Designing for mHealth — Tailoring

Personalisation is a service curated based on user inputs, for example, Down Dog App. During the sign-up process, it prompted the users to select a goal, identify their preferences on background music, the voice of the meditation facilitator, the duration of meditation, etc. Then, the mHealth providers assign the user a personalised programme according to their input. Instead of auto-assigning the users to the programme, some providers offer options for the users. It allows the users to make a conscious decision on the tracks or programmes they want to. For example, the Fastic app lets the users choose the fasting intervals. Both approaches provide a certain level of tailored experiences to the users. There is not any recognition on which approaches works better. However, it is notable that tailoring content has been shown to positively influence user engagement to the programme and the intervention outcome (Sziney, 2020, Yarley, 2016).

Tailoring Improves Motivations

Wannheden (2021) analysed the satisfaction level of 122 users of digital health tools explored whether the tools (without tailoring/personalisation) satisfy or frustrate the user basic psychological needs of autonomy, competence and relatedness in the area of self-monitoring and communication. The studies found the need to be competent is the most obvious influence; most of the impactful events highlighted by users are competency related: recognising the increased knowledge, understanding about their health conditions, effectiveness in completing tasks required, and performing the expected behaviours.

The survey also indicated tension between positive and negative experiences across the three needs, indicating there are individual variations in responding to the delivery of the programme. In responding to the observation, a tailored programme will reduce frustration and increase the satisfaction of the user basic psychological needs in making behaviour change.

Adopting the self-determination theory of motivation to mHealth design, the providers could offer tailored programmes to assist the users in making positive health decisions by increasing their competency, relatedness and autonomy to perform the new behaviour.

Some areas to provide tailoring based on the target users:

(1) Accessibility.

Apart from UI accessibility, it is important to consider the accessibility of the information of the target users. Users with low educational backgrounds and health literacy were found to have a lower engagement rate than the users with better health literacy. This observation highlighted the importance of tailored content. Suggestions:

• Providing micro-copy
• Visualisation
• Use plain and easy understand language

(2) Adaptive intervention.

As the users move along with the programme, a curated programme helps to provide the user safe, relevant and appropriate guidance according to the individual needs and status change. Suggestions:

• Well-design reminders
• Equip with self-monitoring features

Note: This is an exploratory piece to enable the digital health product owners and health programme creators some insights on product design during early-stage MVP.

Szinay D, Jones A, Chadborn T, Brown J, Naughton F. Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review
J Med Internet Res 2020;22(5):e17572

Wannheden C, Stenfors T, Stenling A and von Thiele Schwarz U (2021) Satisfied or Frustrated? A Qualitative Analysis of Need Satisfying and Need Frustrating Experiences of Engaging With Digital Health Technology in Chronic Care. Front. Public Health 8:623773. doi:10.3389/fpubh.2020.623773

Yardley, L., Spring, B. J., Riper, H., Morrison, L. G., Crane, D. H., Curtis, K., … Blandford, A. (2016). Understanding and Promoting Effective Engagement With Digital Behavior Change Interventions. American Journal of Preventive Medicine, 51(5), 833–842. doi:10.1016/j.amepre.2016.06.015