention [3], although the rate of decline in effects is lower in telerehabilitation when compared with conventional rehabilitation [10]. In addition, patients do not maintain positive lifestyle adaptations enforced during rehabilitation after the end of the program, leading to increased risk of recurrence.…”

Bridging Patients’ Needs and Caregivers’ Perspectives to Tailor Information Provisioning during Cardiac Rehabilitation

“…For workshop 1 (with the caregivers), visual trigger signs were used to tag the topics and indicate the relation of the topic and the intended behavior change that it should trigger. We used four trigger signs based on persuasion intents that were identified in a study targeting comprehensive tele-rehabilitation for cardiac patients (Sankaran et al, 2016). We represented these triggers using road sign symbols that correspond to a certain way of persuasion.…”

Design of Behavior Change Environment with Interactive Signage Having Active Talk Function

“…To cope with this problem, a lot of research and development to promote behavior change by using information technology have shown up. For instance, Sankaran et al have proposed a telerehabilitation application which induces Coronary Artery Disease (CAD) patients to comply with the treatment plan and prevent disease recurrence [2]. In the management of smoking cessation, hazardous drinking, obesity, diabetes, asthma, tinnitus, stress, depression, and insomnia, positive results have also been obtained [3].…”