Hi everyone. My name is Herman Saksono.
I'm a computer science Ph.D. candidate at Northeastern University.
And in this talk, I will answer the question of how to make families more
motivated to use health and fitness apps.
But before we answer that question, we need to talk about
the challenges in designing physical activity promotion apps
especially to reduce the risk of obesity
As you may already know
adult and childhood obesity has been a major
public health concerns for many decades
in upper-income countries like the United States.
And obesity is often linked to socio-economic status.
What that means is if you are poor then
you are more likely to be obese. And being obese is associated with
higher risk of chronic diseases
like diabetes and cardiovascular diseases.
There are several ways to reduce the risk of obesity.
One is by improving your diet
and the other is regular physical activity.
Within HCI (Human-Computer Interaction) research
There is a great deal of work
examining how technologies can support physical activity
and we can see that many of these studies shows many promising results.
But, to better understand how to design technologies for promoting physical activity
we need to focus on two things.
First, physical activity behavior often begins at a young age so therefore we need to
design physical activity promotion apps for families.
Especially families of low socioeconomic status backgrounds
who face many barriers to live a healthy life.
Second, many studies have raised concerns about
Novelty effect, that is, declining engagement
once the initial interest with the technology fades.
So therefore, we need to examine
how to support family motivation to use and stay engaged with health apps.
To better understand the mechanism of
human motivation, we turn to the Self-Determination Theory or SDT
which is a theory that explains human motivation.
In SDT, our motivation falls into the
continuum of intrinsic motivation and extrinsic motivation
You are intrinsically motivated if you are
doing a task for the sake of doing the task itself because the task
is inherently enjoyable and satisfying.
On the other hand
you are extrinsically motivated if you are doing a task because someone
else told you so.
Or because you are concerned that bad
things will happen if you don't do the tasks.
Intrinsic motivation is generally more sustainable.
Intrinsically motivated people usually have better well-being
and they're less likely to give up when they face obstacles.
Three things facilitate the development of intrinsic motivation
They are competence, autonomy, and relatedness.
Competence is the feeling that you can complete the task effectively.
Autonomy is the feeling that you are doing the task at your own volition.
And relatedness is the feeling of being connected to other people
and care for them.
And in this work, we are focused on how to support relatedness.
This is informed by our 2015 study
on a gamified family fitness app called "Spaceship Launch."
Our evaluation of "Spaceship Launch" shows that
caregivers seek social interactions with their children
because they appreciate the opportunity
to bond as a family.
Now the question is how can we support
relatedness in a novel way?
Apps with gamification often provide virtual rewards.
You get badges or virtual trophies when you
achieve your fitness goals.
But these virtual rewards are not always effective.
And as our data suggest, families value social interactions.
What if we can reward families with social interactions?
And this is, in essence, is the idea of the Storywell app.
We want to support intrinsic motivation by supporting families
to experience relatedness.
The Storywell app seeks to support relatedness by
providing opportunities for social interactions by rewarding
families with storybook chapters.
We call our design: Social Rewards.
Rewards that catalyze social interactions.
But we don't stop there. We also added health intervention in the app
in the form of reflection questions.
At the end of every chapter, we added a set
of reflection questions that are related to the story.
And the goal is this question supports families to think more deeply about
their physical activity.
So this is how it works.
This is Storywell's fitness monitoring screen.
The blue balloons represent the caregiver's progress
and the red balloons represent the child's.
Here's the family completes their
fitness goal and they are unlocking their social rewards, the storybook chapter.
And now the family is reading the storybook chapter about
Eli the Elephant and the Red Hat Blown by the Wind.
And at the end of every chapter, we added reflection questions.
Families can record their answers and listen to them later.
These questions were designed to help families
think about the good feelings about being active and
also plan to be active in the future.
Before we do a large-scale study to
examine the effect of social rewards and reflection questions
on family behavior, we start by
conducting a study to answer these two questions.
First, how can social rewards influence caregiver's motivation to use a health app
And what are the barriers to health app engagement for
families of low socioeconomic status backgrounds who are
burdened with the greater risk of obesity.
We conducted a three-month study
with families living in low-income neighborhoods.
To participate a family must have an Android phone
and have at least one child aged
between three to eight years old.
We then interviewed the families four times.
Then we analyzed the interview data
using the general inductive method.
18 families participated in the study
the median income was US $21,000 annually
And all family participants' household incomes were below
150% of the United States' federal poverty level.
So what did we find?
We found that, yes, caregivers reported that they
feel connected with their children when they use the social rewards in the app
For example, mom #3 said that the storybooks
felt like a treat because she got to spend time with her daughter.
And this is something that we heard over and over again
with the families participating in the study.
We call these bonding moments.
But bonding moments were not the only moments that satisfy
caregivers' need for relatedness.
We also identified
discovery moments and educating moments.
These moments appeared to satisfy relatedness
because caregivers felt they were caring for
their children towards a valued goal.
Discovery moments, for example.
Caregivers said that they experienced
discovery moments when they observe their children's
behaviors and needs towards the pursuit of valued goals.
For example, mom #1 said that she was very pleased to
see her daughter being active to get a book.
And, particularly because reading is very important for her.
Another example is mom #15 who learned that her son was
overconfident when playing sports.
Now she's better prepared to handle moments
when her son loses a game.
Another theme is educating moments.
Other caregivers reported that they experienced
educating moments when they felt their actions supported their children's
attitudes and behaviors towards valued goals.
For example, mom #8 loved seeing her son excited every time he
unlocked a story, because she can use that moment to
work on her son's reading skills.
Another mom said that the Storywell app
can teach her daughter about
the importance of earning things.
And she thinks it's important because
learning that things need to be earned
will be an important life lesson.
In short, we have these three categories
of moments that can satisfy relatedness.
Bonding, discovery, and educating moments.
What's really interesting is that these moments have different
involvement levels.
And also different immediacy levels.
Bonding moments are more hedonic, because they
satisfy relatedness in the moment.
And in contrast, discovering and educating moments
are more eudaimonic because they satisfy
relatedness from the feeling of caring,
even though the expected benefits
are in the distant future.
What is also very important is
caregivers' distal goals and aspirations
were driven by caregivers' experiences of
missed opportunities in the past.
Many caregivers we work with
felt they miss life opportunities
due to immigration status,
family structure
and also racial discrimination in the United States.
And they saw that the reading component in Storywell
as valuable because reading and education can help their children
to be successful adults and regain the missed opportunities.
Caregivers also reported some challenges in using the app regularly
These barriers can inhibit the development of intrinsic motivations
Some families reported that demanding caregiving duties
limits their ability to use the app regularly
Other parents reported that seasonal changes made it hard to use the app
because their children stay at home all the time during the summer break.
And other parents said that they often deal with disruptive events that
put a stop on their ability to use the app.
And these barriers need to be taken into account
when designing family health apps,
especially in low-socioeconomic status context.
Before i talk about the design implications i would like to
revisit the Self-Determination theory a little bit.
In SDT, intrinsic modification is preferable because it is more sustainable.
And relatedness is one of the psychological needs that
facilitate the development of intrinsic motivation.
Our data shows that three moments can satisfy relatedness.
They are bonding, discovery, and educating moments.
I want to emphasize that intrinsic motivation
is something that we develop over time.
Therefore, it takes time to become
motivated to use a help app.
Based on our findings, we suggest health apps
to enable users
to experience satisfying moments
repeatedly over time
towards the development of intrinsic motivation.
In the paper, we discussed several
designs to support families to experience these satisfying moments.
To support bonding moments we suggest designing apps where parents can observe
their children's positive emotional reactions by being proximally close
For example, a mini health game
that the caregiver and their children can use on the same screen
so that they can be physically close
and experience game moments together.
To support discovery and educating moments
family health apps should incorporate design elements that
cater to the range of aspirations that caregivers may have.
Perhaps a wellness app that also supports language and math development
social-emotional skills
and also the passing of
important family values.
In short, these are the key takeaways from our study
To support intrinsic motivation we suggest that researchers and designers
should insert satisfying moments during users'
interactions with health apps.
Bonding, discovery, and educating moments
are moments that can fulfill caregivers' need for relatedness.
And the feeling of missed opportunities shape what is valued during discovery
and educating moments.
We recommend everyone to check out our full paper at
ACM Digital Library.
If you have any questions or feedback
please reach out to us online.
Thank you.