||The TTM-Matched exercise intervention design principles for adaptive mobile applications
||Department of Industrial Design
Mobile Interface Design
長期的規律運動是保持健康的方法之一。但對許多人而言，運動習慣的建立並非一蹴可幾，而是一個需要持續進行、經歷不同階段的過程。過去的研究指出，基於行為改變理論所發展的調適性介入策略，能幫助人們持續進行運動。然而，大部分開發運動促進裝置或系統的開發者，由於未受到足夠的行為理論運用訓練，因此難以將相關理論直接轉化為具體的調適性設計。因此，本研究基於理論基礎與行為探討，提出設計師可以運用的調適性行動應用之設計準則。我們透過深度訪談、問卷調查等方法，探索可能影響研究參與者運動的原因。透過探索性因素分析，探討在跨理論模型(Transtheoretical Model, TTM)的不同行為改變階段中，主要影響研究參與者運動的因素。我們發現對於Contemplation 和Preparation的族群，主要影響的因素為運動成就的累積；對於Action 和 Maintenance的族群，主要影響的因素則為運動相關資訊的提醒。當開發調適性運動促進系統時，開發者可以應用本研究提供的設計準則，權衡各個行為改變階段中，優先應該呈現的運動促進資訊或功能為何。藉此描繪能依據使用者運動階段改變而調適的互動系統之設計藍圖。
Exercise regularly is one of the ways to keep healthy, but establishing exercise habits is not easy for most people. It is a process that requires sustainability and has to go through many stages. Research has shown that adaptive intervention strategy based on behavior change theory could support people to exercise regularly and maintain it. However, most developers of exercise promotion device or interactive system lack training of applying behavior change theories. Therefore, it is difficult to interpret behavior change theories and models into concrete adaptive design. In this study, we provide the design principles based on theories and behavior research. We explore people’s reasons of exercise through interview and online questionnaire. Exploratory factor analysis was conducted to explore the factors influencing participants in the different stages of behavioral change in a Transtheoretical Model (TTM). We found that the major factor is accumulations of exercise achievements in the Contemplation and Preparation group, and for the Action and Maintenance groups, the main influencing factor is motion-related information reminders.When developing adaptive exercise-promotion systems, developers can apply the results of this study to weigh the exercise-promoting information or functions that should be presented first in each behavioral change stage, thereby depicting a design blueprint of an interactive system that can be adapted in response to a change in user’s behavioral change stage.
TABLE OF CONTENTS
ABSTRACT IN CHINESE i
TABLE OF CONTENTS iv
LIST OF TABLES vi
LIST OF FIGURES vii
CHAPTER 1 INTRODUCTION 1
1.1 Background 1
1.2 Research Motivations 3
1.3 Research Purpose 3
1.4 Research Framework 4
CHAPTER 2 LITERATURE REVIEW 5
2.1 The Exercise Study of Office Workers 5
2.1.1 The Current Exercising Status of Office Workers 5
2.1.2 The Lack of Exercise and Its Impact on Office Workers 6
2.2 Establishing Exercise Habits 6
2.2.1 How to Establish Exercise Habits 6
2.2.2 The Process of Exercise Habit Forming 9
2.2.3 Brief Summary 10
2.3 Adaptive Design Strategy 11
2.3.1 The Value of Adaptive Design 11
2.3.2 Adaptive Health Strategy Promotion's Application in Technology 11
CHAPTER 3 RESEARCH METHODOLOGY 13
3.1 Interview 13
3.1.1 Participants 13
3.1.2 Outline 15
3.1.3 The Exercise Factors from Interview 16
3.2 Questionnaire 18
3.2.1 Expert Validity Analysis 19
3.2.2 Item Analysis 19
3.2.3 Reliability Analysis 19
3.2.4 The Online Formal Questionnaire 20
3.2.5 Questionnaire analysis 20
CHAPTER 4 RESULTS 22
4.1 Descriptive Statistical Analysis 22
4.2 Exercise Factors 22
4.3 The Consent Value of Exercise Factors 26
CHAPTER 5 Structure of Adaptive Function 33
5.1 Precontemplation 33
5.2 Contemplation 35
5.3 Preparation 36
5.4 Action & Maintenance 37
CHAPTER 6 DISCUSSION 40
6.1 The TTM Stages of Behavioral Change and Design Strategy 40
6.2 Structural Presentation of Adaptive Function 44
6.3 Research Contributions 47
6.4 Reflection 47
CHAPTER 7 CONCLUSIONS AND SUGGESTIONS 49
7.1 Conclusions 49
7.2 Recommendations 49
Appendix A THE RESULTS OF FACTOR ANALYSIS 53
Appendix B FORMAL QUESTIONNAIRE 57
LIST OF TABLES
Table 3.1 Participants with exercise habit 14
Table 3.2 Participants without exercise habit 15
Table 3.3 Interview outline for participants with exercise habit 16
Table 3.4 Interview outline for participants without exercise habit 16
Table 3.5 Categories of influential factors of exercising 18
Table 3.6 Categorize of Exercise reasons 21
Table 4.1 Descriptive statistical analysis 22
Table 4.2 The results of factor analysis 24
Table 4.3 Sorting exercise factors with average 27
Table 4.4 The questionnaire result of Precontemplation 28
Table 4.5 The questionnaire result of Contemplation 29
Table 4.6 The questionnaire result of Preparation 30
Table 4.7 The questionnaire result of Action 31
Table 4.8 The questionnaire result of Maintenance 32
Table 6.1 Average value of exercise factor in Precontemplation 40
Table 6.2 Average value of exercise factor in Contemplation 41
Table 6.3 Average value of exercise factor in Preparation 42
Table 6.4 Average value of exercise factor in Action 43
Table 6.5 Average value of exercise factor in Maintenance 44
LIST OF FIGURES
Figure 2.1 The structure of TPB 7
Figure 2.2 Fogg behavioral model 8
Figure 2.3 The Hook canvas 9
Figure 5.1 Structure of Adaptive Function in Precontemplation 34
Figure 5.2 Structure of Adaptive Function in Contemplation 36
Figure 5.3 Structure of Adaptive Function in Preparation 37
Figure 5.4 Structure of Adaptive Function in Action 39
Figure 6.1 The design principle for TTM matched exercise intervention strategy 46
 Ajzen, I. and Fishbein, M., "Understanding attitudes and predicting behavior," ed: Englewood Cliffs, NJ: Prentice Hall, 1980.
 Ajzen, I., "The theory of planned behavior," Organizational behavior and human decision processes, vol. 50, pp. 179-211, 1991.
 Ajzen, I., Attitudes, personality, and behavior: McGraw-Hill Education (UK), 2005.
 Benyon, D. and Murray, D., "Adaptive systems: From intelligent tutoring to autonomous agents," Knowledge-Based Systems, vol. 6, pp. 197-219, 1993.
 Biddle, S. J. and Asare, M., "Physical activity and mental health in children and adolescents: a review of reviews," British journal of sports medicine, p. bjsports90185, 2011.
 Carter, M. C., Burley, V. J., Nykjaer, C., and Cade, J. E., "Adherence to a smartphone application for weight loss compared to website and paper diary: pilot randomized controlled trial," Journal of medical Internet research, vol. 15, p. e32, 2013.
 Chan, C. B., Ryan, D. A., and Tudor-Locke, C., "Health benefits of a pedometer-based physical activity intervention in sedentary workers," Preventive medicine, vol. 39, pp. 1215-1222, 2004.
 Clawson, J., Pater, J. A., Miller, A. D., Mynatt, E. D., and Mamykina, L., "No longer wearing: investigating the abandonment of personal health-tracking technologies on craigslist," in Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing, pp. 647-658. , 2015
 Consolvo, S., McDonald, D. W., and Landay, J. A., "Theory-driven design strategies for technologies that support behavior change in everyday life," in Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, pp. 405-414. , 2009
 Corbin, J. M. and Strauss, A., "Grounded theory research: Procedures, canons, and evaluative criteria," Qualitative sociology, vol. 13, pp. 3-21, 1990.
 Cowan, L. T., Van Wagenen, S. A., Brown, B. A., Hedin, R. J., Seino-Stephan, Y., Hall, P. C., et al., "Apps of steel: are exercise apps providing consumers with realistic expectations? A content analysis of exercise apps for presence of behavior change theory," Health Education & Behavior, p. 1090198112452126, 2012.
 Croft, W. B., "The role of context and adaptation in user interfaces," International Journal of Man-Machine Studies, vol. 21, pp. 283-292, 1984.
 de Vries, R. A., Truong, K. P., Kwint, S., Drossaert, C. H., and Evers, V., "Crowd-designed motivation: Motivational messages for exercise adherence based on behavior change theory," in Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems, pp. 297-308., 2016
 Edmonds, E., "Adaptive man-computer interfaces," Computing skills and the user interface, vol. 122, pp. 389-426, 1981.
 Eyal, N., Hooked: How to build habit-forming products: Penguin Canada, 2014.
 Ferron, M. and Massa, P., "Transtheoretical model for designing technologies supporting an active lifestyle," in Proceedings of the Biannual Conference of the Italian Chapter of SIGCHI, p. 7. , 2013
 Fishbein, M. and Ajzen, I., "Belief, attitude, intention, and behavior: An introduction to theory and research," 1977.
 Fogg, B. J., "Persuasive technology: using computers to change what we think and do," Ubiquity, vol. 2002, p. 5, 2002.
 Fogg, B. J., "A behavior model for persuasive design," in Proceedings of the 4th international Conference on Persuasive Technology, p. 40. , 2009
 Gay, V., Leijdekkers, P., and Barin, E., "A mobile rehabilitation application for the remote monitoring of cardiac patients after a heart attack or a coronary bypass surgery," in Proceedings of the 2nd International Conference on PErvasive Technologies Related to Assistive Environments, p. 21. , 2009
 Geven, A., Sefelin, R., and Tscheligi, M., "Depth and breadth away from the desktop: the optimal information hierarchy for mobile use," in Proceedings of the 8th conference on Human-computer interaction with mobile devices and services, pp. 157-164. , 2006
 Gong, J. and Tarasewich, P., "Guidelines for handheld mobile device interface design," in Proceedings of DSI 2004 Annual Meeting, pp. 3751-3756. , 2004
 Grimley, D., Prochaska, J. O., Velicer, W. F., Blais, L. M., and DiClemente, C. C., "The transtheoretical model of change," Changing the self: Philosophies, techniques, and experiences, pp. 201-227, 1994.
 Hallal, P. C., Andersen, L. B., Bull, F. C., Guthold, R., Haskell, W., Ekelund, U., et al., "Global physical activity levels: surveillance progress, pitfalls, and prospects," The lancet, vol. 380, pp. 247-257, 2012.
 Hu, F. B., "Sedentary lifestyle and risk of obesity and type 2 diabetes," Lipids, vol. 38, pp. 103-108, 2003.
 Kaptein, M. and van Halteren, A., "Adaptive persuasive messaging to increase service retention: using persuasion profiles to increase the effectiveness of email reminders," Personal and Ubiquitous Computing, vol. 17, pp. 1173-1185, 2013.
 Katon, W. and Sullivan, M. D., "Depression and chronic medical illness," J Clin Psychiatry, vol. 51, pp. 3-11, 1990.
 Koch, S., Marschollek, M., Wolf, K.-H., Plischke, M., and Haux, R., "On health-enabling and ambient-assistive technologies," Methods of Information in Medicine, vol. 48, pp. 29-37, 2009.
 Lazar, A., Koehler, C., Tanenbaum, J., and Nguyen, D. H., "Why we use and abandon smart devices," in Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing, pp. 635-646. , 2015
 Lin, J. J., Mamykina, L., Lindtner, S., Delajoux, G., and Strub, H. B., "Fish’n’Steps: Encouraging physical activity with an interactive computer game," in International Conference on Ubiquitous Computing, pp. 261-278. , 2006
 Michie, S., Johnston, M., Francis, J., Hardeman, W., and Eccles, M., "From theory to intervention: mapping theoretically derived behavioural determinants to behaviour change techniques," Applied psychology, vol. 57, pp. 660-680, 2008.
 Murnane, E. L., Huffaker, D., and Kossinets, G., "Mobile health apps: adoption, adherence, and abandonment," in Adjunct Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing and Proceedings of the 2015 ACM International Symposium on Wearable Computers, , pp. 261-264. 2015
 Nilsson, E. G., "Design patterns for user interface for mobile applications," Advances in Engineering Software, vol. 40, pp. 1318-1328, 2009.
 Nunnally Jum, C. and Bernstein Ira, H., "Psychometric theory," ed: New York: McGraw-Hill, 1978.
 Owen, N., Healy, G. N., Matthews, C. E., and Dunstan, D. W., "Too much sitting: the population-health science of sedentary behavior," Exercise and sport sciences reviews, vol. 38, p. 105, 2010.
 Porter, J.. Principles of User Interface (2013)
 Prochaska, J. O. and DiClemente, C. C., "Transtheoretical therapy: Toward a more integrative model of change," Psychotherapy: Theory, research & practice, vol. 19, p. 276, 1982.
 Prochaska, J. O. and Velicer, W. F., "The transtheoretical model of health behavior change," American journal of health promotion, vol. 12, pp. 38-48, 1997.
 Purpura, S., Schwanda, V., Williams, K., Stubler, W., and Sengers, P., "Fit4life: the design of a persuasive technology promoting healthy behavior and ideal weight," in Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, pp. 423-432. , 2011
 Rey-Lopez, J. P., Vicente-Rodríguez, G., Biosca, M., and Moreno, L. A., "Sedentary behaviour and obesity development in children and adolescents," Nutrition, Metabolism and Cardiovascular Diseases, vol. 18, pp. 242-251, 2008.
 RIIHIMÄKI, H., TOLA, S., VIDEMAN, T., and HÄNNINEN, K., "Low-Back Pain and Occupation: A Cross-Sectional Questionnaire Study of Men in Machine Operating, Dynamic Physical Work, and Sedentary Work," Spine, vol. 14, pp. 204-209, 1989.
 Riley, W. T., Rivera, D. E., Atienza, A. A., Nilsen, W., Allison, S. M., and Mermelstein, R., "Health behavior models in the age of mobile interventions: are our theories up to the task?," Translational behavioral medicine, vol. 1, pp. 53-71, 2011.
 Schneider, H., Moser, K., Butz, A., and Alt, F., "Understanding the Mechanics of Persuasive System Design: A Mixed-Method Theory-driven Analysis of Freeletics," in Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems, pp. 309-320. , 2016
 Sheppard, B. H., Hartwick, J., and Warshaw, P. R., "The theory of reasoned action: A meta-analysis of past research with recommendations for modifications and future research," Journal of consumer research, vol. 15, pp. 325-343, 1988.
 Spencer, L., Adams, T. B., Malone, S., Roy, L., and Yost, E., "Applying the transtheoretical model to exercise: a systematic and comprehensive review of the literature," Health promotion practice, vol. 7, pp. 428-443, 2006.
 Tsai, C. C., Lee, G., Raab, F., Norman, G. J., Sohn, T., Griswold, W. G., et al., "Usability and feasibility of PmEB: a mobile phone application for monitoring real time caloric balance," Mobile networks and applications, vol. 12, pp. 173-184, 2007.
 Van der Ploeg, H. P., Chey, T., Korda, R. J., Banks, E., and Bauman, A., "Sitting time and all-cause mortality risk in 222 497 Australian adults," Archives of internal medicine, vol. 172, pp. 494-500, 2012.
 WHO, "Physical inactivity: a global public health problem," World Health Organization, Geneva, 2008.
 Xu, Y., Poole, E. S., Miller, A. D., Eiriksdottir, E., Kestranek, D., Catrambone, R., et al., "This is not a one-horse race: understanding player types in multiplayer pervasive health games for youth," in Proceedings of the ACM 2012 conference on computer supported cooperative work, pp. 843-852. , 2012
 李筱萱, "身體活動量與睡眠品質之相關研究-以高科技產業員工為例," 臺 灣 師 範 大 學 運 動 與 休 閒 管 理 研 究 所 在 職 碩 士 班 學 位 論 文, pp. 1-90, 2007.
 邱皓政, 量化研究與統計分析: 五南圖書出版股份有限公司, 2006.