JMIR Publications

ABSTRACT

Background:

Accounting for how end-users engage with technologies is imperative for designing an efficacious mobile behavioral intervention.

Objective:

This mixed-methods analysis examined the translational potential of user-centered design and basic behavioral science to inform the design of a mobile intervention for obesity and binge eating.

Methods:

Twenty-two adults (33% non-Hispanic white; 36% male) with self-reported obesity and recurrent binge eating (≥12 episodes in 3 months) who were interested in losing weight and reducing binge eating completed a prototyping design activity over one week. Leveraging evidence from behavioral economics on choice architecture, participants chose treatment targets from 20 options (aligned with the intervention’s theoretical model) to learn which targets and theoretical constructs are relevant to end-users. Analyses were of the process by which participants selected and implemented targets and their change in outcomes.

Results:

Participants selected 1-3 treatment targets based on perceived achievability, helpfulness, or relevance. Over the week, all practiced a treatment target at least once; 82% struggled with implementation and 23% added a new treatment target. Several themes emerged on successes and challenges with implementation, which yielded design implications for supporting users in behavior change. In post-experiment reflections, 82% indicated the treatment target was helpful and 86% planned to continue use. One-week average within-subject changes in weight (-2.2 pounds) and binge eating (-1.6 episodes) indicated small clinical improvement.

Conclusions:

Applying user-centered design and basic behavioral science yielded design insights to incorporate personalization through user choice with guidance, which may enhance engagement with and the potential efficacy of digital health interventions.