JMIR Publications

ABSTRACT

Background:

It is not well understood why some physical activity (PA) mobile health (mHealth) interventions successfully promote PA and others do not. One possible explanation is the great variety in PA mHealth interventions – not only do interventions differ in the selection of persuasive strategies, but the design and implementation of persuasive strategies can also vary. Yet, limited studies examined the different designs and technical implementations of strategies or explored if they indeed influenced the effectiveness of the intervention.

Objective:

This review sets out to explore the different technical implementations and design characteristics of common and likely most effective persuasive strategies, namely goal setting, monitoring, reminders, rewards, sharing and social comparison. Furthermore, it aims to examine to what extent the implementations and designs have an influence on the effectiveness of the strategy to persuade the user to engage in PA.

Methods:

A snowball and grey literature search was performed to identify literature that evaluated the persuasive strategies in experimental trials (e.g. randomized controlled trial, pre-post-test). The study methods, implementations and designs of persuasive strategies and the study results were systematically extracted from the literature by the reviewers.

Results:

Twenty-nine experimental trials were identified. A great heterogeneity for how the strategies are being implemented and designed was found. Moreover, the findings indicate that the implementation and the design of the strategy has an influence on the effectiveness of the PA intervention. For instance, the effectiveness of rewarding showed to vary between types of rewards; rewarding ‘goal achievement’ seems more effective than rewarding ‘each step taken’. Furthermore, studies comparing different ways of goal setting suggests that assigning a goal to users appears might be more effective than letting the user set her own goal, just as using adaptively tailored goals are demonstrated to be more effective than static generic goals. The review further demonstrates that only few studies examined the influence of different technical implementations on PA behavior.

Conclusions:

The different implementations and designs of persuasive strategies in mHealth interventions should be critically considered when developing such interventions and before drawing conclusions on the effectiveness of the strategy as a whole. Future efforts are needed to examine which implementations and designs are most effective in order to improve the translation of theory-based persuasive strategies into practical delivery forms.