Investigating Avatar Customization as a Motivational Design Strategy for Improving Engagement with Technology-Enabled Services for Health
Technology-enabled services for physical and mental health are a promising approach to improve healthcare globally. Unfortunately, the largest barrier for effective technology-based treatment is participants' gradually fading engagement with effective novel training applications, such as exercise apps or online mental health training programs. Engaging users through design presents an elegant solution to the problem; however, research on technology-enabled services is primarily focused on the efficacy of novel interventions and not on improving adherence through engaging interaction design. As a result, motivational design strategies to improve engagement---both in the moment of use and over time---are underutilized. Drawing from game-design, I investigate avatar customization as a game-based motivational design strategy in four studies. In Study 1, I examine the effect of avatar customization on experience and behaviour in an infinite runner game. In Study 2, I induce different levels of motivation to research the effects of financial rewards on self-reported motivation and performance in a gamified training task over 11 days. In Study 3, I apply avatar customization to investigate the effects of attrition in an intervention context using a breathing exercise over three weeks. In Study 4, I investigate the immediate effects of avatar customization on the efficacy of an anxiety reducing attentional retraining task. My results show that avatar customization increases motivation over time and in the moment of use, suggesting that avatar customization is a viable strategy to address the engagement barrier that thwarts the efficacy of technology-enabled services for health.
digital health, avatar customization, motivational design, engagement
Doctor of Philosophy (Ph.D.)