Context matters: personalizing behavior change strategies toward motivating older adults to be more physically active

As we age, we tend to become less active which exasperates the severity of a variety of chronic conditions increasing our need for care. Physical activity has many proven benefits for older adults including supporting independence, decreasing the symptoms of frailty and supporting an overall feeling of wellbeing. There is a clear need to create behavior change (BC) solutions to motivate older adults to engage in a healthy amount of physical activity not just to alleviate the pressure on Europe’s healthcare system but more importantly to support their happiness and wellbeing.
Though behavior change is a well-studied field of research, limited work has focused on designing personalized behavior change technologies for older adults. It is therefore unclear how to profile older adults in order to inform the use of behavior change strategies to motivate increased physical activity. This lack of focus is due, in part, to barriers that exist preventing an important subset of older adults to engage in research towards the development of new technologies. Consequently, there are two important research questions to address here:
RQ1: How can we effectively personalize behavior change solutions for older adults to motivate increased physical activity towards a healthier lifestyle?
RQ2: How can we overcome the barriers to engage older adults in research related to technology development?
Method. We carried out a general research process consisting of exploring, designing and evaluating to address our research questions. During the exploration phase we conducted two studies. The first aimed to better understand which behavior change strategies might be promising for older adults. The second study was a field study to gain a better understanding of the barriers that older adults face to research participation using both cultural and technological probes. In the design phase we built a system to engage older adults in research and created two mobile applications aimed at motivating increased physical activity. In our final study we evaluated the effect of the two mobile applications had on participant’s physical activity and whether the system we created supported research engagement in an in-context research towards behavior change technology development.
Results. In the first study of our exploration phase, we analyzed the outcomes of twelve iterative user focused design processes by student teams and found that ‘self-awareness’ and ‘social fitness’ were the two most common strategies used to motivate increased physical activity among older adults (Valk et al. 2017). In the second study, we were able to identify barriers and facilitators to technology acceptance by taking a critical theoretical reflection of data collected from 44 community-dwelling older adults using a commercially available wearable activity tracker over a period of three months (Valk et al. 2018). Based on these results, we proposed a set of codesign strategies to address technology acceptance among older adults to be used in the design of future wearable tracking technologies (Valk et al. 2018). These strategies were used in our design phase to create a specific product-service-system to support older adults to engage in an in-context behavior change research (Valk et al. 2019). Also, in the design phase, we created two mobile applications, through a codesign process with older adults, which implemented the behavior change strategies identified in the first study. During our evaluation phase we used the product-service-system we created to enable the nine-week randomized controlled trial (N=53) in-context evaluation of the two mobile applications (Valk et al. 2019). Based on the statistical analysis of the measured step data and the collected questionnaire data, we suggested how to create effective motivational profiles to personalize these behavior change strategies toward increased physical activity for older users.
Contribution. To address our first research question, we propose a way of creating motivational profiles linked to behavior change strategies. To address our second research question, we provide design criteria for the setup and execution of design research to overcome the barriers to research participation. Here we establish the importance of inclusivity in both the final design solution and in the design process, so that even initially nontechnology savvy older people can benefit from technologies potential to motivate healthy behavior change.