Most health technologies are designed to support people who have already decided to work toward better health. Thus, there remains an opportunity to design technologies to help motivate people who have not yet decided to make a change. Understanding the experiences of people who have already started to make a health behavior change and how they made a pivotal decision can be useful in understanding how to design such tools. In this paper, we describe results from data collected in 2 phases. Phase 1 consisted of 127 surveys and 13 interviews with adults who have already accomplished behavior change(s). Phase 2 consisted of 117 surveys and 12 interviews with adults who have either already accomplished their behavior change(s) or are currently working toward them. We identified four factors that lead to pivotal experiences: (1) prolonged discontent and desire to change, (2) significant changes that increase fear or hope of future, (3) increased understanding of one's behavior and personal data, and (4) social accountability. We also describe a design space for designing technology-based interventions for encouraging people to decide to make a change to improve their health. Based on feedback from participants, we discuss opportunities for further exploration of the design space for people who are not yet motivated to change and for ethical considerations for this type of intervention.
Keywords: Behavior change; Design; Health; Motivation; Persuasive technologies; Pivotal moments.
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