Behaviour Change Support Systems (BCSSs) are not utilising conscious psychological behavioural models and instead focusing on non-conscious behaviour change. A well established model of behaviour change is the Transtheoretical Model (TTM) which combined with Motivational Interviewing (MI) can help transform a person's behaviour. In this paper we outline how we can integrate the TTM and MI techniques within BCSSs with the aim of enacting sustained behaviour change.
Transtheoretical Model
In A foundation for the study of behaviour change support systems, Oinas-Kukkonen
describes a Behaviour Change Support System as \a socio-technical information
system with psychological and behavioural outcomes designed to form, alter or
reinforce attitudes, behaviours or an act of complying without using coercion or
deception." [
Additionally, in a review of mobile applications for weight management [
Motivational Interviewing (MI) can provide a way to diagnose which
particular stage of change a client is currently in, and ways to progress them to further
stages. MI is \a collaborative, goal-oriented style of communication with
particular attention to the language of change. It is designed to strengthen personal
motivation for and commitment to a speci c goal by eliciting and exploring the
persons own reasons for change within an atmosphere of acceptance and
compassion" [
The twin problems of over-reliance on a persuasive technology system and
lack of longevity of use are major challenges currently facing the BCSS
community. Fogg's 2002 warning that the main limitation of the then-current approach
to persuasive technology was that if a person stops using the system, their change
in behaviour ceases with it [
We hypothesise that integrating belief change techniques as well as behaviour change into BCSS's will help to address both problems of over-reliance and longevity. In particular, we advocate using techniques which help people to diagnose a current stage and to transition into further stages of change. 2
The Stages of Change The TTM proposes that health behaviour change involves progress through six stages of change, shown in Figure 1. To transition through these stages the model utilises processes such as consciousness raising, in which awareness is gained, and knowledge and self re-evaluation, in which understanding of the e ects of a given behaviour is gained. This process is nonlinear and can involve many \relapses" to a previous stage before termination is achieved.
Motivational Interviewing MI utilises 4 core skills, open questions that give people the opportunity to re ect on their current situation and to elaborate, afrmations where the counselor accentuates the client's particular strengths, abilities, e orts and good intentions, re ective listening where the client's thoughts Designing Behaviour Change Support Systems for Behaviour Transformation and feelings are re ected back to them in di erent words and summaries which are re ections of what the client has been saying, pulled together.
In order to diagnose a particular stage, MI uses the Readiness Ruler (RR).
There are two main questions that can provide information about a person's
readiness to change: How important is it for you to make a change? and How
con dent do you feel that you can make changes to your lifestyle? Answers are
given on a scale of 0 (no thoughts about change) to 10 (speci c plans to change).
The con dence scale helps to assess a client's self-e cacy. A low score would
suggest they require further skills to implement a change in behaviour and may need
help formulating a plan of action. This can also be supplemented by
questionnaires, for instance, [
As described above, MI involves a multifaceted approach which is currently beyond the capacity of BCSSs to implement. The challenges then, are how to assess the stage of change within a BCSS and how a BCSS can transition a user from one stage of change to the next.
For us to incorporate the TTM we must develop a robust method to
computationally measure and evaluate the current stage of change the user is in.
As well as the Readiness Ruler we can also incorporate techniques adapted from
other measures of a person's readiness to change such as a short questionnaire.[
To solve the next challenge we must formulate strategies that can be
implemented within a BCSS to facilitate a transition from one stage of change to the
next (see Table 1) [
To implement these strategies, we can utilise sensors that can provide data which can allow us to monitor and provide feedback on the user's progress. We can also incorporate computational tools such as ranking tasks or questionnaires to understand the current beliefs, behaviours and motivations of the user in order to personalise the approach. 4
To meet these challenges we aim to build a system that will measure and evaluate the stage of change a user is in, develop a strategy to motivate a user to transition to the next stage of change based on their data and deliver this strategy through a BCSS. By adapting and incorporating the TTM and MI techniques, we aim to investigate whether we can achieve sustained behavior transformation within a BCSS. 5
We are grateful to Stephen Valentine at the Learning & Development Centre in Dundee for discussion of the material on motivational interviewing. We acknowledge the nancial support of the European Commission for the H2020 Council of Coaches project, under Grant Agreement No. 769553.