In the frame of FitCity, I presented a seminar on the most common design strategies for behavioural change toward an active lifestyle. These design strategies are based on classic psychological theories, such as Goal-Setting theory , Transtheoretical Model of Behavior Change, Presentation of Self in Everyday Life, Cognitive Dissonance. In the seminar, I also reviewed some relevant studies that employed persuasive strategies through artefacts and technology for fostering an active lifestyle.

1. Theory-based design strategies
& lessons learned from previous studies

2. Theory-Driven Design Strategies for Technologies that
Support Behavior Change in Everyday Life
(Consolvo, McDonald, & Landay, 2009)
 Design strategies based on psychological, social and
cognitive theories, previous studies and other
persuasive technologies
 People want to be fit, but still: physical inactivity and
poor eating habits
 Psychological theories can be used to design
technologies to promote an active life
 Technologies should
 be persuasive, effective, without being invasive;
 support behavioral change AND fundamental social
needs

3. Goal-Setting theory (see later)
 how people respond to different types of goals and
which is more motivating.
 The goal must be:
 important to the user
 decided by the user (or with the help of an expert), not
assigned without rationale
 challenging but realistically achievable
 it should be easy to monitor the progresses toward the
goal
 feedbacks and incentives must be provided as progress is
made (and not solely at goal achievement)

4. Transtheoretical Model of Behavior Change
 5 stages in the intentional modification of behavior
 precontemplation: no
intention to change.
 contemplation: seriously
considering changing, but no
action and no commitment
yet.
 preparation: intention to take
actions in the next months
but no successful action in
the past year.
 action: has performed the
behavior consistently for less
than six months.
 maintenance: has performed
the behavior consistently for
more than six months.
Persuasive action
education
overcoming barriers +
rewards
rewards (even when the behavior is
inconsistent) + increasing
awareness of behavioral patterns
to encourage consistency
keeping track of progresses to
maintain consistency + social
influencecoping strategies for problems +
awareness: “I'm becoming the kind
of person I want to be”
Stage

5. Presentation of Self in Everyday Life
 Novel application to persuasive technology
 Daily social interactions, and how individuals attempt
to manage the impressions they want others to have
of them: Theatre metaphor
 The individual
performs for an
audience
Backstage: no
audience
allowed –
secret
consumption

6. Presentation of Self in Everyday Life
 In the front stage: In the backstage:
secret consumption
(need to conceal these behaviors)

7. Presentation of Self in Everyday Life:
Implications for technology
 Support impression management needs:
 the user must be able to control the information we collect
(e.g. what to share, with whom); to disguise something; to
misrepresent something, for example to support secret
consumption
 technology aiming at representing the “perfect
information” (i.e. weight, height, scores of the initial test
as well as every activity session in detail, km run,
speed, etc.) do not support individuals' needs to control
the backstage
 enable the user to perform differently for different
audiences (or the user will perceive a privacy violation;
e.g. Google+)

8. Cognitive Dissonance Theory
 Novel application to persuasive technology
 what happens when behaviors and attitudes are
inconsistent
 An individual realizes that:
attitudes behavior
inconsistent
Cognitive
dissonance
(psychologically
uncomfortable)

9. Cognitive Dissonance Theory
 She will try to reduce the dissonance. How?
 Change behavior: healthy lifestyle  “I will train more”
 Change knowledge (attitude): stop believing that I should
have a healthier lifestyle  “I’m not that fat/sedentary”
 Reduce the importance of the dissonance: seeking
information about worse things, avoiding
information/situations which could reinforce the
dissonance  “having diabetes is worse”, avoid gyms,
not going to the beach

10. Cognitive Dissonance Theory:
Implications for technology
 Change behavior (“I will train more):
 Address the factors preventing the individual to change
 Help to remain focused
 Awareness system should be persistently available and
easy to access but also subtle  to support occasional
needs for information/situation avoidance.
 Change knowledge (“I’m not that inactive”):
 Awareness
 Reduce the importance of the dissonance (“having
diabetes is worse”):
 Education, information, examples

11. Strategies used in recent persuasive
technology research
 Breakaway: to encourage users to take a break while working.
 It provides peripheral awareness. Participants appreciate the
possibility to ignore it in busy times.
 Abstract: the feedback is given in the form of abstract information, not
raw sensor data collected from the user
 Non-intrusive: the data are available all the time
 Public: data are presented in an appropriate way to be presented in
public),
 Aesthetic: the device should be interesting over time

12. Strategies used in recent persuasive
technology research
 Fish'nSteps: to make users taking more steps.
 step count affects:
 growth of the fish (more steps, larger fish),
 facial expression (happy for sufficient, angry for near-sufficient, sad
for insufficient),
 water (clean for sufficient, murky with no decoration for insufficient).
 Motivated participants increased their daily step count. But:
they ignored the display when they had an insufficient step
count (bad decision to use punishment).

13. Strategies used in recent persuasive
technology research
 Houston: to make users taking more steps.
 Users share step count and performance
 Add notes, send messages and see trending
information
 Receive congratulations and stars (*) when
they achieve goal
 Most participants increased awareness
 But: they complained that the pedometer
did not register other activities (e.g. cycling,
etc.): they pointed out that receiving credit
for all activities is critical.

14. New design strategies based on theories and
previous studies
1. Abstract & reflective
2. Unobtrusive
3. Public
4. Aesthetic
5. Positive
6. Controllable
7. Trending & historical
8. Comprehensive

15. 1. Abstract & reflective
 People in their social relationships need to conceal
something, sometimes (Presentation of Self theory).
 Abstract data are flexible. Flexibility and ambiguity
allow people to create different interpretations of the
data, to disguise and manage them
 Both Breakaway and Fish'nSteps use abstract
information.

16. 2. Unobtrusive
 Data should be available to the user, but without
interrupting or calling her attention.
 Apps for mobile phones are appropriate.
 Technology should support the occasional need to
ignore the dissonance (Cognitive Dissonance Theory
- see the user's comments in the Breakaway study)

17. 3. Public
 The data (personal) should be presented in an
appropriate way to be shown in public.
 The user should be comfortable with the fact that
others will see it  never make the user feel
uncomfortable
 In Breakaway the sculpture was public but did not
draw unwanted attention to the user (thanks to data
abstraction)
 In Houston the technology was on mobile phones,
and users were discrete in its use

18. 4. Aesthetic
 The technology should be inquisitive, comfortable,
attractive and maintain attention.
 The aesthetic aspect deals with the front stage
(Presentation of Self) and should reflect the user's
personal style  provide different displays for
males/females?
 It should convey credibility: people judge the
credibility of an object on the basis of some surface
features (B. J. Fogg)
 In Fish'nSteps users where satisfied with the aspect
of the happy fish (when they walked enough), and at
the same time complained about the ugliness of the
pedometer

19. 5. Positive
 Positive reinforcement and rewards
 When the user does not perform the behavior: nor
rewards or punishments, but her interest should be
sustained.
 In the long-periods the user could get sick or injured,
need a break or secret consumption:
 sustain the user's interest without making her feeling bad
 Houston: stars (*) and congratulations as rewards;
 Fish'nSteps: happy fish, tank decoratins, clean water.
Users appreciated the rewards (motivating). The use of
punishment (Fish'nSteps angry fish, murky water,
removal of decorations) resulted in system abandonment

20. 6. Controllable
 Controllability over data overcomes the problem
inaccurate data and respects users social needs
 Always able to decide what to share and with whom, to
modify the data (add, delete, edit, manipulate), both
when the information is manually entered or
automatically detected.
 Automatic detection of data: inaccuracy is particularly
problematic and leads to loss of credibility (failure of
technology):
 users will be upset when they are not given credit for
something they did (e.g. Houston participants complained
about missed steps → important to include all possible
activities) → system abandonment
 users will be frustrated when they receive credit for something
they did not do (e.g. based on the technology feedback they
should have lost weight but they haven't

21. 7. Trending & historical
 Information about patterns of behaviors in relation to the user's
goals.
 The presentation of data should be accommodated as the
goals change, and support portability across devices.
 The user usually don't focus on patterns of behaviors, but on
single decisions
 Awareness on patterns of behaviors
 Information/situation avoidance (Cognitive Dissonance
Theory) is more difficult if the user reflects on her past
behavior in relation to her goal

22. 8. Comprehensive
 Account for a wide range of healthy behaviors (→ as
many activities as possible + letting users add their
own activities, e.g. housework).
 In Houston and Fish'nSteps: only walking
(pedometer)
 Participants complained and were discouraged to do
other activities  This resulted in users doing less
healthy activities (e.g. they did not run, just walk).
 For contemplators, preparators and action stagers
(Transtheoretical Model) this kills motivation,
inhibiting progress and reverting users to a previous
stage.

23. UbiFit Garden System
Small butterflies, big butterfly, different
flowers

24. UbiFit Garden System: Demographics
 28 participants for 3 months
 15 females, general public, 25-54 years old
 17 participants were employed full-time, 8 part-time, 2
homemakers, 1 full-time student
 a range of occupations:
 real estate agent, personal care assistant, public relations
specialist, retail manager, psychologist, event laborer,
project manager, human resources specialist, teacher,
business developer, and comedian
 education:
 4 college, 19 bachelor, 1 course work at master, 3 master
degree, 1 phd
 12 normal weight, 9 overweight, 7 obese

25. UbiFit Garden System
1. Abstract & reflective: the garden is a methaphor; frequent reflections;
feedback at a glance.
2. Unobtrusive: the garden is on the mobile phone wallpaper
3. Public: If someone unintentionally sees the wallpaper she could explain it
in several ways.
4. Aesthetic (not for males…)
5. Positive: rewards are flowers and butterflies; flowers don't die; Every week
the user starts over with an empty garden, so even if she was not active
the previous week she can concentrate of the current week.
6. Controllable: the user can always add comments, add, delete, modify
activities both when they are manually or automatically entered.
7. Trending & historical: through weekly patterns there are feedbacks up to a
month; the interactive app goes far back in the past (no website here)
8. Comprehensive: the MSP (Mobile Sensing Platforms) records walking,
running, cycling, elliptical and stair machine; activities that are not
registered can be manually entered by the users.

26. UbiFit Garden System
 Experimental conditions
 Interactive application + accelerometer (no garden)
 Interactive application + display (no msp)
 Full system
 Goal setting
 Weekly goal
 At least 1 session cardio 10 min, walking 10 min, strength
or fexibility
 <n° sessions> <activity> <minimum duration> per week
 2 cardio sessions > 30 min/session
 4 walking sessions > 15 min/session
 3 flexibility sessions (no min duration)

27. UbiFit Garden System: Lessons learned
(Klasnja, Consolvo, McDonald, Landay, & Pratt, 2009)
 Supportare nel tempo l'attivazione cognitiva degli
obiettivi  persistent visual
 Differenza significativa fra chi aveva il display e chi
no:
 chi aveva il display (condizioni “no msp” e “full system”)
ha mantenuto l'attività fisica nei 3 mesi nonostante
l'inverno.
 Chi non aveva il display ha diminuito l'attività fisica.
 Future directions: il display di Ubifit ricorda
costantemente l'impegno a fare attività fisica e allo
stesso tempo fornisce feedback sui risultati. In futuro
+ >

28. UbiFit Garden System: Lessons learned
 Incoraggiare un ampio range di comportamenti salutari
 includere quante più attività possibili, altrimenti
rischio che l'utente si focalizzi solo sulle attività
supportate dal sistema tralasciandone altre
importanti
 es. il pedometro è frustrante (es. “my main source of exercise
[rock climbing] doesn’t register”).
 Se il sistema non considera certi tipi di attività, molti partecipanti
semplicemente scelgono di non farla (the pedometer did not “care
whether you went up and down hills or whether you walk on flats,
so why kill yourself?”).
 In UbiFit gli utenti registrano tutte le loro attività: 26 tipi di attività
cardiovascolari (including skiing, cardio classes, dancing,
swimming, and ice skating.)

29. UbiFit Garden System: Lessons learned
 InUbiFit users did 1853 activities (almost every day)
 only 35-40% of them were automatically detected by the
MSP
 All the others were manually entered by users, who
recorded a broad range of activities (e.g. 26 types of
cardio activities alone).
 So, no one refrained from doing an activity because it was
not tracked by the system.

30. UbiFit Garden System: Lessons learned
 Puntare su pattern di attività a lungo termine  rappresentare nel
display il progresso su obiettivi settimanali o mensili
 Le persone tendono a focalizzarsi su singole decisioni e non sui
pattern
 E' necessario rappresentare nel display il progresso su obiettivi
settimanali o mensili per permettere alle persone di focalizzarsi su
pattern di comportamenti
 es. “quanto mi sono allenato questa settimana e quanto mi manca per
raggiungere l'obiettivo?”
 e non sulle singole sessioni di allenamento “devo fare movimento oggi?”
 In questo modo non ci si scoraggia dopo un paio di giorni di sedentarietà
perché si può ancora recuperare.
 Vedere i progressi sulla settimana aumenta la consapevolezza della propria
inattività, cosa che di solito sorprende.

31. UbiFit Garden System: Lessons learned
 Future directions:
 aumentare la consapevolezza dei propri pattern di
comportamento
 e dei fattori che li influenzano
 Es. fornire analisi di correlazione tra pattern di attività fisica e
specifiche situazioni
 giorno lavorativo/feriale, fasce orarie, quando si va all'università / al
lavoro / si resta a casa a studiare;
 quando nelle vicinanze ci sono amici o piste ciclabili;
 che tipo di attività fisica si predilige;
 il passo successivo potrebbe essere dare consigli mirati
sulla base di questi dati

32. UbiFit Garden System: Lessons learned
 Utilizzare il supporto sociale come incentivo
opzionale, non primario  il supporto sociale non
va usato come incentivo primario, va data la
possibilità di scegliere cosa, come, quanto
condividere e con chi.
 arma a doppio taglio: funziona e aumenta la
motivazione quando i partecipanti sono già attivi e
motivati, ma è controproducente quando sono poco
attivi e se percepiscono troppa competizione.
 Houston: i partecipanti potevano decidere quando e cosa
condividere, e lo facevano quando erano attivi e motivati,
altrimenti non si sentivano a proprio agio

33. Goal-setting considerations for persuasive
technologies that encourage physical activity
Consolvo, Klasnja, McDonald, & Landay, 2009
 How people respond to different types of goals and
how to set them to motivate them
 The goal should be difficult & specific
(unambiguous):
 people give the highest effort and reach the highest
performance for specific, difficult goals.
 too general goals (“do your best”) have too many levels of
acceptable performance and it is difficult to say if the goal
was reached → the goal should be specific
(unambiguous) and difficult.
 FitCity: the goal assigned now in UniFit is quite
ambiguous

34. Goal-setting considerations for persuasive
technologies that encourage physical activity
 Commitment: 2 factors
 Importance of the goal: how to increase it?
 Public commitment (e.g. share online)
 Incentive: throughout the whole process, not only at goal achievement.
 Feedback on single activities in relation to the overall goal.
 Increase the importance of the cognitive dissonance providing
information (on benefits of healthy lifestyle)
 Increase awareness (e.g. WiiFit age?)
 Self-efficacy: the individual must believe she can reach the goal
 Overcome barriers (e.g. lack of time, children, workload; tips to organize
better)

35. Goal sources: who sets the goal?
Interviews after UbiFit
 Assigned: significantly lower
performance
 By national recommendations, fitness
expert, medical expert
 Group-set (not preferred; users with
similar abilities/goals)
 Strangers (slightly preferred)
 Social network, friends/family
 Pros: accountability & motivation (for
difficult weeks)
 Cons: when exercise is not a priority (work
deadlines, illness); don’t like the
responsibility

36. Goal sources: who sets the goal?
Interviews after UbiFit
 Self-set (preferred)
 Self-efficacy
 When preferred it was because of the cost of a personal trainer
 Participatory (preferred)
 Fitness expert (*) or medical expert (not preferred)
 Guided (preferred)
 Fitness expert (*) or medical expert
 Self-efficacy, accountability, motivation
 Possible to modify the goal without notifying the trainer?
 Keep the trainer goal as primary and define an alternate
secondary goal
 Important on-going relationship with the trainer

37. Goal sources: who sets the goal?
Interviews after UbiFit
 However: not enough literature to support a type of goal
source as most effective
 Past studies only found that setting goals leads to better
performances than not to

38. Goal timeframes: time periods to each the goal
Interviews after UbiFit
 UbiFit: weekly goals (national recommendations). Options:
 Rolling week: 7-days timeframe showing the user's last 7 days
which never resets
 for users who tended to be more active at the end of the week
 Fixed calendar: the goal resets at the end of the week, with a
fixed start day
 Customizable week (preferred): the goal resets at the end of the
week, but the user decides when the week starts. Preferred
days: Monday (1st) & Sunday (2nd)
 Users liked having a deadline and a fresh start every week

39. Goal-Setting strategies applied
What has been done
 Houston: small groups of women from pre-existing
social networks shared step count and progress
toward a daily goal via mobile phone.
 Goal was assigned (derived from the step count detected
during a baseline period)
 Fish'nSteps: weekly goal assigned (derived from a
baseline period), which became progressively more
challenging (exponential function)

40. Goal-Setting strategies applied
What has been done
 Gasser et al., 2006: every participant has the same
daily assigned goal:
 “to earn at least 7 lifestyle points”. Each point: 10 min
activity or by eating one serving of fruit or vegetables.
 At least 4 points must come from fruit/vegetables.
 Bickmore et al., 2005: daily
participatory goal (on step
count) negotiated with the
virtual agent Laura.
 The goal takes into account
the current's day step count
and the step count history

41. So far, goal design strategies: FitCity
 Goal defined in a participatory/guided way
 with the fitness expert (real or virtual)  with this regard,
the possibility to leverage fitness experts knowledge
designing a virtual guide sounds particularly promising
 Overall long-term goal (to be reached by the re-test):
e.g. to reach the sufficient level in every physical test
 At the beginning:
 user provide information about motivation, time
commitment, constraints (e.g. exam session, work
deadlines, vacation periods, specific busy days)
 Workplan made of weekly goals
 defined on the basis of the overall long-term goal & user's
information

42. So far, goal design strategies: FitCity
 Weekly goals adjusted in progress
 on the basis of user's information (e.g. work deadlines,
illness)
 reduce the workload accordingly, without letting the user
deliberately ignoring the technology (cognitive
dissonance)
 Default weekly timeframe: calendar week starting on
Monday
 with the option to change the start date,
 and to switch to a rolling 7-days window
 On “public commitment”: it increases users'
motivations.
 Sharing options: take into account possible undesirable
effects (shame, excessive competition) leading to system

43. The Social fMRI: Measuring, Understanding, and
Designing Social Mechanisms in the Real World
(Aharony, Pan, Ip, Khayal, & Pentland, 2011)
 130 persone
 di proposito < numero di Dunbar
 “Friends & Family”: a residential community made of 400
young couples with friendship ties (each one with at least
1 member affiliated to the university; nearly 200 have
children).
 Attività fisica non meglio specificata (misurata con
accelerometro che rileva l'attività per 15 sec ogni 2
min)

44. The Social fMRI
 3 condizioni:
 control: fino a 5$ in base alla
propria attività
 peer-view: A vede i
progressi di 2 compagni (B e
C) dello stesso gruppo (i
progressi di A sono visti da D
e E) + compenso fino a 5$ in
base alla propria attività
 peer-reward: il compenso di
A è fino a 2,5$ per ogni
compagno B e C
 NB: il compenso minimo è
0.5$ per evitare
scoraggiamento.
A
B
C
D
E
solo A può guadagnare dall'attività di B o
viceversa, ma non entrambi

45. The Social fMRI
 Triadi:
 Amici
 Sconosciuti
 A + 1 amico + 1
sconosciuto
A
B
C
D
E

46. The Social fMRI: Risultati
 In generale, “peer-reward” > “peer-view” > “control”,
ma dipende da come sono formate le triadi:
 amici: “peer-reward” è doppiamente efficace di “peer-
view”
 sconosciuti: “peer-reward” > “peer-view”
 misti: “peer-view” > “peer-reward”
 Quindi:
 l'intensità del legame sociale influenza la performance
 sembra che mentre le performance di “control” e “peer-
view” diminuiscano nel tempo, quella di “peer-reward”
cresca più lentamente all'inizio ma si mantenga nel tempo

47.  69 overweight and obese people in their late 50s
 12 group sessions over 6 months focusing on
nutrition, exercise and behavioral changes
 Half received a personal digital assistant (PDA) to
record food intake and activity (mobile group). They
also had a coach who checked in with them by
phone after the first month to set personalized
weight loss goals
 Mobile technology, in combination with an existing
system of care and telephone coaching, led to more
short-term weight loss than a typical weight loss
program alone.
Does It Actually Work? Study Shows Mobile Technology
Enhances Weight Loss
http://www.medgadget.com/2012/12/does-it-actually-work-study-shows-mobile-technology-enhances-weight-loss.html

48.  Mobile technology, in
combination with telephone
coaching (?), led to more short-
term weight loss than a typical
weight loss program alone
 after 6 months the mobile group
had lost on average 3.9 kg more
than the standard treatment
group.
 41% of the mobile group had
met the goal of losing at least
5%of their initial body weight,
compared to 11% in the
conventional group
 the mobile group lost weight in a
shorter time-frame
Does It Actually Work? Study Shows Mobile
Technology Enhances Weight Loss