Designing health apps
Katarzyna Stawarz explores the features of apps that help people develop healthy habits
Have you ever used a smartphone app to track what you eat, count steps
or start a new habit? Hundreds of apps that promise to make us healthier are a few taps away. They let us set goals and track our behaviour with the hope that this will lead to a long-term change. Unfortunately it is not that simple.
Behaviour change starts when we realise we need to change. Self-tracking apps can help here: they are great at telling us how we are doing (e.g. how active we already are). Next, we need to take action. Looking at summaries can help, but this step relies on one’s own motivation, which can’t always be supported by technology.
Once the intention turns into action, we must repeat the behaviour until it becomes a habit. This is where most health apps fall short: they help us repeat the behaviour, but they don’t help us develop habits.
We tend to think of habits as ‘things people do on a regular basis’ , but this is
not enough for a behaviour to be considered a habit. Psychologists define habits as ‘automatic responses to contextual cues’. This means that, to form a habit, we need to repeat the new behaviour in the same context: after the same routine event, in the same location, and so on.
I reviewed the functionality of 115 habit formation apps for iOS and Android to understand how they support contextual cues. Turns out they don’t. Almost all apps follow the same pattern: you enter a goal, set up optional reminders, and then record every day that you’ve done your task.
Even though context is crucial, apps do not encourage users to select environmental cues that could guide their behaviour. Instead of forming a healthy habit, users develop the habit of using the app and learn to rely on
reminders. The latter can actually get in the way of habit formation.
My colleagues from UCL and I ran two studies to investigate how reminders support habit formation compared with contextual cues. We asked some participants to use existing routine events as cues and to form action plans (e.g. ‘I will do X after eating lunch’). Another group received reminders,
and the rest (the control group) were simply told to repeat their behaviour.
We discovered that participants who formed action plans and relied on daily
routines developed stronger habits. Those who had to respond to reminders forgot less often, but formed even weaker habits than the control group. This is not entirely surprising: if people know something will remind them, they don’t even try to remember on their own.
Of course, all that complicates the design of health and wellness apps. Providing reminders and simple tracking options is not enough if we want our apps to be effective in the long term. These make people dependent on the app, rather than helping them achieve real change. To ensure our
users form new habits we need to remind ourselves why people use these apps.
Good behaviour change apps are like bicycle training wheels. They help you start off and guide you as you develop your skills, so you can finally ride without them. The goal is to help users make that new behaviour part of their daily routine. Over-reliance on the app can get in the way of this.
We need to change how we think about behaviour change apps. The obsolescence should be the main measure of success, and continued engagement with the app a sign of failure. So the next time you’re working
on an app that aims to help users change their behaviour, ask yourself what you can do to make users abandon the training wheels. Because if your app works, they won’t need them any more.
Katarzyna is currently doing a PhD at UCL. Her research explores how smartphone apps could help people make healthy behaviours part of their daily routine
This article originally appeared in issue 273 (November 2015) of net magazine.