The costs and benefits of self-monitoring for health and wellness

By Dr Rita Orji – Dalhousie University, Canada

The use of persuasive technologies aimed at encouraging desirable change by shaping and reinforcing behavior, attitude, or both, is growing in virtually all areas of health and wellness. Self-monitoring, through various tools including smartphone apps and other devices, is the cornerstone of many of these technologies – enabling the user to track and evaluate their behavior and set personal targets.

While the use of such technologies is widespread, inconsistencies have been reported in the effectiveness of these methods in successfully supporting users to reach their health and wellness goals. Research conducted in this area has reported mixed findings and some failure.

In order to advance work in this area and provide a rewarding and successful experience for users, designers must consider the downfalls of current self-tracking applications and find ways to mitigate their weaknesses, and also develop strategies to amplify the reported strengths. To contribute to research and design in this area, we conducted two large-scale studies with 1768 participants, aiming to further explore the strengths and weaknesses of self-monitoring as a strategy for promoting health and wellness. We investigated the strategy in the context of interventions for two commons areas: healthy eating behavior and risky health behavior such as binge drinking.

To collect our data, we used prototype persuasive implementation of the self-monitoring strategy. We specifically represented the self-monitoring strategy in a storyboard about a persuasive intervention for encouraging healthy eating for study one and a PT for promoting change of risky alcohol behavior for study two. The implementations used closely imitated how the strategy is often operationalized in existing persuasive interventions. We also collected qualitative comments. Through these methods, we were able to draw some strong conclusions regarding the strengths and weaknesses of this method and offer some design recommendations.

 

Benefits of self-monitoring

On the plus side, one of the major strengths of self-monitoring is that it increases awareness, curiosity and consciousness within the user. Our research suggests that this awareness often leads to users taking responsibility for their behavior rather than placing blame on external attribution factors such as genetics. Self-monitoring can reveal problematic behaviours which can tangibly be changed and are very much in control of the individual – inspiring accountability. The other major learning we took from our research regarding the strengths of self-monitoring, is the intrapersonal competition that comes from this method through comparing performance against an individual’s own goal and past performance – striving to break previous records and keep on track.

 

Costs of self-monitoring

Aside from the fact that using self-monitoring tools can be tedious, particularly where manual input is required, our research brought to the surface two stand-out weaknesses.

Some participants showed concern that self-monitoring could lead to the development of health disorders such as eating disorders and depression, particularly where calorie counting is involved as a method. The strategic design of self-monitoring tools needs to consider such risks and the psychological impact of this method to encourage healthy behaviours rather that potentially catalyze unhealthy extremes.

Alongside this, it became very apparent through our research that designers don’t often consider the behavioural stage the user is at when developing self-monitoring tools, particularly when users are in the pre-contemplation phase. Design tends to assume that users are already motivated to reach their goals and therefore ready to self-monitor. We recommend that design becomes more in tune with the various stages a user may go through to ensure effectiveness along their journey.

Designers have a strong chance of increasing the success rate of self-monitoring tools for users. By capitalizing on the strengths that exist and considering the fall-downs of this method, we have a chance of using persuasive technological interventions more effectively to help individuals meet their health and wellness goals in a healthy, sustainable way.

 

Read more in our original article: Orji, R., Lomotey, R., Oyibo, K., Orji, F., Blustein, J., & Shahid, S. (2018). Tracking feels oppressive and ‘punishy’: Exploring the costs and benefits of self-monitoring for health and wellness. Digital health, 4, 2055207618797554.

 

Questions:

• How do we create a balance when designing self-tracking tools to ensure users work towards their goals without developing unhealthy behaviours?
• How do we tailor methods for users at different stages of their health and wellness journey?

 

Author Bio:

Dr. Rita Orji (@ritapurity) is a Computer Science Professor at Dalhousie University, a hEr VOLUTION top 150 Canadian Women in STEM, and the 2018 Digital Nova Scotia Women Leaders in the Digital Economy Award winner. Her major research focus is in the area of technology for promoting health and wellness. She is particularly passionate about designing technologies to tackle issues faced by under-served populations