mobile technology as a channel for health

interventions

Case Study: SMS triggering of deep breathing stress reduction habit in Stanford undergraduates.

By Shuqiao Songhabits.stanford.edu

About Me

Human Biology | Designing for Behavior Change

Communication | Communication Technologies

Health + Technology + Design

Why think about stress reduction?

Because of this…

Mental Health: Managing Stress…

What to do?

Smallest Behavior That Matters

Deep Breathing

How to persuade students to develop habit of deep breathing?

A Model for Behavior Change

www.behaviormodel.org

Motivation + Ability + TRIGGERS = Behavior

Change

…use SMS for triggering?!

Current ResearchStill relatively new…But, evidence shows that SMS

interventions can work well. (Cole-Lewis & Kershaw) ◦Mostly for disease management.

Need more research and innovation using SMS for disease prevention behaviors!

Let’s try this out!

Ideal User Experience

Shotgun User Testing

10 busy students. 7 days. SMS. And, deep breaths.

So, what happened?

10 created accounts.7 responded to post-survey.5 were able to post-intervention

stress assessment.

Uh Oh…Some users having difficulty

using the program early on.…iterate, use Google Voice to

text message personal reminders to them

Did it work?In doing the behavior:

◦3 users took a deep breath each time they received the reminder!

◦Overall, 67% rate of success in triggering behavior.

In reducing stress:◦Pre and Post stress assessment survey

(scale 1-48)◦On average, participants decreased

stress level by 2 points…during FINALS week!

Some important findings though…

Mismatch in Expectation of EffortMost thought this would be simpleFor some it was extremely

difficult and their participation became a source of anxiety!

“It was stressful to sign up for the experiment”

Why?

Interface Confusion◦Perception of Difficulty was very

varible 4 users thought scheduling SMS was

extremely difficult or did not schedule; 3 thought it was easy

But the idea has potential!“I had received the messages during

finals week and it was sort of a uplifting moment for some reason. I'm not sure why. It's just not many people tell you personally ( in person or through YOUR cellphone not just a generalized email) to relax.”

“[Felt] cared for.”“The reminders were cheerful. […] I

liked them more because they came from someone I knew, a friend.”

So focus onReducing Effort on their Part Personal Touch—from a friend as

a light hearted and caring reminder, not a stress inducing reminder

Use mobile tech as a rapid prototyping tool!Best part of intervention was the

rapid iteration of the project idea to use Google Voice text message!

Other features to explore:◦MMS, voice calling, Internet

connectivity

The potential of mHealth◦Personal, portable, connected,

intelligent (Adler)◦Widely available, inexpensive, and

instant (Cole-Lewis & Kershaw)

Use those features for…◦Trigger◦Social Support◦Reinforcement/Feedback

Tech Tools with PotentialJITSRViveCoachFrontline SMSGoogle Voice

Take Home PointsKeep it simple! Make the trigger source personal!

Thank you!