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Leveraging Self-Affirmation to Improve Behavior Change: A Mobile Health App Experiment.

Aaron Springer^1,2, Anusha Venkatakrishnan¹, Shiwali Mohan¹

¹Palo Alto Research Center, Palo Alto, CA, United States.

JMIR Mhealth and Uhealth

|July 21, 2018

Summary

Self-affirmation exercises improved adherence to mobile health (mHealth) goals for healthy eating. However, this did not reduce participant attrition from the mHealth intervention.

Keywords:

adherence attrition behavior change health behavior mHealth self-affirmation telemedicine treatment adherence and compliance

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Area of Science:

Behavioral Science
Health Technology
Psychology

Background:

Mobile health (mHealth) interventions show promise for improving well-being but suffer from low adherence and high attrition.
Self-affirmation exercises can enhance positive behaviors, but traditional essay-based formats are unsuitable for mobile platforms.

Purpose of the Study:

To adapt self-affirmation exercises for mobile app delivery targeting healthy eating behaviors.
To evaluate the impact of varying self-affirmation doses on adherence to behavior change goals over time.

Main Methods:

A 2x2 factorial design was used to assess the effects of initial and ongoing self-affirmation exercises in an mHealth app over 28 days.
Adherence, attrition rates, and a model for self-affirmation behavior change were analyzed.

Main Results:

Higher doses of self-affirmation significantly improved adherence to mHealth intervention goals (P=.04).
Increased adherence did not correlate with reduced participant attrition (P range .61-.96).
A model of intention was developed (R²=.39, P<.001), but self-affirmation did not directly influence final intentions.

Conclusions:

Self-affirmations effectively boost adherence to healthy eating goals within mHealth apps.
The adapted, mobile-friendly self-affirmation exercises are simple, low-cost, and suitable for integration into various mHealth applications.
Further research should explore the effectiveness of these exercises in diverse behavioral contexts.