Designing a Self-Determination Theory-Based App for a Wellness Behavior Change

Abstract

Chronic diseases and mental health conditions are a costly and rising health concern. According to the Centers for Disease Control and Prevention (CDC), chronic diseases are rapidly growing and are currently the number one cause of death in America (Chronic Diseases in America). In addition, 19.2% of Americans suffer from a mental health illness, according to the National Alliance on Mental Health (“Mental Health By the Numbers | NAMI: National Alliance on Mental Illness”). Many of these diseases are related and can be linked to unhealthy personal behaviors, such as lack of physical activity and poor nutrition (Chronic Diseases in America;“WHO | 2. Background”). Improving these health behaviors could help lower and/or improve many physical and mental conditions. In the last decade, there has been an expansion in health and fitness apps, but that does not translate to improved health behaviors. One concern is there is a lack of regulation and theory implemented in them (Higgins; Herrmann and Kim; Ozdalga et al.). Few apps take the needed step to use behavior change strategies and building self-efficacy and instead only monitor behavior, provide information, and assist with goal setting (Direito et al.; Higgins; Herrmann and Kim; Sullivan and Lachman, Schoeppe et al.). Apps often offer incentive programs that do not show long-term results and are a source of extrinsic motivation (Herrmann and Kim). Rewards and extrinsic motivation can be helpful for starting a program or health change, but intrinsic motivation is needed for behavior maintenance (Pope and Harvey; Sardi et al.). Self-determination theory is a human behavior meta-theory that suggests people become self-determined by three innate needs: autonomy, relatedness, and competence (Ryan and Deci). Building an app around self-determination theory will better promote long-term health changes that the user will be intrinsically motivated to maintain. This thesis proposes a prototype app designed around self-determination theory. Both the user experience and the design of the user interface promote the theory. This is a design-based project intended to explore a way in which the app could be designed. With this approach, the app would have three levels, moving the user towards becoming intrinsically motivated. As the user advances levels, the app assists with and promotes the user’s autonomy, relatedness, and competence. The final level (and goal) of the app should have two effects on the user that work together: assist the user in developing intrinsic motivation to make healthy choices and to discourage reliance on the app to the point of potentially not needing it at all. This will create a long-term change for the user in multiple health and wellness behaviors, which will, in theory, lead to fewer health problems and chronic diseases and a longer, healthier life.