Embedding Psychological Factors in Technology Design to Improve Adherence to Physical Activity: Literature Review and Survey (Preprint)

Abstract

BACKGROUND
Physical inactivity is a main risk factor of death worldwide, and contributes to psychological and physical problems, including obesity. Physical activity (PA) is critical to preventing health deterioration. Many technological interventions designed to promote PA have limited efficacy as some critical variables affecting PA are not considered. This study aims to understand the variables affecting PA, including barriers or facilitators for doing PA to facilitate the design of effective interventions

                OBJECTIVE
                    (1) To investigate the mediating non-demographic variables of physical (in)activity, with emphasis on psychological variables, (2) to study which PA variables are considered in the design of intervention technologies to promote PA, (3) to provide a tool - a questionnaire- that allows the identification of PA variables when exploring the design space, (4) to investigate the relationship of PA variables with individuals' weight and actual PA level.

                METHODS
                    We conducted two literature reviews on PA barriers/facilitators, using PsycINFO and ACM Digital Libraries. The PsycINFO literature search yielded 470 articles of which 50 articles were finally selected; PA barriers/facilitators were studied from these articles and used to design the Barriers Questionnaire for PA (BQPA) with 63 items. The ACM literature search yielded 123 articles, of which 15 articles were finally selected and used to evaluate the attention given to the PA variables in the design of technologies for PA. We then conducted a survey study using the BQPA, the International Physical Activity Questionnaire and demographic questions. The survey was filled out by a representative sample of the Spanish population (N=1012), including participants from all PA and weight levels.

                RESULTS
                    38 variables were identified as PA barriers/facilitators. Few studies evaluate their relationship with the actual PA level, and most lack an actual PA measure. The same barriers are reported for the overweight/obese and the normal-weight population, but some barriers are stronger in the obese. Only 17 out of the 38 variables were considered when developing PA technologies. On the survey data, we related the item scores with the participant's PA level and weight. We found significant correlations between PA level and 62 BQPA items (all P<=.027) and between weight group and 35 BPQA items (all P<=.049).

                CONCLUSIONS
                    Our contribution is three-fold. First, the literature reviews provide an in-depth account of barriers to PA in normal-weight, overweight and obese populations, and illustrate the lack of consideration of these in the design of PA technologies. Second, we propose a novel questionnaire on barriers to PA, specifically designed to ensure consideration of factors identified in the literature review. Third, we show high correlations between many identified variables and PA participation, and demonstrate how actual PA levels and body weight must also be considered. These results can guide future work on technological interventions for PA.