Jax Wechsler

Technology assisted health behaviour change

I recently did some research for a project which aims to facilitate health-related behaviour change using technology.

Some of this research is summarised below.

1. BJ Fogg’s model

Fogg's model for behaviour changeFogg's model for behaviour change

In order to build persuasive technology, people need to be encouraged to change their behaviours. The BJ Fogg model was developed in 2009 to understand human behaviour and identify how people’s behaviours can be influenced using technology.

The Fogg model comprises of three factors: Motivation, Ability and Triggers. Fogg says that for behaviour change to happen, these three factors must happen together, so a person must be sufficiently motivated, have the ability to perform the behaviour and be trigger to do something about it. The model below shows how behaviour change increases with high motivation, high ability and triggers. If these aren’t present, then behaviour change is less likely to occur.

This model assisted us to guide our  research  and inform how we thought about the tool’s design.

The different components of the model are summarised below.

High motivation: This might be the difference between a person being hopeful or fearful. People are motivated by hope when then joining a dating web site. They are motivated by fear when they update settings in virus software. With motivation this can also include Pleasure/Pain or Social Acceptance/Rejection. In relation to CVD, a high motivator might be motivated by wanted to avoid the physical and emotional pain of a heart attack.

High ability: This might have to do with time, money, effort, routine, social deviance (going against the societal norms) or brain cycles which Fogg describes as when a person has to think too hard about things discouraging them to take action. In relation to the e-health tools for CVD, ability will largely have to do with technical literacy. If a person with  CVD has a low technical literacy ‘brain cycles’ might lead to perceiving too much effort to use the technology

Triggers: Triggers are forms of facilitatorsthat help remind or encourage people to change their behaviour. A trigger could be a person, a GP, an SMS text, an email etc.


2. 7 guidelines for motivating behaviour change with mobile by Margie Morris from Intel Research & Development

Some interesting pointers were found in a publication from the Intel Research & Development labs about technology and health.

  1. Remind people of who they want to be
  2. Foster an alliance (between patient & device)
  3. Apply social influence
  4. Show people what they could lose
  5. Put the message where the action is
  6. Raise emotional awareness
  7. Reframe Challenges


3. The Power of Habit : Why We Do What We Do and How to Change by Charles Duhigg

Book cover - The power of habit by charles duhigg This is a great book about changing behaviour.
Some notes from this publication:

a. People need to feel that change is possible.
Social groups/communities can assist with this
Change becomes possible through witnessing it in others 
(e.g.AA groups)
Small wins are important
b. Will-power is like a ‘muscle’. It needs to be practiced. 
Will-power is finite.
c. Commitment – People that commit to one thing often get better at self-regulation in other ways as well.
d. Getting over ‘motivation humps’
Willpower becomes a habit by choosing a certain behaviour in advance and following the routine when distraction arrives.
e. Give people choice and a sense of control/freedom
People need to feel like they have a choice and not being told to do something.

4. Literature review of academic papers

The following key insights were identified from a survey of academic literature about ehealth.

  • Personalisation in interventions were recommended in the literature as this increased user engagement
  • Video and text messaging were popular among users
  • eHealth needs to support the emotional needs of users
  • It was suggested that written instructions should be provided for less tech-savvy users
  • Users had a positive response to professional feedback, social support and dynamic features to eHealth tools
  • Credibility of information is important to users
  • eHealth tools need to have features that include family members who can provide assistance to users. By involving family members it also raises their awareness to health issues and the use of e-Health tools
  • eHealth is a relatively new area of research in the academic literature and it was challenging to find consistency across studies of evaluations of user engagement in digital interventions


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