Adolescent Self-Reflection Process Through Self-Recording on Multiple Health Metrics: Qualitative Study

Self-recording is an effective behavior change technology that has long been used in diverse health contexts. Recent technological advancements have broadened its applications. While previous studies have explored its role and benefits in enhancing self-awareness and informed decision-making, relatively little attention has been given to its potential to address the multidimensional nature of health with various health metrics.

This study investigates the process of self-recording in adolescent health, recognizing the connections between lifestyle behaviors and mental health. Specifically, we aim to incorporate both behavioral and emotional health metrics into the self-recording process. Grounded in self-regulation theory, we explore how adolescents record lifestyle behaviors and emotions, and how they inform and implement health management strategies.

We conducted a qualitative study using the grounded theory methodology. Data were collected through individual semistructured interviews with 17 adolescents, who recorded their emotions and behaviors over 4 weeks using a prototype application. Analysis followed iterative phases of coding, constant comparison, and theme saturation. This process revealed how adolescents engage in self-recording for behaviors and emotions, as well as their failures and potential system support strategies. We further examined the relevance of the identified themes to theoretical constructs in self-regulation theory.

Under self-regulation theory, we gained insights into how adolescents manage their health through self-recording. The findings suggested variability in the self-recording process, in relation to specific health metrics of lifestyle behaviors and emotions. Adolescents focused on evaluating behaviors for management purposes while exploring the causes underlying emotional experiences. Throughout the health management, which involved modifying behavior or distancing from triggering factors, they monitored progress and outcomes, demonstrating a self-experimental approach. Uncertainty emerged as a barrier throughout the self-regulation process, suggesting that self-recording systems for adolescents should prioritize strategies to address these uncertainties. In addition, the self-recording system demonstrated interventional effects in aiding future planning and fostering a sense of relatedness among users.

This study offers a theoretical framework for adolescents' self-recording process on diverse health metrics. By integrating self-regulation theory, we suggest a stepwise process from recording lifestyle behaviors and emotions to health management behaviors. Through exploring potential features and health-supportive effects, our findings contribute to the development of digital self-recording systems that address various health metrics in adolescent health.