Journey

The design of persuasive prompts to induce behavioral change through an mHealth application for people with depression

Role

  • Researcher
  • Designer
  • CHISEL

Problem Space

Alteration of an individual’s lifestyle is considered to be one of the primary factors that could prevent the onset of various mental health disorders such as depression and anxiety. It is also widely acknowledged that lifestyle modification could be beneficial in reducing the existing symptoms of a range of mental health disorders, including depression. With the emergence of mHealth (mobile health) being a viable intervention for both diagnosis and therapy, we set out to design a lifestyle mobile application that uses a combination of cognitive and behavioral change to reduce depressive symptoms in people suffering from mental health problems.

Finding The Gap

While there has been an  increase in mHealth applications targeted towards mental health disorders, the dropout rate of these applications is alarmingly high with around 77% of applications losing its users within the first 3 days post-installation. Hence, the first step we took in designing our application was to carry out an extensive preliminary research phase to find the gaps in the existing work in this field.

The preliminary research took three different directions. We downloaded and tested over 100 mobile applications available on play store and apple store that were focused on depression monitoring, awareness and behavioral intervention of depression. In parallel to testing the applications, we conducted a systematic review on the design and effectiveness of behavior change applications. And lastly, we dove deep into the workings of different behavior change and psychotherapy models and frameworks.

The Idea

While it was evident that adapting positive behaviors in your day-to-day routine could help in the reduction of depressive symptoms, how can one induce those behaviors and then also maintain them?

An individual, when trying to make a certain decision or accomplish a task during the day, is usually prompted to do so by some internal or external trigger. This trigger could be anything from another person, to an object you pass by while walking the street. Whatever the trigger, it prompts you to perform some action. Now imagine constantly having this trigger in your pocket. That is exactly what we set out to do.

Using the benefits of a mobile phone, we decided to design an application that uses personalized persuasive prompts which act as triggers to help a person adopt healthier behaviors.

Persuasive Prompts

Persuasive prompts are messages that try to persuade the user to perform particular tasks or try to embed an idea into the user’s mind. At this stage of the project, our primary focus was on the concept of the prompts. We created different variations using different messaging techniques and behavior change models and mapped them on to 10 different behaviors which, research shows, can help in the reduction of depressive symptoms.

Sample Prompts: In the image on the right, the left screen is one of the screens for the prompt persuading the user to incorporate exercise in their daily routine. The right screen is one of the screens for the prompts persuading the user to adopt concentration techniques when they are unable to focus.

Concept Testing

It was important for us to keep the user front and center during the ideation process and understand what our target user group thought of the idea. Heavily focusing on the content, low fidelity prototypes (above image) of the prompts were developed using JustInMind. We then used the prototypes to conduct a concept acceptability study to introduce users to the concept to evaluate the feasibility, appeal, and potential success of the idea.

Designing Journey

Journey uses persuasive prompts to persuade the user to adopt behaviors proven to improve mental health. While designing Journey, we were interested in developing a process that leads people to begin to engage in and then also maintain healthy behaviors. For this reason, we chose the Transtheoretical Model of Behavior Change (TTM) as a framework for designing the application. According to TTM, people move through a series of stages when modifying a behavior. These stages are namely precontemplation, contemplation, preparation, action, and maintenance. Our persuasive prompts aid the user to move through these stages.

User Journey

We created the journey a user would take while using Journey. Along with our extensive research on behavior change and psychotherapy, we were able to identify the different variables, such as motivation and self-efficacy, that affect a person’s decision to perform an action.

Modules

Journey is divided into 3 modules.   

  • The journey module allows the user to select from a premade journey that they want to explore through the application. Each of the premade journeys is a combination of different behaviors that can help to reduce depressive symptoms. For instance, the ‘Physical Health’ journey will assist users to adopt healthy habits in the form of exercise, healthy eating and adopting a healthy sleeping schedule.
  • This brings us to the second module, which is the behavior module. The behavior module divides each journey into separate behaviors. While a user cannot be on multiple journeys at the same time, they can choose to either work on each behavior in that journey collectively or individually based on their own requirements and capabilities
  • The final module is the goal module in which each behavior is divided into small, achievable goals. These goals are divided into 5 categories with each goal in each category aiding the user to move from one stage of the Transtheoretical Model to the next.

Wireframes

The next step was to develop wireframes, which was done through simple sketching using pencil and paper.

Prototype

We next made a high fidelity prototype using Figma. The purpose of the prototype was not only to assist the development phase, but to also test the usability of the application.