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JMIR MHealth and UHealth Jan 2021It is unclear why some physical activity (PA) mobile health (mHealth) interventions successfully promote PA whereas others do not. One possible explanation is the... (Review)
Review
BACKGROUND
It is unclear why some physical activity (PA) mobile health (mHealth) interventions successfully promote PA whereas others do not. One possible explanation is the variety in PA mHealth interventions-not only do interventions differ in the selection of persuasive strategies but also the design and implementation of persuasive strategies can vary. However, limited studies have examined the different designs and technical implementations of strategies or explored if they indeed influenced the effectiveness of the intervention.
OBJECTIVE
This scoping 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, this review aims to explore whether previous mHealth studies examined the influence of the different design characteristics and technical operationalizations of common persuasive strategies on the effectiveness of the intervention to persuade the user to engage in PA.
METHODS
An unsystematic snowball and gray literature search was performed to identify the literature that evaluated the persuasive strategies in experimental trials (eg, randomized controlled trial, pre-post test). Studies were included if they targeted adults, if they were (partly) delivered by a mobile system, if they reported PA outcomes, if they used an experimental trial, and when they specifically compared the effect of different designs or implementations of persuasive strategies. The study methods, implementations, and designs of persuasive strategies, and the study results were systematically extracted from the literature by the reviewers.
RESULTS
A total of 29 experimental trials were identified. We found a heterogeneity in how the strategies are being implemented and designed. Moreover, the findings indicated that the implementation and design of the strategy has an influence on the effectiveness of the PA intervention. For instance, the effectiveness of rewarding was shown to vary between types of rewards; rewarding goal achievement seems to be more effective than rewarding each step taken. Furthermore, studies comparing different ways of goal setting suggested that assigning a goal to users might appear to be more effective than letting the user set their own goal, similar to using adaptively tailored goals as opposed to static generic goals. This study further demonstrates that only a few studies have 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 to improve the translation of theory-based persuasive strategies into practical delivery forms.
Topics: Adult; Exercise; Exercise Therapy; Humans; Motivation; Persuasive Communication; Telemedicine
PubMed: 33459598
DOI: 10.2196/16282 -
PloS One 2023Existing task-oriented virtual agents can assist users with simple tasks like ticket booking, hotel reservations, etc. effectively and with high confidence. These...
PURPOSE
Existing task-oriented virtual agents can assist users with simple tasks like ticket booking, hotel reservations, etc. effectively and with high confidence. These virtual assistants, however, assume specific, predictable end-user behavior, such as predefined/servable objectives, which results in conversation failures in challenging situations, such as when goals are unavailable.
METHODOLOGY
Inspired by the practice and its efficacy, we propose an end-to-end framework for task-oriented persuasive dialogue generation that combines pre-training and reinforcement learning for generating context-aware persuasive responses. We utilize four novel rewards to improve consistency and repetitiveness in generated responses. Additionally, a meta-learning strategy has also been utilized to make the model parameters better for domain adaptation. Furthermore, we also curate a personalized persuasive dialogue (PPD) corpus, which contains utterance-level intent, slot, sentiment, and persuasion strategy annotation.
FINDINGS
The obtained results and detailed analysis firmly establish the effectiveness of the proposed persuasive virtual assistant over traditional task-oriented virtual assistants. The proposed framework considerably increases the quality of dialogue generation in terms of consistency and repetitiveness. Additionally, our experiment with a few shot and zero-shot settings proves that our meta-learned model learns to quickly adopt new domains with a few or even zero no. of training epochs. It outperforms the non-meta-learning-based approaches keeping the base model constant.
ORIGINALITY
To the best of our knowledge, this is the first effort to improve a task-oriented virtual agent's persuasiveness and domain adaptation.
Topics: Persuasive Communication; Learning; Reinforcement, Psychology
PubMed: 36602995
DOI: 10.1371/journal.pone.0275750 -
Social Science & Medicine (1982) Dec 2023In this article we develop the concept of the 'idealised policy patient' to contribute to a better understanding of patient-family activism and the mechanisms through...
In this article we develop the concept of the 'idealised policy patient' to contribute to a better understanding of patient-family activism and the mechanisms through which powerful and persuasive patient narratives are facilitated and mobilised. The context through which we explore the idealised policy patient is the UK debates about the legalisation of mitochondrial donation, which primarily took place between 2011 and 2015. In our example, the idealised policy patient was constructed around a culturally persuasive narrative of patient suffering, where mitochondrial donation was presented as a desirable and ethical solution. We draw on interviews with patient-families and stakeholders, and documentary analysis to identify four dimensions of the idealised policy patient - narrating, curating, enacting and navigating. Narrating describes how the idealised policy patient appears in public and policy spaces, as a culturally available narrative which conveys certain meanings and is designed to invoke an emotional and practical response. Curating identifies the multiple forms of labour and facilitation involved in supporting patient-families in activist activities which strengthen the dominant narrative and its embodiment. Enacting focuses on the work of patient-families themselves in supporting and contributing to the idealised policy patient in a way that enlivens and embodies the specifically curated narrative. Finally, navigating considers how those offering an opposing viewpoint position themselves in relation to the idealised policy patient. To conclude, we argue that medical sociology has often given insufficient scrutiny to how the capacity of patients to leverage their status for political ends is bolstered through alignment with existing powerful groups, particularly in hegemonic campaigns. We encourage future researchers to examine how the idealised policy patient is reproduced and reorientated within different policy contexts.
Topics: Pregnancy; Female; Humans; Narration; Labor, Obstetric; Policy; Persuasive Communication
PubMed: 37871394
DOI: 10.1016/j.socscimed.2023.116333 -
Journal of Health Communication Oct 2011This study explores the effects of tissue requesters' relational, persuasive, and nonverbal communication on families' final donation decisions. One thousand sixteen (N...
This study explores the effects of tissue requesters' relational, persuasive, and nonverbal communication on families' final donation decisions. One thousand sixteen (N = 1,016) requests for tissue donation were audiotaped and analyzed using the Siminoff Communication Content and Affect Program, a computer application specifically designed to code and assist with the quantitative analysis of communication data. This study supports the important role of communication strategies in health-related decision making. Families were more likely to consent to tissue donation when confirmational messages (e.g., messages that expressed validation or acceptance) or persuasive tactics such as credibility, altruism, or esteem were used during donation discussions. Consent was also more likely when family members exhibited nonverbal immediacy or disclosed private information about themselves or the patient. The results of a hierarchical log-linear regression revealed that the use of relational communication during requests directly predicted family consent. The results provide information about surrogate decision making in end-of-life situations and may be used to guide future practice in obtaining family consent to tissue donation.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Decision Making; Family; Female; Humans; Male; Middle Aged; Nonverbal Communication; Persuasive Communication; Professional-Family Relations; Third-Party Consent; Tissue and Organ Procurement; Young Adult
PubMed: 21512935
DOI: 10.1080/10810730.2011.561908 -
Prevention Science : the Official... Jul 2021Many past cannabis prevention campaigns have proven largely ineffective due in part to the diversity of adolescents' cannabis-relevant beliefs. The current studies... (Randomized Controlled Trial)
Randomized Controlled Trial
Many past cannabis prevention campaigns have proven largely ineffective due in part to the diversity of adolescents' cannabis-relevant beliefs. The current studies evaluated the impact of a sequential multiple message approach tailored to the usage norms of adolescents expressing negative attitudes toward a cannabis prevention appeal. A multiple-message strategy was implemented-initial unfavorable message evaluations were invalidated using attitudinal rebuttal feedback prior to presenting a third tailored communication. Participants were cannabis-abstinent middle and high school students (ages 11 to 16). Study 1 (N = 808) compared effects of gain- and loss-framed messages tailored to each student's normative usage perceptions. In Study 2 (N = 391), students were randomly assigned to receive a tailored or non-tailored message after receiving feedback meant to destabilize anti-message attitudes. For at-risk adolescents in Study 1 who perceived cannabis use as normative, a tailored gain-framed message resulted in the lowest usage intentions (p < .05). In Study 2, a conditional multiple-moderated mediation model showed that for high-risk teens with normative beliefs and pro-cannabis attitudes, exposure to a tailored gain-framed communication was associated with decreased cannabis attitude certainty, and lower usage intentions 2 months later (p < .05). Findings have implications for sequential messaging utilization in mass media campaigns and support the efficacy of tailored messages over a one-size-fits-all media approach. Further, results suggest that systematically weakening resistance to persuasive communications and tailoring messages consistent with individually perceived peer norms is an effective prevention strategy.
Topics: Adolescent; Attitude; Cannabis; Child; Humans; Intention; Persuasive Communication; Social Norms
PubMed: 33791930
DOI: 10.1007/s11121-021-01224-9 -
JMIR Human Factors Mar 2024Medication incidents (MIs) causing harm to patients have far-reaching consequences for patients, pharmacists, public health, business practice, and governance policy.... (Review)
Review
BACKGROUND
Medication incidents (MIs) causing harm to patients have far-reaching consequences for patients, pharmacists, public health, business practice, and governance policy. Medication Incident Reporting and Learning Systems (MIRLS) have been implemented to mitigate such incidents and promote continuous quality improvement in community pharmacies in Canada. They aim to collect and analyze MIs for the implementation of incident preventive strategies to increase safety in community pharmacy practice. However, this goal remains inhibited owing to the persistent barriers that pharmacies face when using these systems.
OBJECTIVE
This study aims to investigate the harms caused by medication incidents and technological barriers to reporting and identify opportunities to incorporate persuasive design strategies in MIRLS to motivate reporting.
METHODS
We conducted 2 scoping reviews to provide insights on the relationship between medication errors and patient harm and the information system-based barriers militating against reporting. Seven databases were searched in each scoping review, including PubMed, Public Health Database, ProQuest, Scopus, ACM Library, Global Health, and Google Scholar. Next, we analyzed one of the most widely used MIRLS in Canada using the Persuasive System Design (PSD) taxonomy-a framework for analyzing, designing, and evaluating persuasive systems. This framework applies behavioral theories from social psychology in the design of technology-based systems to motivate behavior change. Independent assessors familiar with MIRLS reported the degree of persuasion built into the system using the 4 categories of PSD strategies: primary task, dialogue, social, and credibility support.
RESULTS
Overall, 17 articles were included in the first scoping review, and 1 article was included in the second scoping review. In the first review, significant or serious harm was the most frequent harm (11/17, 65%), followed by death or fatal harm (7/17, 41%). In the second review, the authors found that iterative design could improve the usability of an MIRLS; however, data security and validation of reports remained an issue to be addressed. Regarding the MIRLS that we assessed, participants considered most of the primary task, dialogue, and credibility support strategies in the PSD taxonomy as important and useful; however, they were not comfortable with some of the social strategies such as cooperation. We found that the assessed system supported a number of persuasive strategies from the PSD taxonomy; however, we identified additional strategies such as tunneling, simulation, suggestion, praise, reward, reminder, authority, and verifiability that could further enhance the perceived persuasiveness and value of the system.
CONCLUSIONS
MIRLS, equipped with persuasive features, can become powerful motivational tools to promote safer medication practices in community pharmacies. They have the potential to highlight the value of MI reporting and increase the readiness of pharmacists to report incidents. The proposed persuasive design guidelines can help system developers and community pharmacy managers realize more effective MIRLS.
Topics: Humans; Learning; Persuasive Communication; Suggestion; Motivation; Canada
PubMed: 38512325
DOI: 10.2196/41557 -
Health Informatics Journal Dec 2019Persuasive technologies are tools for motivating behaviour change using persuasive strategies. socially-driven persuasive technologies employ three common...
Persuasive technologies are tools for motivating behaviour change using persuasive strategies. socially-driven persuasive technologies employ three common socially-oriented persuasive strategies in many health domains: , and . Research has shown the possibilities for socially-driven persuasive interventions to backfire by demotivating behaviour, but we lack knowledge about how the interventions could motivate or demotivate behaviours. To close this gap, we studied 1898 participants, specifically Socially-oriented strategies and their comparative effectiveness in socially-driven persuasive health interventions that motivate healthy behaviour change. The results of a thematic analysis of 278 pages of qualitative data reveal important strengths and weaknesses of the individual socially-oriented strategies that could facilitate or hinder their effectiveness at motivating behaviour change. These include their tendency to and their tendency , and , and provoke a and , respectively. We contribute to the health informatics community by developing 15 design guidelines for operationalizing the strategies in persuasive health intervention to amplify their strengths and overcome their weaknesses.
Topics: Cooperative Behavior; Health Behavior; Health Promotion; Humans; Interpersonal Relations; Persuasive Communication
PubMed: 29801426
DOI: 10.1177/1460458218766570 -
Journal of Medical Ethics Aug 2017Nudges-policy proposals informed by work in behavioural economics and psychology that are designed to lead to better decision-making or better behaviour-are...
Nudges-policy proposals informed by work in behavioural economics and psychology that are designed to lead to better decision-making or better behaviour-are controversial. Critics allege that they bypass our deliberative capacities, thereby undermining autonomy and responsible agency. In this paper, I identify a kind of nudge I call a nudge to reason, which make us more responsive to genuine evidence. I argue that at least some nudges to reason do not bypass our deliberative capacities. Instead, use of these nudges should be seen as appeals to mechanisms partially constitutive of these capacities, and therefore as benign (so far as autonomy and responsible agency are concerned). I sketch some concrete proposals for nudges to reason which are especially important given the apparent widespread resistance to evidence seen in recent political events.
Topics: Behavior Therapy; Decision Making; Health Behavior; Humans; Knowledge; Personal Autonomy; Persuasive Communication; Thinking
PubMed: 28526778
DOI: 10.1136/medethics-2017-104153 -
BMC Public Health Dec 2018Responsible gambling messages are widely used as a tool to enable informed choice and encourage appropriate gambling behavior. It is generally accepted that gamblers... (Review)
Review
BACKGROUND
Responsible gambling messages are widely used as a tool to enable informed choice and encourage appropriate gambling behavior. It is generally accepted that gamblers have different levels of risk of developing gambling problems and require various harm minimization tools and resources. Therefore, it is reasonable to expect that responsible gambling messages should be customized and target specific groups of gamblers. This project aimed to understand hypothesized differences between cohorts of gamblers and receive qualitative feedback on archetypal targeted messages used to increase use of responsible gambling tools.
METHODS
Focus groups were held to test messages for specific cohorts: young adults (18-24 years), seniors (60+ years), frequent gamblers (weekly), and gamblers of skill-based games (poker, sports betting).
RESULTS
Cohorts exhibited different preferences and responses to message archetypes. Seniors preferred messages about limit setting, whilst young adults and frequent gamblers responded to messages about their own play and expertise. Skill game gamblers were interested in the odds of winning and their own outcomes over time. However, all groups agreed that using positive, non-judgmental language in messaging is important.
CONCLUSIONS
This research makes an important contribution to the field by demonstrating that the wording of message content will likely influence the effectiveness of such messages differentially across various groups of gamblers for engaging gamblers in harm reduction tools. Guidance is provided on themes that can be used by public health marketers.
Topics: Adolescent; Adult; Female; Focus Groups; Gambling; Harm Reduction; Humans; Male; Middle Aged; Persuasive Communication; Young Adult
PubMed: 30558568
DOI: 10.1186/s12889-018-6281-0 -
Journal of Medical Internet Research Jun 2023Taxonomies and models are useful tools for defining eHealth content and intervention features, enabling comparison and analysis of research across studies and... (Review)
Review
BACKGROUND
Taxonomies and models are useful tools for defining eHealth content and intervention features, enabling comparison and analysis of research across studies and disciplines. The Behavior Change Technique Taxonomy version 1 (BCTTv1) was developed to decrease ambiguity in defining specific characteristics inherent in health interventions, but it was developed outside the context of digital technology. In contrast, the Persuasive System Design Model (PSDM) was developed to define and evaluate the persuasive content in software solutions but did not have a specific focus on health. Both the BCTTv1 and PSDM have been used to define eHealth interventions in the literature, with some researchers combining or reducing the taxonomies to simplify their application. It is unclear how well the taxonomies accurately define eHealth and whether they should be used alone or in combination.
OBJECTIVE
This scoping review explored how the BCTTv1 and PSDM capture the content and intervention features of parent-focused eHealth as part of a program of studies investigating the use of technology to support parents with therapy home programs for children with special health care needs. It explored the active ingredients and persuasive technology features commonly found in parent-focused eHealth interventions for children with special health care needs and how the descriptions overlap and interact with respect to the BCTTv1 and PSDM taxonomies.
METHODS
A scoping review was used to clarify concepts in the literature related to these taxonomies. Keywords related to parent-focused eHealth were defined and used to systematically search several electronic databases for parent-focused eHealth publications. Publications referencing the same intervention were combined to provide comprehensive intervention details. The data set was coded using codebooks developed from the taxonomies in NVivo (version 12; QSR International) and qualitatively analyzed using matrix queries.
RESULTS
The systematic search found 23 parent-focused eHealth interventions described in 42 articles from various countries; delivered to parents with children aged 1 to 18 years; and covering medical, behavioral, and developmental issues. The predominant active ingredients and intervention features in parent-focused eHealth were concerned with teaching parents behavioral skills, encouraging them to practice and monitor the new skills, and tracking the outcomes of performing the new skills. No category had a complete set of active ingredients or intervention features coded. The two taxonomies conceptually captured different constructs even when their labels appeared to overlap in meaning. In addition, coding by category missed important active ingredients and intervention features.
CONCLUSIONS
The taxonomies were found to code different constructs related to behavior change and persuasive technology, discouraging the merging or reduction of the taxonomies. This scoping review highlighted the benefit of using both taxonomies in their entirety to capture active ingredients and intervention features important for comparing and analyzing eHealth across different studies and disciplines.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-doi.org/10.15619/nzjp/47.1.05.
Topics: Child; Humans; Behavior Therapy; Delivery of Health Care; Persuasive Communication; Technology; Telemedicine
PubMed: 37342082
DOI: 10.2196/42083