Skip to main content

Persuasive System Design Features for Mobile Mental Health Applications

  • Conference paper
  • First Online:
Persuasive Technology (PERSUASIVE 2024)

Abstract

Mobile mental health applications show promise and may be suitable for low-resource contexts, however, they remain underutilized. Designing and developing mental health applications that consider users’ preferences and experts’ recommendations and integrate with persuasive design principles may increase uptake. However, research in the field is scarce in low-income contexts including Ethiopia.

Our research involved five main steps. First, we performed a literature review to identify existing evidence and recommendations. We adapted 15 app features from the existing literature. Second, we conducted two rounds of a modified Delphi study with 21 experts in the first and 16 in the second rounds to reach a consensus on the 15 adapted key app features. Third, we surveyed 419 individuals in Ethiopia with mental disorders to understand their needs and preferences for the adapted app features. Fourth, we integrated persuasive system design principles into the adapted app features. Fifth, we collaborated with experts to code the application content and finalize the prototype. The next step will be the development of the app in the Ethiopian official language, and usability testing of the application.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Arias, D., Saxena, S., Verguet, S.: Quantifying the global burden of mental disorders and their economic value. EClinicalMedicine 54, 101675 (2022)

    Article  Google Scholar 

  2. Vigo, D., Thornicroft, G., Atun, R.: Estimating the true global burden of mental illness. Lancet Psychiatry 3(2), 171–178 (2016)

    Article  Google Scholar 

  3. Walker, E.R., McGee, R.E., Druss, B.G.: Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiat. 72(4), 334–341 (2015)

    Article  Google Scholar 

  4. Funk, M.: Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level, Retrieved 30 2016

    Google Scholar 

  5. Fekadu, A., et al.: Excess mortality in severe mental illness: 10-year population-based cohort study in rural Ethiopia. Br. J. Psychiatry 206(4), 289–296 (2015)

    Article  Google Scholar 

  6. Kassa, G.M., Abajobir, A.A.: Prevalence of common mental illnesses in Ethiopia: a systematic review and meta-analysis. Neurol. Psychiatry Brain Res. 30, 74–85 (2018)

    Article  Google Scholar 

  7. Giorgis, K.S.T.W.: National Mental Health Strategy 2020–2025: Ministry of Health, Ethiopia (2020)

    Google Scholar 

  8. Ben-Zeev, D.: Technology in mental health: creating new knowledge and inventing the future of services. Psychiatr. Serv. 68(2), 107–108 (2017)

    Article  Google Scholar 

  9. Roth, C.B., et al.: Psychiatry in the digital age: a blessing or a curse? Int. J. Environ. Res. Public Health 18(16), 8302 (2021)

    Google Scholar 

  10. Serrano-Ripoll, M.J., et al.: Impact of smartphone app-based psychological interventions for reducing depressive symptoms in people with depression: systematic literature review and meta-analysis of randomized controlled trials. JMIR Mhealth Uhealth 10(1), e29621 (2022)

    Article  Google Scholar 

  11. Levin, M.E., et al.: Evaluating an adjunctive mobile app to enhance psychological flexibility in acceptance and commitment therapy. Behav. Modif. 41(6), 846–867 (2017)

    Article  Google Scholar 

  12. Lipschitz, J., et al.: Adoption of mobile apps for depression and anxiety: cross-sectional survey study on patient interest and barriers to engagement. JMIR Ment Health 6(1), e11334 (2019)

    Article  Google Scholar 

  13. Hsu, M., et al.: Smartphone ownership, smartphone utilization, and interest in using mental health apps to address substance use disorders: literature review and cross-sectional survey study across two sites. JMIR Form Res 6(7), e38684 (2022)

    Article  Google Scholar 

  14. Magee, J.C., et al.: Mobile app tools for identifying and managing mental health disorders in primary care. Curr. Treat. Options Psych. 5(3), 345–362 (2018)

    Article  Google Scholar 

  15. Larsen, M.E., et al.: Using science to sell apps: evaluation of mental health app store quality claims. NPJ Digit. Med. 2(1), 1–6 (2019)

    Article  MathSciNet  Google Scholar 

  16. Islam, M.A., Choudhury, N.: Mobile apps for mental health: a content analysis. Indian J. Mental Health 7(3), 222–229 (2020)

    Article  Google Scholar 

  17. de Almeida, R.S., et al.: Patients’ perspectives about the design of a mobile application for psychotic disorders = Perspetivas dos pacientes sobre o design de uma aplicação móvel para perturbações psicóticas (2018)

    Google Scholar 

  18. Goodwin, J., et al.: Development of a mental health smartphone app: perspectives of mental health service users. J. Ment. Health 25(5), 434–440 (2016)

    Article  Google Scholar 

  19. Shen, N., et al.: Finding a depression app: a review and content analysis of the depression app marketplace. JMIR mHealth uHealth 3(1), e16 (2015)

    Article  Google Scholar 

  20. Nicholas, J., et al.: Mobile apps for bipolar disorder: a systematic review of features and content quality. J. Med. Internet Res. 17(8), e198 (2015)

    Article  Google Scholar 

  21. Torous, J., et al.: Clinical review of user engagement with mental health smartphone apps: evidence, theory and improvements. BMJ Ment. Health 21(3), 116–119 (2018)

    Google Scholar 

  22. Pywell, J., et al.: Barriers to older adults’ uptake of mobile-based mental health interventions. Digit. Health 6, 2055207620905422 (2020)

    Google Scholar 

  23. Oinas-Kukkonen, H.: Behavior change support systems: a research model and agenda. In: Ploug, T., Hasle, P., Oinas-Kukkonen, H. (eds.) PERSUASIVE 2010. LNCS, vol. 6137, pp. 4–14. Springer, Heidelberg (2010). https://doi.org/10.1007/978-3-642-13226-1_3

    Chapter  Google Scholar 

  24. Ajzen, I.: Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, Prentice-Hall (1980)

    Google Scholar 

  25. Ajzen, I.: The theory of planned behavior. Organ. Behav. Hum. Decis. Process. 50(2), 179–211 (1991)

    Article  Google Scholar 

  26. Fogg, B.J.: A behavior model for persuasive design. In: Proceedings of the 4th International Conference on Persuasive Technology (2009)

    Google Scholar 

  27. Alqahtani, F., et al.: Apps for mental health: an evaluation of behavior change strategies and recommendations for future development. Front. Artif. Intell. 2, 30 (2019)

    Article  Google Scholar 

  28. Shiferaw, S., et al.: Designing mHealth for maternity services in primary health facilities in a low-income setting - lessons from a partially successful implementation. BMC Med. Inform. Decis. Mak. 18(1), 96 (2018)

    Article  MathSciNet  Google Scholar 

  29. Nigussie, Z.Y., et al.: Using mHealth to improve timeliness and quality of maternal and newborn health in the primary health care system in Ethiopia. Glob. Health Sci. Pract. 9(3), 668–681 (2021)

    Article  Google Scholar 

  30. Guracho, Y.D., Thomas, S.J., Win, K.T.: Smartphone application use patterns for mental health disorders: a systematic literature review and meta-analysis. Int. J. Med. Inform. 179, 105217 (2023)

    Google Scholar 

  31. Zamanzadeh, V., et al.: Design and implementation content validity study: development of an instrument for measuring patient-centered communication. J. Caring Sci. 4(2), 165–178 (2015)

    Article  Google Scholar 

  32. Pung, A., Fletcher, S.L., Gunn, J.M.: Mobile app use by primary care patients to manage their depressive symptoms: qualitative study. J. Med. Internet Res. 20(9), e10035 (2018)

    Article  Google Scholar 

  33. Schueller, S.M., et al.: Discovery of and interest in health apps among those with mental health needs: survey and focus group study. J. Med. Internet Res. 20(6), e10141 (2018)

    Article  Google Scholar 

  34. Squires, A.: A valid step in the process: a commentary on Beckstead (2009). Int. J. Nurs. Stud. 46(9), 1284 (2009)

    Article  Google Scholar 

  35. Scrivin, R., et al.: Development and validation of a questionnaire investigating endurance athletes practices to manage gastrointestinal symptoms around exercise. Nutr. Diet. 78(3), 286–295 (2021)

    Article  Google Scholar 

  36. Lynn, M.R.: Determination and quantification of content validity. Nurs. Res. 35(6), 382–386 (1986)

    Article  Google Scholar 

  37. Almathami, H.K.Y., Win, K.T., Vlahu-Gjorgievska, E.: Development and validation of a new tool to identify factors that influence users’ motivation toward the use of teleconsultation systems: a modified Delphi study. Int. J. Med. Inform. 157, 104618 (2022)

    Article  Google Scholar 

  38. Almohanna, A.A.S., et al.: Design and content validation of an instrument measuring user perception of the persuasive design principles in a breastfeeding mHealth app: a modified Delphi study. Int. J. Med. Inform. 164, 104789 (2022)

    Article  Google Scholar 

  39. Davis, L.L.: Instrument review: getting the most from a panel of experts. Appl. Nurs. Res. 5(4), 194–197 (1992)

    Article  MathSciNet  Google Scholar 

  40. Tsegaye, B.S., Asemu, M.M., Hailu, H.B.: Construct validity and Reliability of Amharic version of DASS-21 scale among Ethiopian Defense University College of Health Science Students (2023)

    Google Scholar 

  41. Marcu, G., Bardram, J.E., Gabrielli, S.: A framework for overcoming challenges in designing persuasive monitoring and feedback systems for mental illness. In: 2011 5th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth) and Workshops. IEEE (2011)

    Google Scholar 

  42. Fleming, T., et al.: Digital Tools for Mental Health and Wellbeing: Opportunities & Impact. Findings from the literature and community research (2022). https://www.hpa.org.nz/news/digital-tools-for-mental-health-and-wellbeing

  43. Alqahtani, F., Orji, R.: Insights from user reviews to improve mental health apps. Health Informatics J. 26(3), 2042–2066 (2020)

    Article  Google Scholar 

  44. Howard, A., et al.: Adult experts’ perceptions of telemental health for youth: a Delphi study. JAMIA Open 1(1), 67–74 (2018)

    Article  Google Scholar 

  45. Aryana, B., Brewster, L.: Design for mobile mental health: exploring the informed participation approach. Health Informatics J. 26(2), 1208–1224 (2019)

    Article  Google Scholar 

  46. Matthews, J., et al.: Persuasive technology in mobile applications promoting physical activity: a systematic review. J. Med. Syst. 40, 1–13 (2016)

    Article  Google Scholar 

  47. Win, K.T., et al.: Persuasive systems design features in promoting medication management for consumers (2017)

    Google Scholar 

  48. Portz, J.D., et al.: Persuasive features in health information technology interventions for older adults with chronic diseases: a systematic review. Heal. Technol. 6, 89–99 (2016)

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yonas Deressa Guracho .

Editor information

Editors and Affiliations

Ethics declarations

The authors have no competing interest in the submitted paper. We, all the authors, fully agree to submit to the 19th International Conference on Persuasive Technology 2024 and Publication.

Rights and permissions

Reprints and permissions

Copyright information

© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Guracho, Y.D., Thomas, S.J., Almutairi, N., Win, K. (2024). Persuasive System Design Features for Mobile Mental Health Applications. In: Baghaei, N., Ali, R., Win, K., Oyibo, K. (eds) Persuasive Technology. PERSUASIVE 2024. Lecture Notes in Computer Science, vol 14636. Springer, Cham. https://doi.org/10.1007/978-3-031-58226-4_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-58226-4_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-58225-7

  • Online ISBN: 978-3-031-58226-4

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics