JMIR Publications

ABSTRACT

Background:

Although many digital health interventions have been studied in human-computer interaction, long-term engagement remains a challenge. Micro-interventions that leverage small but meaningful steps towards health outcomes have been proposed as a method for providing flexible and engaging, yet short and focused, interventions. One way to mitigate the potentially limiting scope of each micro-intervention is through narratives combining multiple different micro-interventions over time to facilitate greater effects and engagement. As an emerging field of research significant focus has thus far been placed on the creation and testing of individual micro-interventions with little consideration for the consolidated experience i.e., the narrative over time. A more concise terminology and framework could make it easier to design, evaluate and compare systems for micro-interventions, facilitate collaboration in the field and foster communication across required disciplines.

Objective:

The aim of this paper is to provide a framework for the creation of micro-interventions systems and the narratives served by these through their micro-interventions.

Methods:

Based on a systematic review of existing literature and a critical interpretive synthesis, we created and present the D-MIST (Design for Micro-Intervention Software Technology) framework as well as its rationale which can be used to better classify, design, and evaluate micro-interventions.

Results:

We present and rationalize the D-MIST framework based on an overview of the existing literature. D-MIST defines a micro-intervention system as consisting of three overall levels: 1) the narrative level, 2) the micro-intervention level and 3) the event level. The narrative refers to the consolidated experience of engaging with multiple micro-interventions over time in support of a narrative goal e.g., a clinical goal. A micro-intervention is a highly focused intervention consisting of a number of self-contained events aiming to facilitate small but meaningful steps towards the narrative goal. The event refers to each attempt at positive momentary change through a resource e.g., an exercise. Events may for instance be designed for single use, present variations to facilitate engagement or present order-dependent sequential resources. In addition to these overall components we also discuss supporting constructs, such as: decision rules, conceptual models and the system’s interaction model i.e., how the system interacts with the user through its design and other actors to create a consolidated narrative.

Conclusions:

The resulting D-MIST framework, which is based on current state of the art literature, describes the components of micro-intervention systems and how these contribute to a consolidated experience. We suggest opportunities for personalization of micro-intervention systems, discuss design guidelines and the roles of actors in creating health narratives aiming to obtain better distal health outcomes.