Leveraging Intermediated Interactions to Support Utilization of Persuasive Personal Health Informatics

Behavior change support systems (BCSS) and persuasive technologies for healthcare often entail users interacting with mobile devices. However, especially in developing countries, the target community is unfamiliar with and often intimidated by new technologies. In this paper we propose the use of intermediaries to facilitate interaction with a mobile phone-based application and to motivate ongoing use by the target beneficiaries. The application incentivizes utilization through gamification techniques, using badges, scoreboards, and other rewards. For example, a young girl might help her father keep track of his walking and diet, maintaining participation as much for her father's health as for the social awards given by the app. We explain how intermediaries can be leveraged to improve utilization and engagement of the beneficiaries, and describe factors affecting interaction between the participating pairs and interaction with the application. This study highlights the importance of social rapport - typically through a familial relationship - as a key component of the intervention. Finally, we discuss the implications of designing for the motivation of two different users: gamification, personalization and utility play different roles for the intermediary and the beneficiary but ultimately combine to make a more effective application for the beneficiary than one targeting the beneficiary alone.