ABILITY

The “ABILITY” category groups those features that aim to improve or facilitate patients' capabilities to perform active behaviors (to manage the disease or improve their health status). Such features typically support patients in executing disease related actions such as performing physical therapy, taking medical measurements or support medication intake.


Reduction

Short description

Reduction features aim to minimizes the effort needed to complete the desired health behavior or disease management action. It transforms a complex action into a simpler one, e.g. by performing complex calculations or automating part of the action for the patient.

Bridges to theory

Theory of Planned Behavior Self-Determination Theory Information-Motivation Behavioral skills model Health Belief Model Goal-Setting Theory Social-Cognitive Theory Trans-Theoretical Model

Inspiring questions

Can the mHealth app remember or calculate disease parameters, in order to reduce the cognitive effort needed from the patient?
Can the mHealth app store medication regimens or elaborate exercise procedures?


Note: A mHealth app that automatically logs patients' data is considered Tracking.


Suggest an example of the Reduction feature

Tunneling

Short description

Tunneling features aim to help the patient perform a series of actions necessary for the health behavior or disease management. Tunneling is typically used to guide the patient towards a bigger of more distant goal, by providing the different steps over time, in order to achieve the desired health status.

Bridges to theory

Theory of Planned Behavior Self-Determination Theory Information-Motivation Behavioral skills model Health Belief Model Goal-Setting Theory Social-Cognitive Theory Trans-Theoretical Model

Inspiring questions

Can a wizard be used to guide the patient through a lengthy process?
Can complex tasks be split up into a series of smaller, easier tasks that can be executed sequentially?


Note: Simply providing information on the different steps is considered Instruction (e.g. an illustrated manual).

Note: When the patient can set a personal goal, this is considered Goal Setting. However, Tunneling and Goal Setting often go hand in hand.


Suggest an example of the Tunneling feature

Instruction

Short description

Instruction features aim to help the patient to better understand ‘how’ to perform a disease management action, or how to use the mHealth application to achieve the target health behavior.

Bridges to theory

Theory of Planned Behavior Self-Determination Theory Information-Motivation Behavioral skills model Health Belief Model Goal-Setting Theory Social-Cognitive Theory Trans-Theoretical Model

Inspiring questions

Does the mHealth app provide a help function to explain how to execute specific disease management actions?
Can tips be given so that the patient understands ‘how’ to correctly perform a certain action?
Can the mHealth app offer a section with frequently asked questions?


Note: Providing information why it is important to perform a health behavior is considered General Information .


Suggest an example of the Instruction feature

Rehearsal

Short description

Rehearsal features provide a safe zone for patients to try out health behaviors or performing disease related tasks, before executing them ‘for real’. Rehearsal of a target behavior allows the patient to feel more confident when performing the target behavior.

Bridges to theory

Theory of Planned Behavior Self-Determination Theory Information-Motivation Behavioral skills model Health Belief Model Goal-Setting Theory Social-Cognitive Theory Trans-Theoretical Model

Inspiring questions

Does the mHealth app allow the patient to rehearse a certain action before being executed or communicated to a health professional?
Can a patient first tryout how to perform a certain operation such as giving an injection a number of times?
Can a patient exercise a certain cognitive task to understand how it works?


Note: For Rehearsal, the app needs to be able to measure or track the patient's actions.


Suggest an example of the Rehearsal feature

Reminders

Short description

Reminders help the patient remember to perform the target health behavior or disease management action in a specific situation. Reminders can be time-based but they can also rely on other contextual information (e.g. weather, location, certain actions...). In this manner, reminders can also be understood as triggers.

Bridges to theory

Theory of Planned Behavior Self-Determination Theory Information-Motivation Behavioral skills model Health Belief Model Goal-Setting Theory Trans-Theoretical Model

Inspiring questions

Can the patient set an alarm at a time or an interval of his or her choosing?
Are notifications being sent to the patient or the care circle on when to perform an action when being at the appropriate location?
Can a message to perform the intended behavior be sent out in a specific context (weather, location…)?


Note: With today's technology, not only reminders in time are possible but also reminders based on other or a combination of multiple aspects, i.e. location, weather, amount of physical activity...


Suggest an example of the Reminders feature

INFORMATION

The “INFORMATION” category groups those features that provide disease related information, either at the general level (for everyone), tailored (subgroups) or personalized (for one individual), and may even provide bespoke information about the future.


General Information

Short description

General Information features provide information about the disease or the target health behavior increases the understanding of the disease or health behavior, and ‘why’ it is important to perform certain behaviors or disease management actions.

Bridges to theory

Theory of Reasoned Action Theory of Planned Behavior Information-Motivation Behavioral skills model Health Belief Model Elaboration-Likelihood Model Trans-Theoretical Model

Inspiring questions

Can the mHealth app provide an information-section on the disease or health behavior, listing e.g. severity, prevalence, cause, life expectancies, medication, etc.
Can the mHealth app shed light through on the importance of the target health behavior or possible disease management actions, e.g. how it helps reducing side effects or prolong quality of living?


Suggest an example of the General Information feature

Macro Tailoring

Short description

Macro tailored information features provide information adapted to suit a specific patient group. Macro tailoring targets groups of patients, characterized by a specific disease parameter, gender, age group...

Bridges to theory

Theory of Reasoned Action Theory of Planned Behavior Information-Motivation Behavioral skills model Health Belief Model Trans-Theoretical Model

Inspiring questions

Can the patient indicate to what subtype he or she belongs to?
Can the app filter out relevant information, based on the subtype of disease the patient belongs to?

Note: In case information is organized by subtypes but a patient does not need to indicate to what group he or she belongs, and consequently there is no change in the information provided by the mHealth app depending on the group the patient belongs to, this is NOT considered as Macro Tailoring, but rather General Information.


Suggest an example of the Macro Tailoring feature

Micro Tailoring

Short description

Micro tailored information features provides information on the disease or health behavior adapted to suit a specific patient. Micro tailoring targets individual patients and provide idiosyncratic information for each specific patient.

Bridges to theory

Theory of Reasoned Action Theory of Planned Behavior Information-Motivation Behavioral skills model Health Belief Model Trans-Theoretical Model

Inspiring questions

Can algorithms (e.g. recommender techniques) be used to adapt the information incorporated in the application on the basis of specific characteristics and traits of the patient? This not only relates to disease parameters, but equally to age, gender, socio-economic status, geographic location, language, usage history…

Note: In case a patient can first select a personal goal to tailor disease management actions or strategies, this should be flagged as Goal Setting, not Micro Tailoring.

Note: In case a patient can enter personal information, but this is only used to address that person superficially (e.g. to welcome with the first name, but not to tailor actual information) then this should be flagged as Personalization.


Suggest an example of the Micro Tailoring feature

Simulation

Short description

Simulation features provide bespoke information about the future, and how disease may evolve over time, or what health effects may be related to certain behaviors.. These features help simulate effects over time, based on data provided by and/or actions performed by the patient.

Bridges to theory

Theory of Reasoned Action Theory of Planned Behavior Information-Motivation Behavioral skills model Health Belief Model Trans-Theoretical Model

Inspiring questions

Can the application forecast future disease status based on current disease management actions and/or data (e.g. future weight loss based on current calorie intake)?

Note: The data can both be automatically collected (see Tracking) or manually entered (see Logging).


Suggest an example of the Simulation feature

AWARENESS & PERSONAL INSIGHTS

The “AWARENESS & PERSONAL INSIGHTS” category groups those features that aim to provide users with more awareness of and insight into their disease status, or the disease management actions performed in relation to the target behavior.


Logging

Short description

Logging features provides the possibility to manually or verbally enter information related to the disease status into the mHealth app, to be retrieved later and possibly to be shared with others.

Bridges to theory

Health Belief Model Goal-Setting Theory ocial Facilitation Theory Trans-Theoretical Model Perceptual Control Theory

Inspiring questions

Does the app provide a diary or notebook where patients can log relevant information?
Does the application allow a patient to manually enter data related to the target health behavior?
Can patients add information on disease status via the microphone or keyboard of the mHealth app?


Note: The difference between Logging and Tracking lies in that for Tracking this happens without the patient's effort, whereas for Logging, conscious and intentional effort from the patient is demanded.
Note: Logging goes hand in hand with Self-Monitoring. However, this is not always the case, it is possible that logged data is sent to a database for health researchers, without giving access to patients themselves.


Suggest an example of the Logging feature

Tracking

Short description

Tracking features allow for the automated capturing of data, by sensors in the smartphone, or via wearables or contextual sensors linked to the mHealth app. In this way, physical and physiological data is captured by the app, to further disease insight and support actions.

Bridges to theory

Health Belief Model Goal-Setting Theory ocial Facilitation Theory Trans-Theoretical Model Perceptual Control Theory

Inspiring questions

Can disease management actions be recorded via sensors in the mHealth app?
Can the application automatically link to and collect data via wearables, regarding the target health behavior?


Note: The difference between Logging and Tracking is that Tracking happens without the patient's effort, whereas for Logging, conscious and intentional effort from the patient is demanded.
Note: Tracking is different from Reduction in that Reduction reduces a complex task to a simpler task, e.g. by performing complex computations, conducting automated searches or storing lengthy procedures, but not by automated collection of data.
Note: Tracking goes hand in hand with self-Monitoring. However, this is not always the case, it is possible that Tracking data is sent to a database for health researchers without giving access to patients themselves.


Suggest an example of the Tracking feature

Self-Monitoring

Short description

Self-Monitoring features allow patients to follow-up on their disease status, disease management actions, or health behavior data through visualizations. Hence, Self-Monitoring implies displaying the data of the patient (captured either through logging or tracking), over a certain time period.

Bridges to theory

Health Belief Model Goal-Setting Theory ocial Facilitation Theory Trans-Theoretical Model Perceptual Control Theory

Inspiring questions

Does the mHealth app visualize disease status parameters and/or health actions in a meaningful manner?
Can patients scroll, filter, zoom in and out on data, based on time, location, data type…?
Can the patient’s health related data be visualized in such a way that it allows to track progress over time?


Note: The representation of data for Self-Monitoring can both be graphical (graphs, drawings, images) as well was text-based.
Note: Self-Monitoring goes hand in hand with Tracking and Logging.


Suggest an example of the Self-monitoring feature

Goal Setting

Short description

Goal Setting features allow a patient is able to set a personal goal for his/her health behavior or disease status, and track the progress towards that goal.

Bridges to theory

Theory of Planned Behavior Self-Determination Theory Information-Motivation Behavioral skills model Health Belief Model Goal-Setting Theory Social-Cognitive Theory Trans-Theoretical Model Perceptual Control Theory

Inspiring questions

Is the patient able to choose a goal and possibly a timeframe to achieve this goal?
Can the patient specify how, what and when to reach a specific goal related to disease status or health behaviors?


Note: In case the app coaches the patient through a process but does not allow to set an individual goal, this should be flagged as Tunneling, not Goal Setting


Suggest an example of the Goal Setting feature

Suggestion

Short description

Suggesting applies when the mHealth app suggests different possible actions related to the target behavior, rather than only one. With suggestion, the mHealth app ‘suggests’ rather than obliges a certain action?

Bridges to theory

Theory of Planned Behavior Self-Determination Theory Information-Motivation Behavioral skills model Goal-Setting Theory Trans-Theoretical Model

Inspiring questions

Can the mHealth app provide different types of actions to achieve a certain target behavior (e.g. climb two stairs or do 30 jumping jacks)?
Can the mHealth app rephrase certain actions as choices rather than obligations?


Note: Suggestions that are part of a Tunneling or Goal Setting process are to be flagged as Tunneling or Goal Setting


Suggest an example of the Suggestion feature

Incentivization

The “INCENTIVIZATION” category groups those features that provide (external) incentives for patients to execute or adhere to certain health related behaviors. Often these features are also labeled as gamification.


Rewards

Short description

Rewards features incentivize a patient to perform the target health behavior or disease management action. Upon performing the desired behavior, the patient is virtually rewards via badges, experience points…

Bridges to theory

Operant Conditioning Social-Cognitive Theory Elaboration-Likelihood Model Trans-Theorectical Model Perceptual Control Theory

Inspiring questions

Does the mHealth app present virtual rewards such as stars, badges, experience points... to the patient when the intended behavior is executed?
Can the mHealth app provide a voucher or coupon to the patient to motivate the patient?


Note: Rewards can be as simple as accumulating points through the use of an app.

Note: Rewards can also be physical rewards.


Suggest an example of the Rewards feature

Praise

Short description

Praise features aspire to make the patient feel appreciated and competent by giving messages that encourage and laude the efforts of the patient.

Bridges to theory

Operant Conditioning Social-Cognitive Theory Elaboration-Likelihood Model Trans-Theorectical Model Perceptual Control Theory

Inspiring questions

Can the mHealth app offer encouraging messages to the patient, during or after his or her actions?


Note: When the Praise is given in such a manner that this is also visible for others, than this should be flagged as Recognition (e.g. an app that posts on Facebook that a user has attained a certain goal).


Suggest an example of the Praise feature

Recognition

Short description

Recognition publicly offers praise for a patient’s health-related actions, by posting encouraging and lauding messages at fora where others can see this.

Bridges to theory

Theory of Reasoned Action Theory of Planned Behavior Self-Determination Theory Operant Conditioning Social-Cognitive Theory Trans-Theorectical Model

Inspiring questions

Can the mHealth app post messages of attained health targets at social network sites?
Does the application feature a section that shows e.g. ‘the patient of the month’ or a patient who has performed extraordinary well?


Note: The difference with Praise or Rewards is that Recognition implies that other users are also aware of the achievements of the patient.

Note: Recognition does not need to imply that one patient is outperforming others.


Suggest an example of the Recognition feature

SOCIAL INTERACTIONS

The “SOCIAL INTERACTIONS” category groups those features that allow users to interact with others, either at the individual level, or through interactions with groups, and to trigger comparisons and self-reflection.


Social Encounters

Short description

Social Encounter features allow others to watch or know about the performance of the patient, perhaps even perform the behavior together with him/her.

Bridges to theory

Theory of Reasoned Action Theory of Planned Behavior Self-Determination Theory Social Facilitation Theory Social-Cognitive Theory Trans-Theorectical Model

Inspiring questions

Is the patient able to share his or her actions through the app with others?
Can the patient be made aware that others are following his or her behaviors through the app?


Note: The difference with Social Comparison is that with Social Encounters the purpose is that someone else is following your performance.


Suggest an example of the Social Encounters feature

Social Identification

Short description

Social Identification features allow a patient to see data from other patients who are in the same situation, and to identify with and be inspired by these similar patients.

Bridges to theory

Theory of Reasoned Action Theory of Planned Behavior Self-Determination Theory Social Facilitation Theory Social-Cognitive Theory

Inspiring questions

Can the mHealth app show encouraging stories from other patients, faced with similar challenges?
Is the patient able to find others, needing to execute the same health behavior or confronted with the same disease, to learn from or to identify with?
Can the patient browse the profiles and/or actions of other who can act as role models or inspire?


Suggest an example of the Social Identification feature

Comparisons

Short description

Comparison features help patients to compare their disease status or health-related actions against groups of patients, or against the norm of a population. This allows patients to better evaluate their own health status or health related performance.

Bridges to theory

Theory of Reasoned Action Theory of Planned Behavior Self-Determination Theory Social Facilitation Theory Social-Cognitive Theory

Inspiring questions

Can ranking be used in the application to provide the patient with an idea of how he or she is performing as compared to others?
Does the mHealth app provide statistics with averages of certain disease parameters or health behaviors


Note: The difference with Competition is that this demands patients to take part in an activity/challenge specifically designed for the sake of competing, whereas Social Comparison starts from health-related behaviors or disease actions all patients using the mHealth app are expected to carry out anyhow .
Note: : The difference with Social Facilitation is that this assumes the patient to be aware that someone else is following his/her performance.


Suggest an example of the Comparisons feature

Competition

Short description

Competition features foresee ways in which the patient can challenge or compete with other patients via the mHealth app.

Bridges to theory

Theory of Reasoned Action Theory of Planned Behavior Self-Determination Theory Social Facilitation Theory Social-Cognitive Theory Trans-Theorectical Model

Inspiring questions

Does the mHealth app provide a means for setting up a competition between two or more patients?
Does the mHealth app allow to challenge others?
Does the mHealth app provide a leaderboard?


Note: the difference with Social Comparison is that in case of Competition you challenge and compete with another individual, there has been a conscious act of the patient to challenge another patient.


Suggest an example of the Competition feature

Cooperation

Short description

Cooperation features allow patients to create groups and perform extra activities in group, working together to achieve a bigger goal.

Bridges to theory

Theory of Reasoned Action Theory of Planned Behavior Self-Determination Theory Social Facilitation Theory Social-Cognitive Theory Trans-Theorectical Model

Inspiring questions

Can patients form groups to realize goals together?
Can patients cooperate through the use of the application to achieve a bigger goal?
Can patients conduct a challenge together, e.g. walk 10 000 miles, lose a combined 100lbs…


Suggest an example of the Cooperation feature

TRUSTWORTHINESS & LIKING

The “TRUSTWORTHINESS & LIKING” category groups features related to how the application can increase its credibility and liking by the patient.


Personalization

Short description

Personalization features allow the patient to personalize the designs and styling of the mHealth app, for example when he/she is able to choose the layout of the mHealth app, change colors, change the skin or set a welcome message.

Bridges to theory

Elaboration-Likelihood Model

Inspiring questions

Can the patient customize what is and what is shown on the dashboard of the mHealth app?
Is the patient able to change the colorscheme of the mHealth app?
Can the patient provide and be addressed with a nick name?


Note: Micro/Macro Tailoring, implies that the mHealth app personalizes/adapts the content itself, not merely the styling.


Suggest an example of the Personalization feature

Verifiability

Short description

Verifiability features allow a patient to be able to verify the (scientific) quality of the mHealth app, and look up what are the origins of the content, the contributors to and creators of the app.

Bridges to theory

Elaboration-Likelihood Model

Inspiring questions

Is the patient presented with information that shows the validity of the content of the application (e.g. a link to a scientific research article, a testimonial...)?
Can the patient inspect who created the application?


Note: This is closely related to Expertise, where trust in the application is installed via other people (health experts, expert users, celebrities) advocating the app.


Suggest an example of the Verifiability feature

Expertise

Short description

Expertise related features ensure that patients understand that the content is devised by people or used by people who have expertise, e.g. health professionals, celebrities or other patients. The focus is on highlighting people or organizations using or advocating the mHealth app.

Bridges to theory

Elaboration-Likelihood Model

Inspiring questions

Does the mHealth app display people or organization(s) who promote the application?
Does the mHealth app provide testimonies of people using the app?
Does the mHealth app show quotes of famous doctors who liked the app?
Does the mHealth app show ratings and reviews of how others evaluated the app?


Note: This is closely related to Verifiability, which focuses on providing insight in the (scientific) quality of the app, the content and creators.


Suggest an example of the Expertise feature

Surface Credibility

Short description

Surface Credibility features provide a way for the patient to judge the quality of the application at first glance, in order to install trust and credibility.

Bridges to theory

Elaboration-Likelihood Model

Inspiring questions

Can the mHealth app avoid showing advertisements, banners, pop-ups?
Is the visual design of the application sleek and consistent with design guidelines?


Suggest an example of the Surface Credibility feature