- Monika Imschloss
- Jana Lorenz
Background: Goal setting is among the most common behavioral change techniques employed in contemporary self-tracking apps. For these techniques to be effective, it is relevant to understand how the visual presentation of goal-related outcomes employed in the app design affects users’ responses to their self-tracking outcomes.
Objective: This study examined whether a spatially close (vs distant) presentation of mixed positive and negative self-tracking outcomes from multiple domains (ie, activity, diet) on a digital device’s screen can provide users the opportunity to hedonically edit their self-tracking outcome profile (ie, to view their mixed self-tracking outcomes in the most positive light). Further, this study examined how the opportunity to hedonically edit one’s self-tracking outcome profile relates to users’ future health behavior intentions.
Methods: To assess users’ responses to a spatially close (vs distant) presentation of a mixed-gain (vs mixed-loss) self-tracking outcome profile, a randomized 2×2 between-subjects online experiment with a final sample of 397 participants (mean age 27.4, SD 7.2 years; 71.5%, 284/397 female) was conducted in Germany. The experiment started with a cover story about a fictitious self-tracking app. Thereafter, participants saw one of four manipulated self-tracking outcome profiles. Variables of interest measured were health behavior intentions, compensatory health beliefs, health motivation, and recall of the outcome profile. We analyzed data using chi-square tests (SPSS version 23) and moderated mediation analyses with the PROCESS macro 2.16.1.
Results: Spatial distance facilitated hedonic editing, which was indicated by systematic memory biases in users’ recall of positive and negative self-tracking outcomes. In the case of a mixed-gain outcome profile, a spatially close (vs distant) presentation tended to increase the underestimation of the negative outcome (P=.06). In the case of a mixed-loss outcome profile, a spatially distant (vs close) presentation facilitated the exact recognition of the positive outcome (P=.04). When the presentation of self-tracking outcomes provided the opportunity for hedonic editing, users with a low (vs high) health motivation produced compensatory health beliefs, which led to lower health behavior intentions (index of moderated mediation=0.0352, 95% CI 0.0011-0.0923).
Conclusions: When spatial distance between the presentations of mixed self-tracking outcomes provided the opportunity to hedonically edit one’s self-tracking outcome profile, users recalled their self-tracking outcomes in a more positive light. Especially for users with lower health motivation, the opportunity to hedonically edit one’s mixed self-tracking outcome profile led to reduced health behavior intentions. To prevent the occurrence of hedonic editing in users’ responses to visually presented self-tracking outcome profiles, further research is necessary to determine the ideal distance that should be employed in the app design for the presentation of mixed self-tracking outcomes on a digital device’s screen.
- Crawford K, Lingel J, Karppi T. Our metrics, ourselves: a hundred years of self-tracking from the weight scale to the wrist wearable device. Eur J Cult Stud 2015;18(4-5):479-496. [CrossRef]
- Lupton D. Social Science Research Network. 2014 Aug 21. Self-tracking modes: reflexive self-monitoring and data practices URL: https://papers.ssrn.com/abstract=2483549 [accessed 2017-07-20] [WebCite Cache]
- Oxford Dictionaries. 2017. Definition of self-tracking in English URL: https://en.oxforddictionaries.com/definition/us/self-tracking [accessed 2017-07-24] [WebCite Cache]
- Rabbi M, Pfammatter A, Zhang M, Spring B, Choudhury T. Automated personalized feedback for physical activity and dietary behavior change with mobile phones: a randomized controlled trial on adults. JMIR Mhealth Uhealth 2015;3(2):e42 [FREE Full text] [CrossRef] [Medline]
- Google Play. 2017. Lose It!-Calorie Counter by FitNow, Inc URL: https://play.google.com/store/apps/details?id=com.fitnow.loseit&hl=en [accessed 2017-07-25] [WebCite Cache]
- Google Play. 2017. Calorie Counter-MyFitnessPal by MyFitnessPal Inc URL: https://play.google.com/store/apps/details?id=com.myfitnesspal.android&hl=en [accessed 2017-07-25] [WebCite Cache]
- Conroy DE, Yang CH, Maher JP. Behavior change techniques in top-ranked mobile apps for physical activity. Am J Prev Med 2014;46(6):649-652. [CrossRef] [Medline]
- Dute DJ, Bemelmans WJ, Breda J. Using mobile apps to promote a healthy lifestyle among adolescents and students: a review of the theoretical basis and lessons learned. JMIR Mhealth Uhealth 2016;4(2):e39 [FREE Full text] [CrossRef] [Medline]
- Coughlin SS, Stewart J. Use of consumer wearable devices to promote physical activity: a review of health intervention studies. J Environ Health Sci 2016;2(6) [FREE Full text] [CrossRef] [Medline]
- Direito A, Jiang Y, Whittaker R, Maddison R. Apps for IMproving FITness and increasing physical activity among young people: the AIMFIT pragmatic randomized controlled trial. J Med Internet Res 2015;17(8):e210 [FREE Full text] [CrossRef] [Medline]
- Jakicic JM, Davis KK, Rogers RJ, King WC, Marcus MD, Helsel D, et al. Effect of wearable technology combined with a lifestyle intervention on long-term weight loss: the IDEA randomized clinical trial. JAMA 2016;316(11):1161-1171. [CrossRef] [Medline]
- Recio-Rodriguez JI, Agudo-Conde C, Martin-Cantera C, González-Viejo MN, Fernandez-Alonso MD, Arietaleanizbeaskoa MS, et al. Short-term effectiveness of a mobile phone app for increasing physical activity and adherence to the Mediterranean diet in primary care: a randomized controlled trial (EVIDENT II Study). J Med Internet Res 2016;18(12):e331 [FREE Full text] [CrossRef] [Medline]
- Safran NJ, Madar Z, Shahar DR. The impact of a Web-based app (eBalance) in promoting healthy lifestyles: randomized controlled trial. J Med Internet Res 2015;17(3):e56 [FREE Full text] [CrossRef] [Medline]
- Schoeppe S, Alley S, Van Lippevelde W, Bray NA, Williams SL, Duncan MJ, et al. Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act 2016;13(1):127 [FREE Full text] [CrossRef] [Medline]
- Zhao J, Freeman B, Li M. Can mobile phone apps influence people’s health behavior change? An evidence review. J Med Internet Res 2016;18(11):e287 [FREE Full text] [CrossRef] [Medline]
- Lyons EJ, Lewis ZH, Mayrsohn BG, Rowland JL. Behavior change techniques implemented in electronic lifestyle activity monitors: a systematic content analysis. J Med Internet Res 2014;16(8):e192 [FREE Full text] [CrossRef] [Medline]
- Sullivan AN, Lachman ME. Behavior change with fitness technology in sedentary adults: a review of the evidence for increasing physical activity. Front Public Health 2017;4:289 [FREE Full text] [CrossRef] [Medline]
- Hoj TH, Covey EL, Jones AC, Haines AC, Hall PC, Crookston BT, et al. How do apps work? An analysis of physical activity app users’ perceptions of behavior change mechanisms. JMIR Mhealth Uhealth 2017;5(8):e114 [FREE Full text] [CrossRef] [Medline]
- Sama PR, Eapen ZJ, Weinfurt KP, Shah BR, Schulman KA. An evaluation of mobile health application tools. JMIR Mhealth Uhealth 2014;2(2):e19 [FREE Full text] [CrossRef] [Medline]
- Li I, Dey A, Forlizzi J. A stage-based model of personal informatics systems. In: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems. USA: ACM Presented at: CHI’10; Apr 10-15, 2010; Atlanta, GA p. 557-566. [CrossRef]
- West JH, Hall PC, Arredondo V, Berrett B, Guerra B, Farrell J. Health behavior theories in diet apps. J Consum Health Internet 2013;17(1):10-24. [CrossRef]
- Davis SF, Ellsworth MA, Payne HE, Hall SM, West JH, Nordhagen AL. Health behavior theory in popular calorie counting apps: a content analysis. JMIR mHealth uHealth 2016;4(1):e19 [FREE Full text] [CrossRef] [Medline]
- Thaler R. Mental accounting and consumer choice. Market Sci 1985;4(3):199-214. [CrossRef]
- Thaler R. Mental accounting matters. J Behav Decis Making 1999;12(3):183-206. [3.0.CO;2-F” rel=”noreferrer noopener”>CrossRef]
- Kahneman D, Tversky A. Prospect theory: an analysis of decision under risk. Econometrica 1979;47(2):263-291. [CrossRef]
- Cowley E. The perils of hedonic editing. J Consum Res 2008;35(1):71-84. [CrossRef]
- Thaler RH, Johnson EJ. Gambling with the house money and trying to break even: the effects of prior outcomes on risky choice. Manage Sci 1990;36(6):643-660. [CrossRef]
- Cheema A, Soman D. Malleable mental accounting: the effect of flexibility on the justification of attractive spending and consumption decisions. J Consum Psychol 2006;16(1):33-44. [CrossRef]
- Knäuper B, Rabiau M, Cohen O, Patriciu N. Compensatory health beliefs: scale development and psychometric properties. Psychol Health 2004;19(5):607-624. [CrossRef]
- Hayes AF. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York: Guilford Press; 2013.
- Prelec D, Loewenstein G. The red and the black: mental accounting of savings and debt. Market Sci 1998;17(1):4-28. [CrossRef]
- Rabiau M, Knäuper B, Miquelon P. The eternal quest for optimal balance between maximizing pleasure and minimizing harm: the compensatory health beliefs model. Br J Health Psychol 2006;11(1):139-153. [CrossRef] [Medline]
- Miquelon P, Knäuper B, Vallerand RJ. Motivation and goal attainment. The role of compensatory beliefs. Appetite 2012;58(2):608-615. [CrossRef] [Medline]
- Heath TB, Chatterjee S, France KR. Mental accounting and changes in price: the frame dependence of reference dependence. J Consum Res 1995;22(1):90-97. [CrossRef]
- Linville PW, Fischer GW. Preferences for separating or combining events. J Pers Soc Psychol 1991;60(1):5-23. [Medline]
- Leclerc F, Schmitt BH, Dubé L. Waiting time and decision making: is time like money? J Consum Res 1995;22(1):110-119. [CrossRef]
- Vandelanotte C, Müller AM, Short CE, Hingle M, Nathan N, Williams SL, et al. Past, present, and future of eHealth and mHealth research to improve physical activity and dietary behaviors. J Nutr Educ Behav 2016;48(3):219.e1-228.e1. [CrossRef] [Medline]