The Power of Personal Strengths - using gamification to support patients in chronic illness management

This project explores novel approaches to developing and evaluating eHealth-based self-management and support tools that emphasize activating people's own strengths. With an international group of researchers, the work has been undertaken with a high degree of user involvement and combines knowledge and evidence from psychology, nursing/self-management, and game design. Through the project, the MyStrengths app, an electronic interactive support tool that app users can run on their phones, was created to help people living with long-term health challenges identify and use more of their own strengths in day to day life. Status at projects end, December 2021 The project consisted of two phases: 1.Design and development of the MyStrengths app 2.A Feasibility/pilot study of the MyStrengths app The design and development phase consisted of a range of activities aiming to identify needs, potential use, and ways in which strengths-focused eHealth tools can be developed in line with users' needs, existing evidence and theories, and guidelines for good design. Examples of this include: Idea generating and design workshops with people in the user group as well as other relevant stakeholders, reviewing existing literature and research, yearly working seminars with an international group of experts, and design of the MyStrengths app in collaboration with external designers and the departments' in-house developers. The second phase, undertaken in 2018-2019, consisted of a feasibility evaluation/pilot trial of the MyStrengths app. In this study, 26 participants with various chronic illnesses used the app for a month. To gauge the study participants' satisfaction with, and use of, the MyStrengths app, as well as their thoughts on its design and content, the study collected three types of data: (1) surveys before and after, covering psychosocial measures (e.g., Emotions and quality of life) and usefulness (e.g., engagement and usability), (2) participants' use (i.e, system use logging, and (3) voluntary interviews were conducted after the trial period, focusing on participants' experiences with the MyStrengths app and strengths-focused self-management and coping-support in general. The information gathered provides input on what could be further investigated in future more comprehensive studies on strengths-focused management and support. The interviews provided rich and primarily favourable input regarding an increased focus on patients' own strengths within the field of self-management. The desing of the MyStrengths app draws inspiration from the world of games and consists of, amongst others, spheres of different colors moving about the screen, similar to the concept of the lava lamp. Although many participants appreciated this design, some of them also would have preferred a more simple traditional design akin to typical and ubiquitous lists. Additionally, findings also indicate that such strengths-focused digital tools might be most beneficial for users relatively new to living with health challenges. The knowledge and experiences generated throughout the project have been shared at many national and international arrangements, including multiple presentations and posters at conferences. The project has also published six scientific articles in international peer-reviewed journals. In sum, the project has generated new knowledge contributing to multiple fields of study, including strengths-focused and positive psychology, self-management and mastery, and eHealth design. eHealth tools have the possibility to reach its users irrespective of their location or proximity to health services, and strengths-focused tools, such as the MyStrengths app, can be an inclusive and effective way of providing support to people living with long term health challenges.

Prosjektets fremste bidrag er utviklingen og evalueringen av det som trolig er den første styrkefokuserte mobil helse (mHelse)-intervensjonen, utviklet for å kunne brukes uten assistanse fra hverken behandlere eller helsepersonell. Styrkefokuserte intervensjoner er tradisjonelt gjort i samarbeid med behandlere, og dette prosjektet har vist hvordan en styrkebasert mHelse intervensjon kan utvikles og benyttes av sluttbrukere, i dette prosjektet personer med langvarige helseutfordringer, til å identifisere og gjøre nytte og bruk av egne styrker. Slik åpner dette prosjektet dører for å kunne tilby styrkebasert mestrings-støtte til et stort antall brukere, uavhengig av geografisk bosted eller tilgang til andre helsetjenester.

Epidemic of chronic and life style related illness and the limited success of current interventions approaches call for radically rethinking ways to support patients in self-management. Most current approaches to patient care are based on a deficit model - emphasizing patients' symptoms and limitations. This approach can guide medical interventions, but does not unleash the transformative power of people's positive personal attributes that can help patients to live fulfilling lives despite having chronic health conditions and in the same time achieve better health outcomes. Building on previous work, this international, highly participatory research will explore novel approaches to support chronic patients in using their personal strengths in health management to improve health behavior and patient outcomes. The project will use gamification mechanisms to enhance user engagement and motivation, but also to foster reflection and self-discovery during the process of planning and conducting self-management activities. The project will integrate state of the art knowledge from multiple research areas: behavioral science, positive psychology, gamification and computer science. During the course of the project the goals are to: (1) explore how behavioral models and strategies could be used and tailored to support patients in discovery and use of their personal strengths in ways that it is effecting positive health behavior, (2) explore how gamification mechanism could be leveraged to further enhance user activation, motivation and intervention effectiveness, and (3) through close collaboration with different stakeholders develop, test and optimize user-friendly and useful strength-based patient support IT tool(s) that fits the existing context. This research can thereby significantly contribute to the patient mobilization and activation and optimize collaborative care services in close collaboration with its users.