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Dr Callie Thomson | PhD Project | Dissertation | Thesis | Digital Health Intervention Designer | A Framework for Guiding the Interdisciplinary Collaborative Design of mHealth Intervention Apps for Physical Activity Behaviour Change | Rhodes University

PHD PROJECT

Dr Callie Thomson | PhD Project | Dissertation | Thesis | A Framework for Guiding the Interdisciplinary Collaborative Design of mHealth Intervention Apps for Physical Activity Behaviour Change | Rhodes University
Dr Callie Thomson | PhD Project | Dissertation | Thesis | A Framework for Guiding the Interdisciplinary Collaborative Design of mHealth Intervention Apps for Physical Activity Behaviour Change | Rhodes University
Dr Callie Thomson. PhD Project. Dissertation. Thesis. This thesis is definitely in one of the top three (3) theses I have ever evaluated. PhD Examiner Review.

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- PhD Examiner -

 

​"This thesis is definitely in one of the top 3 theses
I have ever evaluated."

BACKGROUND

Background
Dr Callie Thomson | PhD Project | Dissertation | Thesis | Background | Leading NCDs and Modifiable Health Risk Behaviours with a Contextual Focus on Physical Inactivity
Dr Callie Thomson | PhD Project | Dissertation | Thesis | Background | Digital and Mobile Health Technology
Dr Callie Thomson | PhD Project | Dissertation | Thesis | Background | mHealth App Design Example: Physical Activity Behaviour Change

BACKGROUND

The global pandemic of noncommunicable diseases and its associated premature mortality rates and socioeconomic burden have led to increasingly intensified efforts towards designing and delivering health promotion interventions aimed at addressing the leading modifiable health risk behaviours, such as physical inactivity. Developing physical activity interventions that target individuals has become a key objective worldwide. Digital and mobile technology is revolutionising the ways health behaviour change interventions are delivered, with mobile health (mHealth) apps increasingly recognised as a powerful means of promoting physical activity behaviour change.

However, with the growth and opportunities of mHealth apps, come several design challenges. Key design challenges concern the integration of theory, the incorporation of evidence-based behaviour change techniques, the application of persuasive systems design principles, and the importance of multi- and interdisciplinary collaborative design, development and evaluation approaches. These key challenges influence the output product design and effectiveness of mHealth physical activity behaviour change intervention apps.

PROBLEM

There is a paucity of approaches for guiding and supporting the multi- and interdisciplinary collaborative design, development and evaluation of mHealth physical activity behaviour change intervention apps.

RESEARCH QUESTION

How can interdisciplinary teams collaborate in the design, development and evaluation of mHealth physical activity behaviour change intervention apps?

METHODOLOGY

Methodology

METHODOLOGY

The study applied a five-step Design Science Research Methodology (DSRM) as a problem-solving approach, appropriate to addressing complex and multifaceted real world design problems. The process resulted in artefactual, theoretical and methodological contributions.

STEPS & METHODS

1. Awareness of Problem

  • Literature reviews

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2. Suggestion (Tentative Design)

  • Proposed novel theoretical framework

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3. Artefact Development (Iteration 1)

  • Data collection method: Hermeneutic search and acquisition process

  • Data analysis methods:

    • Weick's theorising approach

    • Critical thematic and comparative theoretical analysis method. Analysis of 20 existing multi- and interdisciplinary digital health intervention development approaches to identify main components for framework artefact development.

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4. Evaluation (with Iteration 2)

  • DSR linguistic interpretivist approach, incorporating ontological evaluation and interpersonal verification, to evaluate and refine the framework components.

  • Data collection method: Virtual semi-structured interviews with 31 international researchers and industry practitioners spanning 10 countries.

  • Data analysis method: Qualitative thematic analysis

  • Evaluation findings inform a revised Interdisciplinary mHealth App Design Framework artefact.

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5. Conclusion

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Dr Callie Thomson | PhD Project | Dissertation | Thesis | Methodology | Design Science Research Methodology (DSRM) Applied in Research Study

Design Science Research Methodology (DSRM) Applied in Research Study

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Methodology | Research Design Outlining Methodology and Chapters

Research Design Outlining Methodology and Chapters

LITERATURE REVIEW

Literature Review
Dr Callie Thomson | PhD Project | Dissertation | Thesis | Literature Review | Research Context: Funnelled Overview of Health Landscape

Research Context: Funnelled Overview of Health Landscape

HEALTH LANDSCAPE

  • Overviews the global health landscape:

    • Worldwide NCD pandemic;

    • Health promotion interventions;

    • Importance of behaviour change interventions targeting physical (in)activity as a leading modifiable health risk behaviour.

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  • Applies the socioecological model of health promotion, with a delineated thesis focus on physical activity interventions targeting individuals at the dual intra-interpersonal levels.

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  • Discusses the design of health promotion behaviour change interventions for physical activity at the dual intra-interpersonal socioecological levels, including:

    • An overview of the role of (1) theory, (2) determinants and correlates, and (3) behaviour change techniques in designing effective theory- and evidence-based health promotion interventions for physical activity behaviour change.

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  • Reviews the challenges faced in the design of effective health promotion physical activity behaviour change interventions targeting individuals at the dual intra-interpersonal socioecological levels.

DIGITAL (M)HEALTH LANDSCAPE

  • Overviews the global digital health and mHealth landscape:

    • Consumer health informatics;

    • mHealth and mHealth consumer apps;

    • Physical activity apps targeting individuals at the dual intra-interpersonal socioecological levels.

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  • Discusses the main challenges faced in the design of mHealth physical activity behaviour change intervention apps:

    • The need for collaboration and integration between two broad health behavioural sciences and information systems perspectives to design.

    • Key design challenges (which influence the effectiveness of apps):

      • Integration of theory;

      • Incorporation of evidence-based behaviour change techniques;

      • Application of persuasive systems design principles;

      • Difficulties with interpretive flexibility;

      • Need for multi- and interdisciplinary collaborative design, development and evaluation approaches.

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  • Discusses the challenges and opportunities with approaches for guiding the multi- and interdisciplinary collaborative design, development and evaluation of mHealth (physical activity) behaviour change intervention apps.

    • Use of different methods and tools;

    • Miscommunications resulting from interpretive flexibility;

    • Lack of practical guidance for operationalising app design features;

    • Interdisciplinary and collaborative teamwork challenges;

    • Lack of "toolboxes" for team use;

    • Need for better guidance for interdisciplinary knowledge sharing, and better support for establishing shared understandings.

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Literature Review | Research Context and Problem: Funnelled Overview of Digital Health mHealth Landscape

Research Context and Problem:

Funnelled Overview of Digital Health Landscape

PROPOSED   SOLUTION

Proposed Solution

BOUNDARY OBJECT VIEW

A proposed novel perspective to addressing the paucity of multi- and interdisciplinary collaborative approaches to guide the design of effective mHealth (physical activity) behaviour change intervention apps in research and practice.

  • A tri-composite theoretical framework, comprising:

    1. Community of practice theory

    2. Boundary object theory

    3. Knowledge boundary theory

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The boundary object view considers the diverse project team member specialisations, boundary objects and supporting artefacts, process activities, and knowledge sharing practices necessary and relevant to the interdisciplinary collaborative design of effective mHealth (physical activity) behaviour change intervention apps.

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Proposed Solution | Proposed Solution: Boundary Object View (Tri-Composite Theoretical Framework)

Proposed Solution: Boundary Object View

(Tri-Composite Theoretical Framework)

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Proposed Solution | Community of Practice Theory

Community of Practice Theory

1. COMMUNITY OF PRACTICE THEORY

Community of practice theory recognises and respects the heterogeneity of disciplines and specialisations necessary and relevant to the interdisciplinary collaborative design of mHealth (physical activity) behaviour change intervention apps.

In mHealth project teams, team members stemming from a diversity of practice communities collaborate within an overlapping shared boundary space, where they engage in boundary crossing/spanning activities and perform various shared activities.

2. BOUNDARY OBJECT THEORY

Boundary object theory emphasises the integral role and indispensable value of conceptual and material artefacts in guiding, facilitating and supporting the collaborative design, development and evaluation activities of intersecting practice communities in shared boundary spaces of mHealth app projects.

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Proposed Solution | Boundary Object Theory

Boundary Object Theory

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Proposed Solution | Knowledge Boundary Theory

Knowledge Boundary Theory

3. KNOWLEDGE BOUNDARY THEORY

Knowledge boundary theory addresses the differences, dependencies and novelties that cause knowledge boundaries to arise between interdisciplinary collaborating team members on mHealth intervention app projects. It provides guidelines for overcoming knowledge boundaries through communication and sharing, integrating and generating knowledge, with the use of appropriate boundary objects. 
 

Knowledge boundaries:

  • Arise across three progressively complex levels:

    • (1) syntactic, (2) semantic and (3) pragmatic levels

  • Are associated with three progressively complex knowledge processes:

    • (1) transfer, (2) translation and (3) transformation

  • Use boundary objects as solutions to overcome knowledge boundaries:

    • (1) common language, (2) common meanings and (3) common interests

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FRAMEWORK DEVELOPMENT

Framework Development

ITERATION 1: FRAMEWORK DEVELOPMENT

Iteration 1 comprised two main steps:

  • Step 1:

    • A critical thematic and comparative analysis of 20 existing multi- and interdisciplinary digital health intervention development approaches.

  • Step 2:

    • The critical analysis findings informed the development of a theoretical framework and its core components.

FRAMEWORK CORE COMPONENTS

The Interdisciplinary mHealth App Design Framework:

  • Four Main Components:

    1. Actors

    2. Interdisciplinary collaborative process

    3. Boundary objects and supporting artefacts

    4. Knowledge

  • Two Supplementary Components:

    1. Project boundary

    2. Outcomes

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[Components described in further detail under "Final Contribution"]

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Framework Development | Iteration 1 | An Interdisciplinary mHealth App Design Framework

Iteration 1: Interdisciplinary mHealth App Design Framework

EVALUATION STUDY & FINDINGS

Evaluation Study & Findings
Dr Callie Thomson | PhD Project | Dissertation | Thesis | Evaluation Study | Interview Evaluation Study: Key Findings

Interview Evaluation Study: Key Findings

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Evaluation Study | Key Findings | Theme 7: Key Challenges and Opportunities for Future Improvement

Theme 7: Key Challenges and Opportunities for Future Improvement

EVALUATION STUDY

The core components of the Interdisciplinary mHealth App Design Framework (Iteration 1) were evaluated by conducting virtual semi-structured interviews with 31 international researchers and industry practitioners. Participants spanned 10 countries: Austria, New Zealand, Australia, Sweden, Finland, Ireland, Singapore, Scotland, Belgium and Portugal.

EVALUATION QUESTION

What are the key actor, process, object and knowledge sharing elements for guiding and supporting interdisciplinary collaborative design, development and evaluation in the mHealth physical activity behaviour change intervention app context?

KEY FINDINGS

Categorised key thematic analysis findings:

  • Eight Main Themes:

    1. mHealth physical activity behaviour change intervention app projects

    2. Goals and objectives

    3. Actors

    4. The interdisciplinary collaborative process

    5. Objects and supporting artefacts

    6. Knowledge

    7. Key challenges and opportunities for future improvement (six subthemes)

    8. Thematic relationships

FINAL CONTRIBUTION

Final Contribution

ITERATION 2: FRAMEWORK REVISION

Iteration 2 comprised two main steps:

  • Step 1:

    • A comparison of the framework and interview findings against an evaluation criteria assessment, with:

      • Evaluation criteria: (1) construction adequacy; (2) language adequacy; (3) clarity

      • Revision states: (1) none; (2) minor; (3) moderate; (4) major

  • Step 2:

    • The comparative findings informed the iterative revision of an enhanced final framework contribution.

FINAL FRAMEWORK CORE COMPONENTS

The Final Enhanced Interdisciplinary mHealth App Design Framework:

  • Four Main Components:

    1. Actors

    2. Interdisciplinary collaborative process

    3. Boundary objects and supporting artefacts

    4. Knowledge

  • Two Supplementary Components:

    1. Project boundary

    2. Outcomes

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Final Contribution | Iteration 2 | Framework Revision | Design Science Research DSR Final Artefact Contribution | An Interdisciplinary mHealth App Design Framework | An Enhanced Interdisciplinary mHealth App Design Framework

Iteration 2: Enhanced Interdisciplinary mHealth App Design Framework

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Final Contribution | An Interdisciplinary mHealth App Design Framework | Main Component 1: Actors

Main Component 1: Actors

MAIN COMPONENT 1: ACTORS

The people, stemming from a heterogeneity of disciplines and specialisations, directly and indirectly involved in mHealth intervention app projects. Heterogeneous knowledge backgrounds and practice experiences give rise to differences in perspectives, which require bridging to enable and support effective collaboration.

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1. The Interdisciplinary Collaborative Team:

  • Team members stem from a heterogeneity of categorised practice communities:

    • (1) health and psychology; (2) information systems; (3) computer sciences and data analysis; (4) business, marketing and product development; (5) research.

  • Team members are managed and led by knowledge brokers:

    • (1) principal investigator; (2) product manager; (3) project manager(s);                (4) team leader(s); (5) researchers.

2. End Users:

  • End users can be directly and/or indirectly involved in the product design, development and evaluation process

3. External Stakeholders:

  • Individuals/companies outsourced and consulted at particular process stages

ACTORS SUBCOMPONENTS

MAIN COMPONENT 2:
INTERDISCIPLINARY COLLABORATIVE PROCESS

An eight-step comprehensive and iterative process that can be referred to and applied flexibly by interdisciplinary teams when designing, developing and evaluating mHealth (physical activity) behaviour change intervention app products. Process steps can be tailored and contextualised to align with team members' knowledge, skills and experience, and the defined project and product goals.

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  1. Project and team formalisation

  2. Problem understanding and formative research

  3. Ideation and conceptualisation

  4. Iterative design, development and formative testing

  5. Optimisation and summative evaluation

  6. Ecological trials and process evaluation

  7. Deployment and release

  8. Post-release market surveillance and continuous improvement

PROCESS STEPS

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Final Contribution | An Interdisciplinary mHealth App Design Framework | Main Component 2: Interdisciplinary Collaborative Process

Main Component 2: Interdisciplinary Collaborative Process

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Final Contribution | An Interdisciplinary mHealth App Design Framework | Main Component 3: Boundary Objects and Supporting Artefacts

Main Component 3: Boundary Objects and Supporting Artefacts

MAIN COMPONENT 3: BOUNDARY OBJECTS AND SUPPORTING ARTEFACTS

The various artificial and sociomaterial objects and artefacts that are directly and indirectly employed, utilised and (iteratively) created (and refined) by the actors during the interdisciplinary collaborative design, development and evaluation process of a mHealth intervention app project.

CATEGORIES OF OBJECTS AND ARTEFACTS

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  1. Project management and interdisciplinary team communication objects

  2. Problem and conceptual solution objects

  3. Design, development and formative testing objects

  4. Intervention content and app design feature objects

  5. Deployment, evaluation and study objects

  6. Market surveillance and continuous improvement objects

  7. Supporting methods

  8. Standards and guidelines

  9. Supporting artefacts and materials

MAIN COMPONENT 4: KNOWLEDGE

The knowledge sharing processes continuously flowing among actors throughout the interdisciplinary collaborative process of an mHealth intervention app project's lifespan. Boundary objects and supporting artefacts can support actors in overcoming knowledge boundaries by enabling, facilitating and mediating knowledge sharing processes across heterogenous practice communities.

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1. Knowledge Boundaries:

  • (1) syntactic; (2) semantic; (3) pragmatic

2. Knowledge Processes:

  • (1) transfer; (2) translation; (3) transformation

3. Knowledge Communication Processes:

  • (1) exchange; (2) deliberation; (3) negotiation

4. Knowledge Boundary Aims: Overcoming Boundaries Using Objects and   

     Artefacts:

  • (1) common language; (2) common meanings; (3) common interests

5. Knowledge Boundaries Scale:

  • (1) complexities; (2) differences, dependencies and novelties; and (3) actors' stakes and trade-offs increase along knowledge boundaries from (4) what is known at (5) low complexity, to (6) what is unknown at (7) high complexity

6. Shared Understanding:

  • (1) knowledge sharing; (2) knowledge generation; (3) knowledge integration; (4) common ground; (5) shared mental models

7. Team Culture and Dynamics:

  • (1) communication; (2) collaboration; (3) cohesion; (4) active listening;        (5) empathy; (6) mutual respect, trust and honesty; (7) self-awareness;       (8) culture of continuous learning and development

8. Actors and Knowledge Brokers:

  • Actors engage in knowledge sharing processes and practices using objects

  • Knowledge brokers guide and manage knowledge sharing processes

9. Knowledge Boundary Objects:

  • (1) syntactic; (2) semantic; (3) pragmatic; (4) co-created

KNOWLEDGE SUBCOMPONENTS

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Final Contribution | An Interdisciplinary mHealth App Design Framework | Main Component 4: Knowledge

Main Component 4: Knowledge

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Final Contribution | An Interdisciplinary mHealth App Design Framework | Main Component 4: Knowledge Flows with Multiple Actors (Practice Communities)

Main Component 4:  Knowledge Flows with Multiple Actors (Practice Communities)

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Final Contribution | An Interdisciplinary mHealth App Design Framework | Supplementary Component 1: Project Boundary

Supplementary Component 1: Project Boundary

SUPPLEMENTARY COMPONENT 1:
PROJECT BOUNDARY

The boundaries of a project and context, wherein:

  • A particular interdisciplinary team is established and all actors engage;

  • A specific co-defined interdisciplinary collaborative process is carried out;

  • A variety of boundary objects and supporting artefacts are employed, utilised and created; and

  • A variation of knowledge is shared, integrated and co-created.

PROJECT BOUNDARY SUBCOMPONENTS

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  1. Actors

  2. Interdisciplinary collaborative process

  3. Boundary objects and supporting artefacts

  4. Knowledge

SUPPLEMENTARY COMPONENT 2: OUTCOMES

The resulting (iterative) effect(s) of the practices enacted within a project boundary.

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1. Process Outcome:

  • The output result from the enacted boundary object-supported and knowledge-integrated collaborative process performed by interdisciplinary team members and actors within a project boundary and context.

  • Components: (1) actors; (2) interdisciplinary collaborative process; (3) boundary objects and supporting artefacts; (4) knowledge

2. Product Outcome:

  • The mHealth (physical activity) behaviour change intervention consumer app product that is (iteratively) produced by the interdisciplinary team as an output result of the enacted interdisciplinary collaborative process and the mHealth intervention app project as a whole.

  • Components: (1) mHealth app product; (2) health goal; (3) project goal and objective; (4) interdisciplinary collaborative team objective

OUTCOMES SUBCOMPONENTS

Dr Callie Thomson | PhD Project | Dissertation | Thesis | Final Contribution | An Interdisciplinary mHealth App Design Framework | Supplementary Component 2: Process and Product Outcomes

Supplementary Component 2: Outcomes

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