Running Head: Thesis

Thesis
Laura Eng
Student Number: 100483366
UOIT Thesis I I
April 2016
Abstract
This study looks at mobile health and fitness apps and their potential to intrinsically
motivate us to achieve our diets and exercise goals. Using Self-Determination Theory as a
framework to guide the research, features that support these psychological needs and in turn
intrinsic motivation were identified. The characteristics of these features were looked at in detail
the outcome was used in the analysis of data which determined that apps that utilize specific
behavior change techniques (BCTs) have the ability to support intrinsic motivation. The same
process was used with specific app features that end users identified as preferable, although more
difficult to determine, some of the features identified by end users also possess the same
characteristics known to support intrinsic motivation.

THESIS

Table of Contents
Abstract............................................................................................................................................1
Acknowledgements..........................................................................................................................4
Chapter 1: Introduction....................................................................................................................5
Statement of the Problem.............................................................................................................5
Significance of the Problem.........................................................................................................6
Chapter 2: Literature Review...........................................................................................................7
Features of Health and Fitness Apps............................................................................................7
Commonly Features used to Promote Behavior Change in Health and Fitness Apps (BCTs).7
Preferred Health and Fitness App Features Identified by End Users.....................................10
Using Self-Determination Theory in a Health and Fitness Context..........................................13
Theoretical Framework..............................................................................................................14
Research Questions....................................................................................................................15
Chapters 3: Methods......................................................................................................................16
Search Strategies........................................................................................................................17
Data Collection & Analysis........................................................................................................17
Inclusion/Exclusion Criteria...................................................................................................17
Thematic Analysis......................................................................................................................18
Chapter 4: Analysis and Discussion..............................................................................................21
Chapter 5: Conclusion...................................................................................................................27
References......................................................................................................................................28
Appendix I

List of Tables
Table 1: Overview of Data Collection and Analysis........................................................................5
Table 2: Behavior Change Techniques (BCTs)................................................................................8
Table 3: Summary of App Features & the Psychological Need they Support...............................11
Table 4: Keyword Search Terms...................................................................................................17
Table 5: List of Themes Based on the Literature Review..............................................................18
Table 6: List of Coded Article used for the Data Analysis............................................................19

List of Figures
Figure 1: The Psychological Needs the Support Intrinsic Motivation...........................................14
Figure 2: Types of Motivation.......................................................................................................15
Figure 3: Features & Characteristics the Support the Psychological needs of Competence,
Relatedness and Autonomy............................................................................................................16
Figure 4: Summary of Data Collected...........................................................................................20
Figure 5: Mapping the Characteristics and Features of SDT to those Found in App the Utilize
BCTs..............................................................................................................................................22
Figure 6: Mapping the Characteristics and Features of SDT to User Identified App Preferences 24
Figure 7: Comparing BCTs to User Identified Preferences...........................................................25
Figure 8: Overview of Mapping of the Data.................................................................................26

Acknowledgements
I like to express my sincere thanks to both Jordanne Christie and Todd Blayone for their
guidance, support and encouragement throughout this research and writing process. Todd your
commitment and enthusiasm certainly helped to get me through the challenging times and your
ability to provide the right resources at the right time was incredibly valuable. Id also like to
take a moment to thank my peers both former and current, the knowledge weve shared and the
bonds weve made have only added to this experience and made it that much more rewarding
and easier to stick to over the course of the last four years.
I want to take a moment to thank my employer for believing in me and providing me with
the opportunity to further my education. Next many thanks to my colleagues, friends, running
and workout companions for the check-ins that kept me motivated and for reminding me that
what Im doing is significant and thats why its hard, nothing worth it ever comes easy.
Finally I have to thank my family and most importantly my children who inspire me to be
better every day. I thank you for your unconditional love, patience and sacrifice. I know sharing
your Momma hasnt been easy, I hope it wont be long before the memories of sacrifice are
replaced with pride.
I honestly couldnt have stuck to it for as long as I have and accomplished what Ive
accomplished along with way without the support of all of you mentioned within, thank you for
playing a role in my personal growth.

Chapter 1: Introduction
The purpose of this paper was to analyze research conducted on the most common features
used in health and fitness apps and to determine if these features have the potential to
intrinsically motivate people to adhere to their diet and exercise goals. Characteristics and
features known to support behavior change as well as user identified preferences were examined
using the theoretical lens of Self-Determination Theory, a theory of motivation. The results of
this meta-synthesis identified features known to support intrinsic motivation which is the type of
motivation most likely to engage in and sustain behavior changes (Segar & Hall, 2011, Deci &
Ryan 2000, Ng. et. al. 2012, Sundar et. at., 2012). Table 1 provides an overview of the process
taken to collect and analyze this data.
Table 1: Overview of Data Collection and Analysis

Statement of the Problem

The benefits of eating well and exercising regularly are well researched, however the
number of overweight and obese adults in Canada continues to climb. As of 2014, 54% of

Canadian adults were considered overweight or obese (Statistics Canada, 2014). Physical
activity and diet are two of the many factors that influence obesity. (Statistics Canada, 2014). Yet
simply getting people to change their behaviors to improve health and wellbeing doesnt happen
based on knowledge. Research shows that lasting behavior change must be intrinsic and come
from within. (Segar & Hall, 2011, Deci & Ryan 2000, Ng. et. al. 2012, Sundar et. at., 2012).
Significance of the Problem
Obesity is a serious public health concern, it has been linked with many chronic diseases,
including hypertension, type 2 diabetes, cardiovascular disease, osteoarthritis and certain types of
cancer (Statistics Canada, 2006) which impact our healthcare system and economy. The
estimated economic cost of obesity was $4.6 billion as of 2008. To date many interventions have
had modest effects (Direito et. al, 2014). However with the latest estimate of one in five people
currently utilizing mobile health and fitness apps (Conroy et. al, 2014) the capability of mobile
health technology to promote health related behavior change becomes an important finding for
public health. To determine this one must understand the psychological needs that support
motivation.

Chapter 2: Literature Review

The review of literature focused primarily on two things, first health and fitness app
features and second self-determination theory. Within the literature review of health and fitness
apps, commonly used features known to support behavior change in apps and user preferred app

features were explored. Within the literature on Self-Determination Theory, characteristics of

competence, autonomy and relatedness were explored.
Features of Health and Fitness Apps
Commonly Features used to Promote Behavior Change in Health and Fitness Apps (BCTs)
A review of current literature was conducted to explore studies that summarized features
commonly used in health and fitness apps to promote behavior change. In my preliminary
research I stumbled upon an article that looked at top apps and their use of Behavior Change
Techniques (BCTs). Through this article I was able to see that there were 26 specific Behavior
Change Techniques the researchers within were looking to find when analyzing top health and
fitness apps. BCTs are identified intervention techniques grounded in health behavior to
promote behavior changes (Webb et. al., 2010). These BCT interventions can be further broken
down into categories of motivational and educational in nature (Conroy et. al., 2014). As part of
my inclusion criteria I analyzed only papers that researched the use of the 26 BCT derived from
the Taxonomy of Behavior Change Techniques developed by Abraham and Michie (2008).
Listed in Table 2 are the 26 BCTs in this taxonomy.

Table 2: Behavior Change Techniques (BCTs)

1. Provide general information

2. Provide information on consequences

3. Provide information on others approval

4. Prompt intention formation

5. Prompt barrier identification

6. Provide general encouragement

7. Set graded tasks

8. Provide instruction

9. Model or demonstrate behavior

10. Prompt specific goal setting

11. Prompt review of behavior goals

12. Prompt self-monitoring of behavior

13. Provide feedback on performance

14. Provide contingent rewards

15. Teach to use prompts/cues

16. Agree on behavior contract

17. Prompt practice

18. Use follow-up prompts

19. Provide opportunities for social

comparison
21. Prompt
identification as a role model

20. Plan social support/social change

22. Prompt self-talk.

23. Relapse prevention

24. Stress management

25. Motivational interviewing

26. Time management

Source: Abraham and Michie (2008).

In a review of smartphone features for behavior change much of the literature available
took a look at top apps in both the paid and free sections within the health and fitness category
of either the Google Play app store or iTunes app store. (Conroy et. al., 2014, Direito et. al,.
2014). In November 2012, Direito et. al. located and downloaded 40 apps that either promoted
health, prevented disease or specifically addressed physical activity and or dietary behavior. Of
the apps, 20 of these came from the paid top apps category and 20 from the free top apps
category. There were 30 related to physical activity, and 6 related to dietary change and 4
incorporated both physical activity and dietary changes. Out of the 26 available BCTs an
average of 8.1 BCTs were used in the 40 apps reviewed. On average paid apps used more BCTs
than free apps. The review the most common BCTs used were provide instruction with 83%, set
graded tasks with 70% and prompt self-monitoring at 60%.

In research conducted by Conroy et. al., 2014, 200 apps were analyzed in an attempt to
characterize BCTs in health and fitness apps. Of the 200 screened health and fitness apps 167
involved physical activity. Through their research they found apps could be broken into two
distinct categories. Of the apps 57% represented physical activity motivation and 46%
represented a focus on physical activity education. Out of the 26 available BCTs, an average of 4
BCTs were used in the 167 apps reviewed. Both Conroy et. al and Direito et. al. found on
average paid apps used more BCTs than free apps. The most common observed BCTs within the
apps included provide instruction with 66%, model demonstrate behavior with 53%, provide
feedback on performance with 50%, prompt specific goal setting at 38% and plan social
support/social change at 37%. Apps that focused on physical activity motivation possessed
BCTs that had an emphasis on social and self-regulation of physical activities such as feedback
on performance, plan social support/change, goal setting. Apps that focused on physical activity
education possessed BCTs that provide instruction on how to perform the behavior as well as
modeling/demonstration.
Webb et. al., also looked at BCTs in apps from an intervention point of view. Using a metaanalysis of 85 studies and 43,236 participants, characteristics of internet based interventions that
best promote health behavior change were examined, in addition to this effectiveness of
incorporated BCTs was also measured. According to Webb et. al, overall interventions had a
statistically small but significant effect on health related behavior (Webb et. al, 2010). Of the
interventions 29% included the BCT goal setting, 30% included barrier identification and
problem solving, 29% included provides instruction, 33% prompt self-monitoring of behavior,

34% provide information on the consequences. Interventions that incorporated more BCTs
tended to have larger effects compared to interventions that incorporated fewer BCTs.
Within the research review of app features used to support behavior change, similarities
between studies include the limited amount of BCTs used in health and fitness apps (Conroy et.
al., 2014, Direito et. al,. 2014, Webb et. al, 2010) and the types of BCTs used in current health
and fitness apps.
Preferred Health and Fitness App Features Identified by End Users
The following articles provide insight into what features users prefer in health and fitness
apps. Research conducted by Ahtinen et al., (2009) examined user experience results to identify
valuable features of three mobile wellness applications. Participants identified ease of use,
usefulness, and motivating factors as important in health and fitness apps. Of particular interest,
motivating features included adaptable training programs and goal setting, long term information
about progress, visuals that show progress towards the goals and coaching. Similar findings
were represented in an articles by Tang et. al (2014) and Bort-Roig et. al. (2014) where in
addition to goal setting participants added self-monitoring, social support to their preferred app
features. Identification of achievements and symbolic rewards as well as and personalized
tailoring, were also listed as motivating features (Tang et. al., 2014) as was real-time feedback
(Bort-Roig et. al. 2014). Many tools were also identified as useful due to their ability to aid in
self-monitoring. Specifics like extensive food databases, scanners and diaries were noted as
particularly useful as they provided users with greater self-awareness (Tang et. al., 2014).
In research presented by Ramanathan et. al,. (2013), persons at risk; those living with HIV
and young mothers, were asked to identify preferences for mobile health for the purpose of self-

management. The preferred features of self-monitoring, social support and personalization noted
in the Tang et. al. (2014) research were mirrored in these two distinctly different groups. Other
features such as reminders, goal setting, motivational messaging, problem solving and feedback
were also listed as attractive.
Contact for social support had both a positive and negative implication specifically as it pertains
to privacy which was as a concern amongst participants (Ahtinen et al., 2009, Ramanthan et. al,
2013, Tang et. al, 2014). To eliminate privacy concerns, Tang et. al., (2014) suggested having
online interactions optional and not mandatory research also suggested end users feel passwords
are important in protecting their personal information (Ramanthan et. al, 2013).
Using Self-Determination Theory to frame their research Mendiola, Kalnicki & Lindenauer
(2015) conducted research on 234 apps to identify features and characteristics most-valued by
patient-consumers (users). Although the purpose of this research was to identify the features
and characteristic most-valued by patient-consumers that contribute to a positive app rating the
app features and characteristics listed within will be used in the analysis section of this paper as
they link app features to the psychological needs of competence, relatedness and autonomy
within Self-Determination Theory (SDT). A summary of these features, descriptions and the
relevant construct they represent can be found in Table 3.
Table 3: Summary of App Features & the Psychological Need they Support
App feature or
characteristic

Description of feature or characteristic

Relevant construct(s) &

principle(s)

Export of Data

Feature that allows the user to communicate or send

information/ data to a health care provider (eg, email
and EHR/PHR)

Relatedness (care team

collaboration and support)

Gamification

Feature that offers points, badges, or movement

Autonomy (extrinsic

App feature or
characteristic

Description of feature or characteristic

Relevant construct(s) &

principle(s)

through levels as a health objective is achieved or

the more a patient is engaged.

motivation, engagement)

General
education

Feature that provides basic educational material

about a disease/condition, including causes,
treatment, or management

Autonomy (intrinsic
motivation); competence
(knowledge)

Plan or orders

Feature that provides a plan of action for reaching

target goal, including specific, executable steps to
guide the process.

Competence [actionable
insights]; Autonomy [goalsetting]

Reminder

Feature that prompts the user to partake in a specific

behavior through the use of a predetermined alert.

Competence [cue to action]

Community
forum

Feature that functions as a message board or chat

room and allows likeminded individuals, whether
patients with similar health conditions or their
caregivers, the opportunity to share questions and
experiences

Relatedness (social support,

social norms); autonomy
(acknowledging individual
perspectives)

Feature that connects the user to Facebook, Twitter,

or other social media platforms, thereby allowing
the user to communicate progress with family,
friends, colleagues, or others with ties to the user

Relatedness (social support,

contextualization)

Addresses
symptoms

Feature that addresses and assists in managing a

disease that is associated with pain or other
noticeable symptom(s)

Competence (educate, inform);

autonomy (self-monitoring)

Tailored
education

Feature that offers patient-specific education tailored

to a persons needs, interests and usage depending
on his/her stage or progression of disease (eg, week
of pregnancy)

Relatedness (personalization);
competence (knowledge, skill
development)

Tracker

Feature that allows for self-monitoring by recording

information in order to modify personal attitudes or
behaviors to achieve a predetermined goal or
outcome.

Autonomy (self-monitoring,
self-regulation)

Cost

Identification of cost of the app (free, upfront

payment, and/or in-app purchases)

N/A

Usability

Identification of satisfactory usability based on

compliance with five interface design heuristics

Nielsens usability heuristics

for user interface design

Social media

Source: Mendiola, Kalnicki & Lindenauer 2015

Using Self-Determination Theory in a Health and Fitness Context

Using Self-Determination Theory to frame their research, Ng et. al., 2012, examined the
idea that behavior change in a health context is more effective when patients are autonomously
motivated. Autonomy is one of the three physiological needs Ryan and Deci claim need to be
fulfilled in order for a person to be intrinsically motivated (Ryan and Deci, 2000). This article
demonstrates a positive correlation between autonomous motivation to exercise and physical
well-being. Similarity using self-determination theory, a positive correlation between users
participation in online health communities and exercise was observed in Ba & Wang (2013)
analyzed data. Here they state that although social motives are extrinsic to the activity they may
contribute to adherence because social interaction can add to enjoyment making it more
intrinsically motivating (Ba & Wang, 2013). Although the research within this paper was not
specific to health and fitness apps, online communities are often features in health and fitness
apps which makes it relevant. Both these articles show how the Self-Determination Theory can
help frame research both digitally or otherwise in a health and fitness context.
Taking a slightly different approach while still using Self-Determination Theory to frame
their research, Saundar et. al.,2012 propose a theoretical model of motivational technology to
promote health behaviors stating interactivity builds relatedness, customization builds autonomy,
navigability builds competence. This article was significant as it specifically identified app
features such as interactivity, customization and navigability as those that support the
psychological needs within self-determination theory, another difference between this article and
the others was that these particular findings were as a results of qualitative studies where end
users had identified motivation features; rather they were based on empirical evidence.

Theoretical Framework
I used Basic Psychological Needs Theory, a sub theory of Self-Determination Theory, as
my theoretical framework. Self-Determination Theory is a motivational theory originally
developed by Deci and Ryan (Deci & Ryan 1985, 1991, 2000, 2002). Self-Determination
Theory (SDT) represents a broad framework for the study of human motivation and personality.
Self-Determination Theory proposes that human behavior is influenced by the primary
psychological needs for autonomy, competence and relatedness (Deci & Ryan 1985, 1991, 2000,
2002). Autonomy reflects the need to engage in behaviors with a sense of choice. Competence
represents the need to feel optimally challenge and capable of achieving goals and desired
outcomes. Relatedness reflects the degree to which an individual feels connected to and
understood by others (Patrick & Canevello, 2011), this is visually represented in Figure 1.
Figure 1: The Psychological Needs the Support Intrinsic Motivation

In addition to this, Self-Determination Theory makes a distinction between controlled and

autonomous regulation of behavior which reflect the degree to which behaviors are volitional

and choiceful (Patrick & Canevello, 2011). When a goal is set by an individual and is selfdriven, the behavior is said to be autonomous; in contrast controlled behavior is a reflection of
forced adherence to certain goals set by other people (extrinsic factors) (Sundar et. al., 2012)
Figure 2 shows the motivational continuum that represents controlled and autonomous
motivation.
Figure 2: Types of Motivation

Research Questions
To determine if mobile health and fitness apps can help to intrinsically motivate us to
achieve our diets and exercise goals, the following questions were explored:

Are there app features which are known to support intrinsic motivation?
What are the common features used in apps to support behavior change?
When given the choice what features or characteristics do end users prefer?
o Are the features currently offered to support behavior change the same features
that we prefer to use?

Chapters 3: Methods
A qualitative meta-synthesis was used to combine the results and generate new meaning
from existing studies related to features of health and fitness apps. Using Self-Determination
Theory as a theoretical lens, a deductive approach was taken whereby the psychological needs
that support intrinsic motivation were used to seek out app features that support these needs.
According to Blackstone, (2012) when researchers take a deductive approach, they move from
theory to data, or from the general to specific (A. Blackstone, 2012). The features found are
visually represented in Figure 3 and were used in the analysis of the data to identify and
characterize app features commonly used to promote behavior change and user identified app
preferences.
Figure 3: Features & Characteristics the Support the Psychological needs of Competence,
Relatedness and Autonomy

Search Strategies
Data was collected through the use of multiple structured searches. Key words used to
perform searches are outlined in Table 4: Keyword Search Terms. Searches were performed
using Google Scholar and the UOIT library, in addition to this some searches were performed
using the Google search engine. As Google is a vast internet search engine, critical information
literacy was used to further filter information. This consists of determining authority, accuracy,
objectivity, currency and coverage of articles found using the Google search engine. Reference
mining was also used in some cases to seek out related articles specific to motivational features
in health and fitness apps.
Table 4: Keyword Search Terms
Search 1

Health + Fitness + Mobile App + Motivation

Search 2

Mobile App + Health + Fitness + Impact + Outcome

Search 3

Health + Fitness + Mobile App + Self Determination

Search 4

Mobile Intervention + Health + Fitness + Self Determination

Data Collection & Analysis

Inclusion/Exclusion Criteria
Given that the topic of mobile health and fitness app usage is relatively new, only articles
less than 10 years old have been included in the analysis of health and fitness app features. To
ensure further consistency in data collection, only papers that researched the use of BCT in top
health and fitness apps were used when looking at app features that commonly used in behavior
change. No date exclusions were made for articles pertaining to theories of motivation and the
theoretical framework Self-Determination Theory, whereby the psychological needs of

competence, relatedness and autonomy are said to promote intrinsic motivation (Deci & Ryan,
2000). Not included in this analysis are thesis papers or dissertations.
Thematic Analysis
Using my theoretical framework I sought to identify and further characterize app features
commonly used in behavior change as well as features identified as preferable by end users. The
themes that emerged through the collection of data and literature review can be found in Table 5.

Table 5: List of Themes Based on the Literature Review

Themes

Codes

Feature identification

BCT Behavior change technique

UIP User identified preference

Type of Apps

ED Educational
MOT Motivational

Reoccurring App Features

EOU Ease of Us

(that support the psychological needs of SDT)

SS Social Support
PER Personalization
SELF Self-monitoring

Theoretical Framework

SDT Self-determination Theory

Four main themes emerged in the coding during the thematic analysis. How features
were identified; the type of app, specific reoccurring features and the use of Self-Determination
Theory in health and fitness. Table 6 contains a list of coded articles use for the data analysis
and discussion.

Table 6: List of Coded Article used for the Data Analysis

No.

Article

Codes

1.

Ahtinen, A., Mattila, E., Vtnen, A., Hynninen, L., Salminen, J.,
Koskinen, E., & Laine, K., 2009

EOU, MOT

2.

Ba, S., & Wang, L., 2013

SELF, SS,

3.

Bort-Roig, J., Gilson, N. D., Puig-Ribera, A., Contreras, R. S., &

Trost, S. G., 2014
Conroy, D. E., Yang, C. H., & Maher, J. P., 2014

SELF, SS, EOU

Direito, A., Dale, L. P., Shields, E., Dobson, R., Whittaker, R., &
Maddison, R., 2014
Friederichs, S. A., Oenema, A., Bolman, C., Guyaux, J., van
Keulen, H. M., & Lechner, L., 2014
Ng, J. Y., Ntoumanis, N., Thgersen-Ntoumani, C., Deci, E. L.,
Ryan, R. M., Duda, J. L., & Williams, G. C., (2012.

BCT, ED, MOT, SS,

SELF
SDT

8.

Mendiola, M. F., Kalnicki, M., & Lindenauer, S., 2015

SDT

9.

Ng, J. Y., Ntoumanis, N., Thgersen-Ntoumani, C., Deci, E. L.,

Ryan, R. M., Duda, J. L., & Williams, G. C., 2012

SDT

10.

Patrick, H., & Canevello, A., 2011

SDT

11.
12.

Ramanathan, N., Swendeman, D., Comulada, W. S., Estrin, D., &

Rotheram-Borus, M. J. , 2013
Sundar, S. S., Bellur, S., & Jia, H., 2012

SELF, SS, PER,

EOU
SDT

13.

Tang, J., Abraham, C., Stamp, E., & Greaves, C., 2015

PER, EOU, SS,

14.

Webb, T., Joseph, J., Yardley, L., & Michie, S., 2010

BCT

4.
5.
6.
7.

BCT, ED, MOT

SDT

Articles reviewed cover a range of studies in terms of size, length and methodology.
Using these articles I was able to gather data on app features that support SDT, Common BCTs
used in top apps and User Identified app Preferences, a summary of this data used in the analysis
is represented in Figure 4.

Figure 4: Summary of Data Collected

Chapter 4: Analysis and Discussion

The goal of the analysis was to map the characteristics and features found to support
intrinsic motivation with both the characteristics and features commonly used to support
behavior change in apps as well as the features identified by end users as preferred. To do this I
analyzed each of the features as well as the description and characteristics of each feature known
to support the psychological needs of competence, relatedness and autonomy; in doing so I was
able to compare them to the BCTs used in top health and fitness apps.
Looking at the commonly used BCTs in apps and the descriptions of the
features/characteristics and corresponding construct or principle identified by Mendiola, Kalnicki
& Lindenauer (2015) the following categories were assigned.
Commonly used BCTs in Apps
barrier identification
model demonstrate behavior
plan social support/social change
problem solving
prompt self-monitoring
prompt specific goal setting
provide feedback on performance
provide information on the consequences
provides instruction
set graded tasks

Relevant construct(s) & Principle(s)

Competence (actionable insights);
Autonomy (intrinsic motivation);
Competence (knowledge)
Competence (actionable insights);
Autonomy (goal-setting)
Competence (success)
Autonomy (self-monitoring, self-regulation)
Competence (actionable insights);
Autonomy (goal-setting)
Competence (actionable insights);
Relatedness (care team collaboration and
support)
Autonomy (self-monitoring, self-regulation)
Autonomy (intrinsic motivation);
Competence (knowledge)
Competence (actionable insights);
Autonomy (goal-setting)

Through this analysis I determined that the features and characteristics that support these
psychological needs can be mapped to the most common BCTs found in tops apps. This is
visually represented in Figure 5
Figure 5: Mapping the Characteristics and Features of SDT to those Found in App the
Utilize BCTs

When looking at apps features that support behavior change it was noted none of the apps
in the analysis utilized more than 8 of the 26 available BCTs. The most commonly used BCTs
were those that provided instruction - autonomy (intrinsic motivation); competence (knowledge),
followed by those that support self-monitoring autonomy (self-monitoring, self-regulation),
and finally those that allow for specific goal setting competence (action able insights); autonomy
(goal-setting).

Mapping the user identified preferences proved to be more difficult. Preferences

identified such as motivating features, coaching and visuals toward goals were not clearly
identified leaving room for misinterpretation.
Looking at the user identified features in apps and the descriptions of the
features/characteristics and corresponding construct or principle identified by Mendiola, Kalnicki
& Lindenauer (2015) the following categories were assigned.
User Identified Features
Ease of use
Usefulness
Motivating factors
Personalized tailoring
Goal setting

Relevant construct(s) & Principle(s)

Competence (skill development)
N/A
N/Aa
Relatedness (personalization);
Competence (actionable insights);
Autonomy (goal-setting)
Progress report
Autonomy (self-monitoring, self-regulation)
Goal visuals
N/A
Coaching
N/A
Self- monitoring
Autonomy (self-monitoring, self-regulation)
Social support
Relatedness (social support, contextualization
social norms);
Autonomy (acknowledging individual
perspectives)
Achievements
Autonomy (extrinsic motivation, engagement)
Feedback
Competence (actionable insights);
Relatedness (care team collaboration and
support)
Self-monitoring tools
Autonomy (self-monitoring, self-regulation)
Competence (knowledge, skill development)
a) Motivating factors vary, specific factors would need to be identified in order to be
characterized

Through this analysis I determined that some of the features and characteristics that
support these psychological needs can be mapped to user identified preferences, a visual
representation is presented in Figure 6.

Figure 6: Mapping the Characteristics and Features of SDT to User Identified App
Preferences

The most commonly requested features were, tools that help with self-monitoring
autonomy (self-monitoring, self-regulation), features that provide social support relatedness
(social support, social norms); autonomy (acknowledging individual perspectives) and feedback
on performance relatedness (social support).
Surprisingly, similarities between the user identified preferences and the commonly used
BCTs were minimal. Some of these similarities included self-monitoring, feedback on
performance, social support and goal setting, a visual representation of the mapping can is
presented in Figure 7.

Figure 7: Comparing BCTs to User Identified Preferences

According to Conroy et. al, (2014) apps that focused on physical activity motivation
emphasize social and self-regulation so features like feedback on performance, plan social
support/change, goal setting are key so its not surprising that both the BCTs and user identified
preferences note these characteristics. Apps that focused on physical activity education
emphasize providing instruction on how to perform the behavior as well as
modeling/demonstration. This was something commonly used in BCT group although not
identified as a user identified preference
Based on the data analysis, overall many of the features known to support the
psychological needs of competence, relatedness and autonomy and in turn intrinsic motivation
were found in apps that utilized BCTs. In addition to this many of these features were similar to
those identified as preferable by end users. Based on this, theoretically is can be said that apps
that utilize these features have the potential to support intrinsic motivation. A visual
representation can be found in Figure 8.

Figure 8: Overview of Mapping of the Data

Chapter 5: Conclusion
This study provided important information as it relates to health and fitness apps and the
features used to support intrinsic motivation. Knowing what features to use, what is being used
and which are preferred brings us one step closer to self-regulation, goal adherence and goal
achievement.
In summary, this study shows there are specific apps features and characteristics that help
to support the psychological needs of competence, relatedness and autonomy and in turn intrinsic
motivation, however it is noted there are limitations. This study reviewed multiple studies which
analyzed multiple apps and features, therefore research is required to determine if these features
might be available in one app or if end users would have to utilize multiple apps to fulfil these
psychological needs. In addition to this it is also suggested that further research be conducted to
determine if increasing the number of features that support psychological needs correlates to a
greater sense of fulfilment and in turn intrinsic motivation.

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Appendix I
Defining Key Terms
Self-determination Theory: is a macro theory of human motivation and personality,
concerning people's inherent growth tendencies and their innate psychological needs. It is
concerned with the motivation behind the choices that people make without any external
influence and interference. SELF-DETERMINATION THEORY focuses on the degree to which
an individuals behavior is self-motivated and self-determined. (Wikipedia, 2015)
Intrinsic Motivation: is defined as the doing of an activity for its inherent satisfactions
rather than for some separable consequence. When intrinsically motivated a person is moved to
act for the fun or challenge entailed rather than because of external prods, pressures, or rewards
(Deci & Ryan, 2000)
Extrinsic Motivation: is a construct that pertains whenever an activity is done in order to
attain some separable outcome. For the purpose of this research and in the context of Selfdetermination theory, extrinsically motivated behavior can vary greatly in the degree from
nonautonomous to autonomous. (Deci & Ryan, 2000)
Behavior Change Techniques (BCTs) 26 specific identified intervention techniques
grounded in health behavior as identified by Abraham and Michie (2008).
Autonomous Motivation: comprises of both intrinsic motivation and the types of extrinsic
motivation people have identified with an activitys value and have integrated it into their sense
of self. When people are people are autonomously motivated, they experience volition or a selfendorsement of their actions. (Deci & Ryan, 2008)

Controlled Motivation: consists of both external regulation, in which ones behavior is a

function of external contingencies of reward or punishment and introjected regulation, in which
the regulation of their action has been partially internalized and is energized by factors such as
approval, avoidance of shame, contingent self-esteem and ego-involvements, when people are
controlled they experience pressure to think, feel or behave in a particular ways. (Deci & Ryan,
2008)
Competence: People need to gain mastery of tasks and learn different skills. (About
Education, ND)
Autonomy: People need to feel in control of their own behaviors and goals. (About
Education, ND)
Relatedness: People need to experience a sense of belonging and attachment to other
people. (About Education, ND)