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Integrating Behavioral Trigger Messages into a mHealth System Design for Chronic Disease Management

Author: Scott Sittig, MHI, RHIA (2017)

Primary advisor: Amy Franklin, PhD

Committee members: Sahiti Myneni, PhD, MSE, Sriram Iyengar, PhD, Jing Wang, PhD, MPH, RN

PhD thesis, The University of Texas School of Health Information Sciences at Houston.


Recent changes in health information technology have dramatically altered the face, delivery, and management of healthcare particularly as it relates to mHealth. With increases in smart phone ownership, mHealth potentially has the ability to provide far-reaching transformation of chronic disease management particularly when aligned with behavioral change theories and persuasive technology. MHealth applications have an advantage over computers and various print communications as the consumer can engage with the application at any time and at any location. The Interactive Health Communication Application (IHCA) states that by combining support mechanisms such as behavior change theories into electronic devices as a method to transmit or receive health information can potentially lead to changes in knowledge, motivation and self-efficacy. Adding constructs of the Fogg Behavior Model, Social Cognitive Theory and Persuasive Technology to the IHCA framework can create an engaged persuasive system leading to improvements in self-efficacy, self-management and knowledge. The hypotheses for our study are 1) participants will demonstrate improved scores on self-efficacy, knowledge and self-management following the intervention period, 2) participants will be more engaged in the usage of capABILITY following behavioral triggers, and 3) participants who receive spark triggers involving motivation will engage in the utilization of capABILITY faster than those who receive facilitator triggers.

The results of this study provide important findings for 1) mHealth system design utilizing IHCA with new constructs for chronic disease management, 2) design and develop of persuasive spark and facilitator trigger messages, and 3) understanding of user engagement when behavioral (spark and facilitator) trigger messages are utilized. The findings of the study revealed that self-efficacy, self-management, and knowledge did improve post intervention. In addition, the study showed that spark triggers continually cued participants to engage with capABILITY quicker than facilitator triggers.