JMIR Publications

ABSTRACT

Background:

Physical inactivity is a global issue that impacts the health and productivity of a large number of people. With the advancement of mobile and wearable technologies, many applications and devices have been developed to facilitate self-health management and promote a healthy lifestyle. However, little research has examined the effectiveness of these mobile health applications (mHealth apps) to motivate exercise adherence.

Objective:

The purpose of this study is to improve the design of mHealth apps for exercise self-management by tailoring the message content and use tactics. Specifically, we 1) investigate whether sending motivational messages can improve adherence to exercise plans; 2) consider whether the motivational effect is impacted by personality; 3) test the impact of message type (logical vs. emotional) and repetition; 4) investigate the interaction effect between message type, repetition, and personality type; and 5) explore the possibility of involving a behavior experiment in the design process and learning new design principles from the results.

Methods:

We proposed an enhanced action design research process by incorporating a behavior experiment into the process. Based on problem framing and theoretical premises, we used Apple’s ResearchKit to develop the initial artifact (i.e. the mHealth app). The app was available for anyone to download from the Apple store. We also recruited participants through a gym, where many members were participating in weight loss programs. We then conducted a field behavior experiment, targeting the users who had used the app for at least 2 months. All user inputs and usage patterns were recorded in the online database for analysis, through which we understood how users interact with the app, and we were thus able to verify, correct, and enhance the design principles of the mHealth app.

Results:

There were 160 users who downloaded the app during the 2-month period; after excluding users who stopped using the application in the middle of the process, 89 participants remained. The results of the experimental study suggest that people with a feeling personality type are more likely to adhere to self-defined exercise plans than people with a thinking personality type. Emotional messages are more effective in motivating exercise adherence than logical messages. With repeated reminders, the adherence rates of people with a thinking personality type are significantly improved.

Conclusions:

This study contributes to the research area of mHealth apps. The principles learned from this study can be applied to make mHealth apps more effective. By incorporating a behavior experiment into the action design research process, we demonstrate the benefit of combining design science and behavior experiments. The application design can be considered a foundation to develop more advanced applications for specific diseases, such as diabetes and asthma for future research.