A Systematic and Comparative Review of Behavior Change Strategies in Stress Management Apps: Opportunities for Improvement.

Mona Alhasani,Oladapo Oyebode,Dinesh Mulchandani,Nilufar Baghaei,Rita Orji

doi:10.3389/fpubh.2022.777567

Mona Alhasani, Oladapo Oyebode + Show 3 more

Open Access

https://doi.org/10.3389/fpubh.2022.777567

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Abstract

Stress is one of the significant triggers of several physiological and psychological illnesses. Mobile health apps have been used to deliver various stress management interventions and coping strategies over the years. However, little work exists on persuasive strategies employed in stress management apps to promote behavior change. To address this gap, we review 150 stress management apps on both Google Play and Apple's App Store in three stages. First, we deconstruct and compare the persuasive/behavior change strategies operationalized in the apps using the Persuasive Systems Design (PSD) framework and Cialdini's Principles of Persuasion. Our results show that the most frequently employed strategies are personalization, followed by self-monitoring, and trustworthiness, while social support strategies such as competition, cooperation and social comparison are the least employed. Second, we compare our findings within the stress management domain with those from other mental health domains to uncover further insights. Finally, we reflect on our findings and offer eight design recommendations to improve the effectiveness of stress management apps and foster future research.

Highlights

Stress is a common and continuous phenomenon that poses mild to serious physical and mental health risks to individuals [1]
Our findings showed that primary task support strategies of the Persuasive Systems Design (PSD) model are the most commonly employed in the reviewed apps, followed by system credibility support, dialogue support strategies, and the CPP strategies
Our results showed that trustworthiness strategy (39%) is the most implemented strategy followed by real-world feel (38% of the coded apps) and expertise (26% of the coded apps) in the system credibility support category of the PSD framework

Summary

Introduction

Stress is a common and continuous phenomenon that poses mild to serious physical and mental health risks to individuals [1]. The mental health consequences of stress (e.g., anxiety, depression, panic attacks, sleep disorders, Persuasive Strategies in Stress Management Apps and low cognitive performance) have been documented [18,19,20,21,22]. Oinas-Kukkonen et al defined persuasive systems as “computerized software or information systems designed to reinforce, change or shape attitudes or behaviors or both without using coercion or deception” [61]. The PSD framework builds upon the FBM to describe how to inject persuasive features that motivate behavior change into systems during the design process.

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