Accelerating Best Practices in Peer Support Around the World

An In-Depth Look at Peer Support App Development, Part 2

Clayton Velicer, MPH

In part 1 of this blog we looked at the development of an app called PersonA for increasing physical activity that includes a function for providing peer support. Specifically, we looked at how Al Ayuba and colleagues used theoretical health behavior theories to inform app development and how users were able to test the usability of the app. In part 2, we will examine how the authors combined usability testing and health theory to incorporate peer support functions into their app and results from the usability testing.

Incorporating Social and Peer Support

PersonA has two mechanisms to facilitate peer and social support. The authors believe the app can persuade people to change behaviors via social comparison (comparing oneself to others) and direct peer interactions.

The first function is a direct comparison feature that allows a user to directly compare their progress with that of one close peer, for example a friend or spouse. Users can choose to share information such as calorie expenditure or distance traveled. Al Ayuba and colleagues believe that social comparison and social learning may make users more likely to engage in behaviors if they can observe the progress or goals of their peers. Users can also compare themselves to a group average, whether it’s a group of friends or a larger community.

A specific peer function allows users to support each other through closed communication that only the two users can see. For example, one user could congratulate another for reaching an exercise goal. They can “like” another user’s update or provide them with a reward within the app. Users can receive additional online support by choosing to share their data on Facebook.

What Do Users Think?

The authors gathered qualitative data on what the users found useful about the social support functions. With respect to the comparison function, one user expressed that:

“A function to compare my physical activity with that of my friends is really nice. It maps myself in the group as well as informs that there are other people doing the same thing, so that I feel I’m not alone in doing it.”

A second user explained how she stopped taking a bus that took approximately half an hour after noticing that some users had thousands more steps:

“I just walk to have more numbers on my app and you know what made me feel better, it turned out I only need about 20 minutes to get there! It saves time and makes me feel healthy.”

Future Peer Support Research in Apps

The authors note that “the online social interaction in the PersonA study included two or more types of social interactions (viewing others’ data, comparing data, sending messages, receiving messages, etc.), so that the independent contribution of any one of these components is difficult to establish.”

Further, while it was very positive to see that users were using social and peer support interaction, I would have personally been interested in seeing more information about the kinds of messages that were exchanged between users. For example, did users provide each other with emotional support (“You are doing a great job”) or was there also informational support (“If you skip that bus ride it is 8000 extra steps”)? Perhaps different kinds of support would have a stronger impact on increasing physical activity.

As we continue to cover the development of more mobile health apps that are incorporating peer support, it is very important to conduct usability evaluations like the one covered in this study. Papers like this provide insight into how and why an app was designed and future directions for research. It is truly enjoyable to see such an in-depth analysis of new technology and we encourage our readers to check out the whole article to read the full analysis.

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