Abstract

The majority of digital health interventions lean on the promise of bringing health and self-care into people’s homes and hands. However, these interventions are delivered while people are in their triggering environments, which places competing demands on their attention. Individuals struggling to change or learn a new behavior have to work hard to achieve even a minor change because of the automatic forces propelling them back to their habitual behaviors. We posit that effort and burden should be explored at the outset and throughout the digital intervention development process as a core therapeutic mechanism, beyond the context of design or user experience testing. In effort-focused conceptualization, it is assumed that, even though goals are rational and people want to achieve them, they are overtaken by competing cognitive, emotional, and environmental processes. We offer the term effort-optimized intervention to describe interventions that focus on user engagement in the face of competing demands. We describe design components based on a 3-step process for planning an effort-optimized intervention: (1) nurturing effortless cognitive and environmental salience to help people keep effort-related goals prominent despite competition; (2) making it as effortless as possible to complete therapeutic activities to avoid ego depletion and self-efficacy reduction; and (3) turning the necessary effortful activities into sustainable assets. We conclude by presenting an example of designing a digital health intervention based on the effort-optimized intervention model.

Highlights

  • Effort is physical, mental, or emotional exertion in an attempt to meet a goal

  • As the generation of digital health interventions is developed, we argue that an exploration of effort and burden should form the baseline for intervention development

  • We are suggesting that effort reduction is often overlooked by our field as we develop interventions from the outset and at every stage of intervention engagement

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Summary

Introduction

Mental, or emotional exertion in an attempt to meet a goal. The effort exerted by an individual depends on the interplay between internal (eg, cognitive ability, motivation) and external (eg, social and environmental) facilitators and the barriers between an individual and their desired objective [1,2]. We describe a 3-step process in the design of an effort-optimized intervention sequence, involving (1) nurturing salience to increase the chance of desired behaviors occurring in the face of competition; (2) making it as effortless as possible to complete therapeutic activities in order to avoid ego depletion and self-efficacy reductions; and (3) turning the necessary effortful activities into sustainable assets.

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