Personal Behavior Change Research Articles

Associations between open drain flooding and pediatric enteric infections in the MAL-ED cohort in a low-income, urban neighborhood in Vellore, India

BackgroundOpen drains are common methods of transporting solid waste and excreta in low-income urban neighborhoods. Open drains can overflow due to blockages with solid waste and during rainfall, posing exposure risks. The goal of this study was to evaluate whether pediatric enteric infection was associated with open drains and flooding in a dense, low-income, urban neighborhood.MethodsAs part of the MAL-ED study in Vellore, India, a cohort of 230 children provided stool specimens at 14–17 scheduled home visits and during diarrheal episodes in the first two years of life. All specimens were analyzed for enteric pathogens. Caregivers in 100 households reported on flooding of drains and households and monthly frequency of contact with open drains and flood water. Household GPS points were collected. Monthly rainfall totals for the Vellore district were collected from the Indian Meteorological Department. Clustering of reported drain and house flooding were identified by Kulldorff’s Bernoulli Spatial Scan. Differences in enteric infection were assessed for household responses and spatial clusters, with interactions between reported flooding and rainfall to approximate monthly drain flooding retrospectively, using multivariable, mixed-effects logistic regression models.ResultsCoverage of household toilets was low (33%), and most toilets (82%) discharged directly into open drains, suggesting poor neighborhood fecal sludge management. Odds of enteric infection increased significantly with total monthly rainfall for children who lived in households that reported that the nearby drain flooded (4% increase per cm of rain: OR: 1.04, 95% CI: 1.00–1.08) and for children in households in a downstream spatial cluster of reported drain flooding (5% increase per cm of rain: OR: 1.05, 95% CI: 1.01–1.09). There was no association between odds of enteric infection and frequency of reported contact with drain or floodwater.ConclusionsChildren in areas susceptible to open drain flooding had increased odds of enteric infection as rainfall increased. Results suggested that infection increased with rainfall due to neighborhood infrastructure (including poor fecal sludge management) and not frequency of contact. Thus, these exposures may not be mitigated by changes in personal behaviors alone. These results underscore the importance of improving the neighborhood environment to improve children’s health in low-income, urban settings.

Longitudinal planning for personalized health management using daily behavioral data

Mitigating globally emerging health problems such as obesity needs scalable solutions that can facilitate health management and promote healthier lifestyles outside of clinical settings. Such scalable solutions, while targeting general population, need to provide personalized behavior change plans that not only fit users’ own underlying physiologic dynamics but also suit their preferences and needs. There has been fast-growing development of mobile health devices and applications for monitoring of human behavior (such as physical activity and food intake) and health status such as BMI. However, there are challenges to translate these noisy and dynamic behavioral data into personalized longitudinal planning. To address such challenges, we develop an integrated framework that unifies dynamic modeling, sparse learning, dictionary learning and matrix completion to translate users’ behavioral data into personalized dynamic system models and use them as constraints for deriving deeply personalized longitudinal health plans. We evaluate the proposed framework on a real-world user behavioral dataset and demonstrate its promising utility and efficacy.

Technology-Based Motivation Support for Seniors' Physical Activity-A Qualitative Study on Seniors' and Health Care Professionals' Views.

This paper investigates seniors’ and health care professionals’ (HCPs) perceptions on needed contributions and qualities of digital technology-based motivation support for seniors’ physical activity (PA). Seniors and HCPs expressed their views in focus groups, which were analyzed separately by inductive content analysis. Similarities and differences in seniors’ and HCPs’ views were identified through thematic analysis of qualitative results from both focus groups. This article’s main findings are that both seniors and HCPs believed digital technology should support and make PA more enjoyable in ways to strengthen seniors’ control and well-being. However, seniors emphasized support for social interaction, while HCPs also requested support for increasing seniors’ insight into PA and for facilitating their dialogue with seniors. Conclusions to be drawn are that seniors and HPCs shared overall views on digital technology’s main contributions but had different perspectives on how those contributions could be obtained. This highlights the importance of the early identification of user groups and exploration of their different needs when developing new solutions. Moreover, seniors’ and HCPs’ perceptions included aspects relevant for personal motivation, technology acceptance, and PA behavioral change according to self-determination theory, unified theory of acceptance and use of technology, and behavioral change techniques for increasing PA.

346-OR: Primary Care Implementation Study to Increase Diabetes Prevention Program Referrals

Background: Intensive lifestyle change programs effectively prevent or delay type 2 diabetes but are underutilized. We evaluated patient and clinician prediabetes attitudes and practices and implemented strategies to increase National Diabetes Prevention Program (DPP) referrals. Methods: The Tailored Implementation for Chronic Diseases framework guided data collection and the interventional approach of our cluster randomized implementation study across two large primary care clinics. Formative data came from clinician surveys, patient focus groups, and electronic health record (EHR) review. Thematic qualitative and descriptive quantitative analyses identified implementation opportunities. Intervention clusters (family medicine teams) received clinician detailing and EHR-guided prediabetes patient identification. All clusters (family medicine and internal medicine) had access to an electronic DPP referral process. The primary outcome was DPP referral. Results: Focus group participants (3 groups, 15 participants) had mixed perceptions of prediabetes risk and desired personalized behavior change guidance. Surveyed clinicians (31 respondents of 45 invited) viewed prediabetes care positively, but had low DPP awareness. Baseline pre-implementation EHR data for two years (15,520 adult patients) revealed A1c screening coverage of 75.9% per national guidelines. Documentation of prediabetes occurred in 50.7% (729/1,437) of patients meeting A1c criteria. Interim analysis of DPP referrals 8 months post-intervention found 4.8% (69/1,423) of diagnosed prediabetes patients received DPP referral in intervention clusters versus 0.7% (17/2,357) of diagnosed prediabetes patients in control clusters. Patients with prediabetes in intervention clusters had 3.32 (95% CI: 0.89, 12.35) odds of receiving DPP referral after covariate and clustered data adjustments. Conclusions: Clinician detailing and EHR patient identification increased DPP referrals. Disclosure J.W. Keck: None. K.L. Roper: None. A. Thomas: None. L. Hieronymus: None. Funding National Center for Research Resources; National Center for Advancing Translational Sciences (UL1TR001998)

Healthier Life with Digital Companions: Effects of Reflection-Level and Statement-Type of Messages on Behavior Change via a Perceived Companion

ABSTRACTQuantified-self tools track personal data as well as emotional and psychological scores, in real time, of people who use such tools. Such data have potential uses for initiating interactions to induce personal health-related behavior changes. However, notwithstanding this potential, not much benefit has been derived from the data tracked using various devices such as smartphones and fitness trackers. The main research goal of this study is to investigate how interactions of quantified-self tools should be designed for inducing user perception and behavior change. Particularly, this study uses two message representation formats (MRF) for users to perceive self-tracking tools as companion devices because the MRFs of smartphones and fitness trackers are important to interact with users in conversational interaction. This study developed a message expression algorithm, “Samantha,” to deliver personalized-messages automatically in real time about the values tracked by these devices to their users. The study studied the effect of the four message representation formats on the perception of companion and to induce behavior change.

Employed Caregivers’ Response to Family-Role Overload: the Role of Control-at-Home and Caregiver Type

Drawing from role theory, stress and coping, and caregiving literatures, this paper develops a model of family-role overload involving two forms of caregiver burden (subjective, objective) and two types of maladaptive changes in employee behavior (at work, personal), and hypothesizes that caregiver type (eldercare-only vs. sandwich) moderates all paths in the model. Partial Least Squares structural equation modeling (SEM) supported all hypothesized direct paths. Contrary to our hypotheses, data analysis showed two positive relationships (i.e., objective caregiver burden to family-role overload, family-role overload to maladaptive changes in personal behavior) were stronger for those in the eldercare-only sample than for those in the sandwich sample. Post hoc analysis revealed five significant gender differences in the relationships included in our model. This study contributes to work–family theory by reinforcing the need to consider both caregiver type and gender when researching the challenges faced by employees trying to balance work and caregiving.

Witnessing change: Dynamic norms help resolve diverse barriers to personal change

Recent research has found that dynamic norms—information about collective change in behavior—can promote meaningful personal behavior change, even if that behavior is not currently the norm. Through what psychological processes do dynamic norms operate? We theorized that, when others change, it can lead observers to infer that whatever factors had loomed large as barriers to change do not, in fact, prevent change. If so, dynamic norms may alter diverse salient mechanisms of personal change, and encourage behavior change in diverse contexts. Investigating four domains—smokers' intention to quit, dietary choice, sleep-related behavior, and men's identification as feminist—Experiments 1–4 found that dynamic norms affected three well-established mechanisms of personal behavior change across contexts: the belief that personal change is possible (increased self-efficacy), the belief that change is important to others (injunctive norms), and the belief that change is compatible with one's social identity. In each case, change in the psychological process also statistically mediated change in personal interest and intentions to change. Experiment 5 tested our hypothesis that psychological barriers that loom large would be remedied most. Manipulating the salience of all three barriers within a single context, we found that dynamic norms had a larger impact on salient than less salient barriers. The results suggest that dynamic norms can help resolve diverse psychological barriers to encourage personal change, especially salient barriers. They may thus be a particularly robust source of social influence across contexts.

116. Engaging Adolescents In A Self-Adaptive Personalized Behavior Change System For Adolescent Preventive Healthcare

116. Engaging Adolescents In A Self-Adaptive Personalized Behavior Change System For Adolescent Preventive Healthcare

Digital Weight Loss Intervention for Parents of Children Being Treated for Obesity: A Prospective Cohort Feasibility Trial.

BackgroundThe prevalence of childhood obesity continues to increase, and clinic-based treatment options have failed to demonstrate effectiveness. One of the strongest predictors of child weight is parent weight. Parental treatment for weight loss may indirectly reduce obesity in the child. We have previously demonstrated the effectiveness among adults of a fully automated, evidence-based digital weight loss intervention (Track). However, it is unknown if it is feasible to deliver such a treatment directly to parents with obesity who bring their child with obesity to a weight management clinic for treatment.ObjectiveThe objective of our study was to evaluate the feasibility of and engagement with a digital weight loss intervention among parents of children receiving treatment for obesity.MethodsWe conducted a 6-month pre-post feasibility trial among parents or guardians and their children aged 4-16 years presenting for tertiary care obesity treatment. Along with the standard family-based treatment protocol, parents received a 6-month digital weight loss intervention, which included weekly monitoring of personalized behavior change goals via mobile technologies. We examined levels of engagement by tracking completed weeks of self-monitoring and feasibility by assessing change in weight.ResultsParticipants (N=48) were on average 39 years old, mostly female (35/42, 82% ), non-Hispanic Black individuals (21/41, 51%) with obesity (36/48, 75%). Over a quarter had a yearly household income of <US $25,000, and about a third had the equivalent of a high school education. Children were on average 10 years old and had a body mass index of 29.8 kg/m2. The median percentage of weeks participants tracked their behaviors was 77% (18.5/24 total weeks; interquartile range [IQR] 6.3 to 100). The median number of attempts via phone or text message (short message service) required to complete one tracking week was 3.3 (IQR 2.6 to 4.9). Nearly half (23/48, 48%) had high levels of engagement, completing 80% (19/24) or more weeks of tracking. Of the 26 participants with weight measurements reported at 6 months, of which 81% (21/26) were self-reported, there was a median 2.44 kg (IQR −6.5 to 1.0) decrease in weight.ConclusionsIt is feasible to deliver an evidence-based digital weight loss intervention to parents or guardians whose children are enrolled in a weight management program. Given the feasibility of this approach, future studies should investigate the effectiveness of digital weight loss interventions for parents on child weight and health outcomes.

Development and Evaluation of a Nutrition-Centered Lifestyle Medicine Curriculum for Physician Assistant Students

BackgroundUS medical schools are increasingly integrating lifestyle medicine competencies into their academic programs. Yet, physician assistant (PA) academic programs have been slower to respond.MethodsWe developed, implemented, and evaluated a nutrition-centered lifestyle medicine curriculum for 2nd-year PA students (n = 24). The 4-week hybrid, 2-credit hour course activities aligned with the American College of Lifestyle Medicine competencies for primary care providers and reinforced four of the Accreditation Standards for PA Education. We combined didactic lectures with weekly hands-on cooking modules from the “Health meets Food” courseware for medical students. We employed a pre-post evaluation design including a comparison group of 2nd-year PA students in a separate program. We assessed changes in personal nutrition behaviors and knowledge and confidence for counseling in nutrition, exercise/physical activity, weight, smoking, and alcohol, using the modified 5A’s framework (assess, advise, agree, assist, and arrange) for lifestyle counseling.ResultsStudents receiving the intervention demonstrated significantly higher gains in both knowledge and confidence for the 5A’s of nutrition counseling compared to the control group. Self-reported knowledge and confidence for the 5A’s of counseling for the other lifestyle behaviors similarly improved among the intervention group compared to the control group, but to a lesser extent.ConclusionA nutrition-centered lifestyle medicine course can demonstrate PA academic program adherence to accreditation standards, while also introducing students to nutrition and lifestyle medicine competencies. Hands-on experiences that reinforce didactic instruction may maximize student knowledge and self-efficacy for implementing lifestyle medicine into their practice.

THE CORRELATION OF PERSONAL PROTECTIVE EQUIPMENT SOCIALIZATION TOWARD THE CHANGING OF OCCUPATIONAL SAFETY AND HEALTH BEHAVIOR OF MUSICAL INSTRUMENT CRAFTSMEN

Background: Cultural conditions K3 in the industry Small Medium Enterprises (SME) craftsmen of traditional musical instruments is low only use 2 personal protective equipment that is protective mask and gloves. The condition can lead to accidents then exerts dissemination of the importance of personal protective equipment in order to minimize accidents. Purpose: This study aimed to determine the correlation between the socialisation of the importance of personal protective equipment (PPE) and the OSH behavior (knowledge and attitude toward the importance of PPE. Method: This was a quantitative research with Experimental approach. Craftsmen working population was taken as a respondent (24 workers). Data was taken by using a questionnaire and checklist. Related Data analysis used T-Test. Results: The results of this study scores showed the value of p = 0.00 (p &lt;0.05), which means that there were significant changes between the socialization of personal protective equipment and behavioral changes K3 workers craftsmen of traditional musical instruments industry in Paju District of Ponorogo. Further research is needed to study the behavior of K3 in the industry small medium enterprises on the other with the number of more samples and compare it to other industry small medium enterprises as well as a variable that has not been studied. Conclusion: Socialization of personal protective equipment can boost of knowledge and attitude for the workers to always use personal protective equipment in each work.

Abstract 16840: A Community Engagement Initiative Supporting a Culture of Heart Health

Background: Historically seen as a man’s disease, coronary heart disease (CHD) is the annual cause of death for approximately the same number of women as men. Strides have been made in raising awareness of women’s CHD risk, and national initiatives call for programs that both raise awareness and sustain engagement in heart healthy lifestyles. A gap remains between women’s personal awareness of risk and the preventative activities in which they engage. Purpose/Methods: Embracing the concept of cardiovascular health (CVH) from the American Heart Association’s Impact Goal, a coalition of community organizations partnered to launch a three pronged community engagement initiative (CEI): Follow the Fifty: Models of Heart Health . The purpose was to: raise women’s awareness of their risks for CHD; raise women’s CVH awareness, and increase women’s knowledge of evidence based activities that promote and support a culture of heart health through reducing cardiovascular risk factors (CVRF). Women participants (N=177), recruited through community advertising, became “Models of Heart Health.” The nine month CEI provided presentations on stress reduction, CVD awareness, and CVRF reduction activities; community gardens for growing heart healthy foods; and coaches paired with Models to support reducing individual CVRF. Community businesses provided CVH options: heart healthy menu choices, gym classes/memberships, group training activities. Baseline biometric data screened Models for participation (weight, BMI, blood pressure, glucose, smoking status). Models completed self-report surveys describing nutrition, physical activity, and stress management behavior changes resulting from the CEI. Focus groups were held to gather qualitative feedback. Results/Conclusions: Follow the Fifty CEI successfully raised women’s awareness of their risk for CVD and influenced personal behavior change to reduce CVRF, thereby promoting and sustaining heart health. Models reported adopting improved diet (93.6%), physical activity (84.6%), and stress management activities (52.5%). Focus groups identified themes of: “goal driven with accountability,” “ongoing process,” “being rewarded,” a sense of “sisterhood/enduring friendships,” “empowerment,” and “confidence to attain goals.” Providing women with a mechanism for decision support and self-management, while identifying and strengthening the link to community resources resulted in adoption of effective therapeutic CVD preventive behaviors, creating a culture of heart health.

From location tracking to personalized eco-feedback: A framework for geographic information collection, processing and visualization to promote sustainable mobility behaviors

Nowadays, most people carry around a powerful smartphone which is well suited to constantly monitor the location and sometimes even the activity of its user. This makes tracking prevalent and leads to a large number of projects concerned with trajectory data. One area of particular interest is transport and mobility, where data is important for urban planning and smart city-related activities, but can also be used to provide individual users with feedback and suggestions for personal behavior change. As part of a large-scale study based in Switzerland, we use activity tracking data to provide people with eco-feedback on their own mobility patterns and stimulate them to adopt more energy-efficient mobility choices. In this paper we explore the opportunities offered by smartphone based activity tracking, propose a general framework to exploit location data to foster more sustainable mobility behavior, describe the technical solutions chosen and discuss a range of outcomes in terms of user perception and sustainability potential. The presented approach extracts mobility patterns from users’ trajectories, computes credible alternative transport options, and presents the results in a concise and clear way. The resulting eco-feedback helps people to understand their mobility choices, discover the most non-ecological parts of their travel behavior, and explore feasible alternatives.

The implementation and evaluation of health professions students as health coaches within a diabetes self-management education program

Background and purposeThe purpose of this article is to describe how health professions students were trained and incorporated as health coaches into a group diabetes self-management education (DSME) program in an underserved, urban federally qualified health center. Educational activity and settingNursing, pharmacy, and physical therapy students from three local colleges were provided health coach training and then integrated into the DSME program with faculty assistance. The students connected with the assigned participants both in person and via weekly telephone calls over a three-month time period, applying concepts learned and providing patient-centered support. FindingsStudents noted self-reported improvement in their own perceived knowledge, skills, and attitudes related to health coaching from both qualitative (weekly and end of experience reflections) and quantitative (pre- and post-survey) measures. Participants were also engaged in assessing the program directly via survey responses and indirectly via attainment of personal health-related behavior change goals based on American Association of Diabetes Educators Seven Self-Care Behaviors. SummaryWith appropriate training and support from faculty, health professions students were successfully incorporated into an existing DSME program in the role of health coach, gaining knowledge, skills, and attitudes needed to help patients make behavior change.

Developing sustainability in a dental practice through an action research approach.

Introduction: For dental practices to become more environmentally sustainable, the full cooperation of all practice staff can lead to greater engagement with proposed initiatives. Action Research is a participatory approach to change that involves participants in the decisions that affect them. Aim: The aim of this study was to collaboratively develop interventions to improve environmental sustainability at one dental practice. Methods: This was a mixed methods study following an Action Research process for intervention design. The study was set in a mixed NHS / private dental practice in England, UK. Results: Participants engaged in the process and were able to choose the measures they wished to implement. Feedback showed that whilst some measures had been discarded, others had led to changes both in professional and personal behaviour. Conclusion: Action Research offers an innovative and constructive method of engaging participants in developing their own sustainability strategies and can encourage positive change.

Medical Nutrition Therapy for Patients with Non–Dialysis-Dependent Chronic Kidney Disease: Barriers and Solutions

Medical Nutrition Therapy for Patients with Non–Dialysis-Dependent Chronic Kidney Disease: Barriers and Solutions

Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design

BackgroundAbout half of people with glaucoma do not adhere to their recommended medications. Interventions for other chronic conditions have successfully utilized reminder systems and motivational interviewing (MI)-based counseling. This study was designed to pilot a personalized intervention that leverages these strategies to assess their impact on medication adherence in glaucoma patients.MethodsGlaucoma patients taking ≥ 1 medication will be pre-screened by telephone survey for adherence to their medication(s). Those who self-report poor adherence will be enrolled in a 3-month monitoring period to measure medication adherence using electronic medication monitors. Participants who are non-adherent (take </=80% of their medication doses) over the 3-month run in phase will be eligible for the study. We plan to enroll 57 participants who are non-adherent to their medications. Participants’ adherence will then be continuously measured with electronic medication monitors, by self-report, and via pharmacy refill data over 2 years, during which two successively more resource-intensive components of an intervention aimed to improve medication adherence will be administered. The first component is a 3-month period of reminders (audio and/or visual) and text message or automated phone call if a dose of medication is not taken within a pre-specified time frame. The second component is a 6-month MI-based counseling program with a trained glaucoma counselor. This component uses the eyeGuide, a computer-based personalized behavior change program that enables para-professional staff to provide personalized education and counseling for glaucoma. The primary outcome is change in medication adherence. The secondary outcomes include changes in clinical outcomes (intraocular pressure, IOP, and IOP fluctuation) and psychosocial mediators of adherence (e.g., competence, energy for change and satisfaction). Participants will undergo semi-structured interviews at 12 months to give feedback about the counseling program in order to improve it.DiscussionThis pilot study will provide insight into ways to deliver more personalized health care to non-adherent glaucoma patients in order to better support them in managing their chronic disease.Trial registrationRetrospectively registered with ClinicalTrials.gov (NCT03159247).

Clinical diagnosis and treatment of pediatric anti-N-methyl-D-aspartate receptor encephalitis: A single center retrospective study.

The aim of the present retrospective study was to investigate the diagnosis, treatment and prognosis of pediatric anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. A total of 23 pediatric patients with anti-NMDAR encephalitis were included in the present study. The clinical data, laboratory test results, imaging examination, treatment outcomes, and follow-up records were reviewed and analyzed. A total of 8 patients exhibited prodromal symptoms, including fever, cough, and vomiting. Clinical symptoms included epilepsy, convulsions, ataxia, coma, dyskinesia, personal behavior change and hallucinations. A total of 20 cases had the initial neurologic symptoms of dyskinesia or seizure, whereas 3 cases exhibited psychiatric symptoms of personal behavior change and hallucinations. Furthermore, pediatric patients >6 years old had more psychiatric symptoms than those ≤6 years. A total of 20 cases exhibited abnormal electroencephalography records, with 1 case of extreme δ brush. A total of 10 cases exhibited abnormal brain magnetic resonance imaging detection. Furthermore, the CSF protein contents for pediatric patients ≤6 years old was significantly higher than those >6 years. For treatment, 18 pediatric patients received the first-line treatment of methylprednisone and intravenous injection of immunoglobulin, and 6 cases were subjected to the second-line treatment of rituximab. A total of 2 patients underwent plasma exchange and/or cyclophosphamide treatment. In follow-up, 12 cases reported no convulsion, whereas 11 cases had moderate or severe neurological and psychiatric sequelae. The recovery rate for pediatric patients ≤6 years old was significantly higher than those >6 years. Anti-NMDAR encephalitis is commonly seen in pediatric patients, mainly with initial neurological symptoms. These patients could respond to immunotherapy, and younger pediatric patients typically have a better prognosis.

The Effect of Health Education on Personal Behavior of Hygiene in Primary School Students Who Have Wear at Pampang I Inpres I Makassar

Health problems that are still considered trivial and less attention is the problem of worms. The prevalence of worms in Indonesia reached 28.12%. This is influenced by a lack of knowledge about the importance of clean and healthy living behavior (PHBS) which includes knowledge of personal hygiene. The purpose of this study is To assess the effect of health education on the behavior of Personal Hygiene In Primary School Students Who Were Experiencing Wear at Pampang I Inpres I Makassar City. The research design used is pre experimental approach with one group pre and post test design with sampling technique that is total sampling, total sample is 146 samples, the result of this research is presented in the form of narration and table. Data were analyzed using T test statistic test with significance level α = 0, 005. The result showed that there was a significant change of personal hygiene knowledge before and after health education with significant value ρ = 0.001, no significant change in personal hygiene attitude before and after health education given the value of ρ = 1, 818, but there is still a positive attitude increase that is before the positive attitude intervention of 18.8% increased to 71.3% after intervention and there is a meaningful change in personal hygiene before and after given health education with value ρ = 0.001. There is a change in personal hygiene behavior from before and after health education given 71.25% to be better behavior. This research became a reference and learning materials for nursing students, especially nursing and nursing epidemiology.

The Potential and Challenges of Digital Well-Being Interventions: Positive Technology Research and Design in Light of the Bitter-Sweet Ambivalence of Change.

Along with the dissemination of technical assistance in nearly every part of life, there has been growing interest in the potential of technology to support well-being and human flourishing. “Positive technology” thereby takes the responsible role of a “digital coach,” supporting people in achieving personal goals and behavior change. The design of such technology requires knowledge of different disciplines such as psychology, design and human-computer interaction. However, possible synergies are not yet used to full effect, and it needs common frameworks to support a more deliberate design of the “therapeutic interaction” mediated through technology. For positive technology design, positive psychology, and resource oriented approaches appear as particularly promising starting point. Besides a general fit of the basic theoretical conceptions of human change, many elements of established interventions could possibly be transferred to technology design. However, besides the power of focusing on the positive, another psychological aspect to consider are the bitter components inherent to change, such as the confrontation with a negative status quo, threat of self-esteem, and the effort required. The present research discusses the general potential and challenges within positive technology design from an interdisciplinary perspective with theoretical and practical contributions. Based on the bitter-sweet ambivalence of change as present in many psychological approaches of motivation and behavior change, the bitter-sweet continuum serves as a proxy for the mixed emotions and cognitions related to change. An empirical investigation of those factors among 177 users of self-improvement technologies provides initial support for the usefulness of the bitter-sweet perspective in understanding change dynamics. In a next step, the bitter-sweet concept is transformed into different design strategies to support positive change. The present article aims to deepen the discussion about the responsible role of technology as a well-being enhancement tool and to provide a fruitful frame for different disciplines involved in positive technology. Two aspects are highlighted: First, investigating well-being technology as a form of “therapeutic interaction,” focusing on the need for sensible design solutions in the emerging dialogue between technology and user. Second, a stronger consideration of the bitter-sweet ambivalence of change, utilizing (positive) psychology interventions to full effect.