Journal of Medical Internet Research · 2021 · 38 citations · 39 references
Public HealthDesignPsychologyBehavioral HealthHuman-centered DesignUser Experience DesignBehavior ChangeBehavior Change StrategiesBehavioral InterventionsMotivationPsychosocial InterventionsSelf-managementBehavior Change InterventionsEffort InvestmentEffort-based Action PlanningEffortful AttentionEffortful ControlEffortless InteractionSalienceUser Engagement
Digital health interventions promise home‑based self‑care, yet they are delivered in users’ everyday environments where competing demands and automatic habits make behavior change effortful. The authors argue that effort and burden should be treated as a core therapeutic mechanism throughout digital intervention development. They propose a three‑step effort‑optimized intervention model that nurtures effortless salience, simplifies therapeutic activities to prevent depletion, and reframes necessary effort as sustainable assets, illustrated with a digital health example.
The majority of digital health interventions lean on the promise of bringing health and self-care into people’s homes and hands. However, these interventions are delivered while people are in their triggering environments, which places competing demands on their attention. Individuals struggling to change or learn a new behavior have to work hard to achieve even a minor change because of the automatic forces propelling them back to their habitual behaviors. We posit that effort and burden should be explored at the outset and throughout the digital intervention development process as a core therapeutic mechanism, beyond the context of design or user experience testing. In effort-focused conceptualization, it is assumed that, even though goals are rational and people want to achieve them, they are overtaken by competing cognitive, emotional, and environmental processes. We offer the term effort-optimized intervention to describe interventions that focus on user engagement in the face of competing demands. We describe design components based on a 3-step process for planning an effort-optimized intervention: (1) nurturing effortless cognitive and environmental salience to help people keep effort-related goals prominent despite competition; (2) making it as effortless as possible to complete therapeutic activities to avoid ego depletion and self-efficacy reduction; and (3) turning the necessary effortful activities into sustainable assets. We conclude by presenting an example of designing a digital health intervention based on the effort-optimized intervention model.
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Implementation intentions: Strong effects of simple plans.
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