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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>The SToP project app: promoting the creation of habits through explicit learning and self-monitoring</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Luca Fusco</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Federico Diano</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Federica Somma</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Raffaele Di Fuccio</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Fabrizio Ferrara</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Luigia Simona Sica</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Smarted SRL</institution>
          ,
          <addr-line>Via Riviera di Chiaia 256, 80121, Naples</addr-line>
          ,
          <country country="IT">Italy</country>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>Università degli studi di Napoli Federico II, Department of Humanities</institution>
          ,
          <addr-line>Naples,</addr-line>
          ,
          <country country="IT">Italy</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>The explicit goal that the SToP App was to achieve the creation of positive habits which can help prevent and fight the obesity problem. Two main psychological processes are used in order to reach this goal: explicit learning and self-monitoring. In this study, it is described how the SToP App achieves these two objectives through a design and implementation consistent with the psychological processes involved in self-regulation processes. In this sense, the App designed within the SToP (Stop Obesity Platform) project represents an example of integration between technology and psychology.</p>
      </abstract>
      <kwd-group>
        <kwd>eol&gt;SToP Project</kwd>
        <kwd>self-regulation</kwd>
        <kwd>health-behaviour</kwd>
        <kwd>gamification</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>•
•
•</p>
      <p>The everyday monitoring of personal parameters related to weight and body shape
The information providing related to the nutritional properties of food</p>
      <p>Feedback related to the everyday nutrition process, set as “nutrition daily goals”
The explicit goal that the SToP App aims to achieve is the creation of positive habits which can help
prevent and fight the obesity problem.</p>
      <p>Two main psychological processes are used in order to reach this goal: explicit learning and
selfmonitoring.</p>
    </sec>
    <sec id="sec-2">
      <title>2. Stimulating habits creation</title>
      <p>
        Human habits have the power to predict human behavior, regardless of explicit intentions [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ].
Therefore, the creation of habits is a strong goal that organization should undertake in order to increase
the likelihood of health-related behaviors for individuals. When behaviors have been performed
repeatedly in the past, individuals can benefit from a lower effort to re-produce it. Finding also report
that explicit intentions to produce a certain behavior are strengthened by the creation of habits in
physical related behaviors [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ].
      </p>
      <p>However, the nutrition process presents complex aspects which individuals must explicitly take into
account when planning food-related behavior.</p>
      <p>Food-related knowledge is a generic construct, which is conceived as having a main role in the
nutritional process. It involves believes and information about the goodness, the healthiness, the
usefulness of quality and quantity of food and drink which can be absorbed in everyday life.</p>
      <p>
        Explicit self-monitoring is an essential behavioral part of undertaking healthy diet. Literature found
it as having a major role in weight loss intervention programs [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ]. According to self-regulation theory
[
        <xref ref-type="bibr" rid="ref6">6</xref>
        ] the process of changing habits requires strong skills related to self-regulation in order to develop the
possibility of acknowledging rewards related to the achievement of goals.
      </p>
      <p>
        For this reason, the Stop app was designed to fulfill a fundamental function: to promote
selfregulation through explicit learning. Let's try to see how these functions are fulfilled and, first, what is
meant by self-regulation. "Self-Regulation refers to the self-directive process through which learners
transform their mental abilities into task related skills" [
        <xref ref-type="bibr" rid="ref7">7</xref>
        ]. This is the process that people can use to
manage and organize their thoughts and convert them into skills. Self-regulation is the process of
continuously monitoring progress toward a goal, checking outcomes, and redirecting unsuccessful
efforts [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ].
      </p>
      <p>According to this definition, the stop App has been designed to allow and stimulate the following
fundamental functions:
1. F1 monitoring progress toward a goal;
2. F2 checking outcomes;
3. F3 redirecting unsuccessful efforts.</p>
    </sec>
    <sec id="sec-3">
      <title>2.1 F1 monitoring progress toward a goal</title>
      <p>
        The process of monitoring one's progress allows people to keep attention focused on the task and
promote individual self-efficacy. Being able to identify a goal and regulate one's behavior according to
the achievement of the set goal is a self-regulation process that gives a sense of direction and meaning
to one's actions. In the context of studies on motivation, a privileged role is reserved for the promotion
of intrinsic motivation, which allows the individual to maintain behavioral persistence, defects to give
continuity to their actions [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ]. This behavioral set makes it possible to plan, verify and possibly modify,
through feedback and feed-forward processes, one's own behaviors to make them functional to the
achievement of the purpose - proceeding towards subsequent objectives becomes, therefore, important
for the achievement of the final purpose and represents a process that needs timely monitoring. Based
on these assumptions, the App was designed according to a flow of daily goals that the user can achieve
and constantly monitor (Figure 1);
      </p>
      <p>Food Goal
Active Lifestyle
Weight*31
Moderately
Active Lifestyle
Weight*38
Sedentary
Lifestyle
Weight*44
Water Goal</p>
      <p>Weight*30
Exercises Goal
500 cal/day is the
amount needof
calories to burn in</p>
      <p>order to lose
weight (by taking a
correct amount of
food)
Since the contents of the app vary positively
or negatively according to the daily fulfillment
of the goals, we have aggregated the Step Goal
and the Exercises Goal. Some people may be
unable to exercise or walk.</p>
      <p>Furthermore, four sources of variation would
have made the daily change of the painting
confusing.</p>
      <p>The app, using a formula, will combine the two
goals (and data) into a single goal (and data).</p>
    </sec>
    <sec id="sec-4">
      <title>2.2 F2 checking outcomes</title>
      <p>In the process of monitoring one's actions, the moment of verifying their effectiveness is crucial for
self-regulation because it allows those adjustments necessary for the progress of one's action. In other
words, verifying one's own work not only fulfills a function of verifying the past, but also of projection
into the future. It is, therefore, using both feedback (my behaviors have been effective and useful in
making me reach the objectives) and feedforward processes (if my behaviors are suitable I can
hypothesize that also in the future they will help me to achieve other objectives) that the individual can
proceed in his own development [10].</p>
      <p>In the App design specific attention was given to the design (in both formal aspects and graphical
interface) to the visualization of the outcomes and feedback connected to them.</p>
      <p>Therefore, app presents a series of panels that change continuously according to the information entered
by the user. The pictures change in a flourishing way when the user has reached the daily goals, and in
a languishing way when, on the other hand, the goals are not achieved (Figure 2);</p>
      <p>Home Page (dailydataentered): The Painting
Each painting has three sources of variation associated with
the daily fulfillment of the three goals.</p>
      <p>In this painting they are the weather (Water Goal), the
vegetation (Food Goal) and the "life“ (Exercise Goal)
intended as fauna and flow of the river.</p>
      <p>The sources of variation have 6 levels.</p>
      <p>Fulfilling the daily goal raises the corresponding level, failing
lowers it. The three sources of variation vary independently
of each other.</p>
      <p>The starting values of the sources of variation of the 8
paintings change according to the result of the previous
week.</p>
    </sec>
    <sec id="sec-5">
      <title>2.3 F3 redirecting unsuccessful efforts</title>
      <p>The third process involved in self-regulation implies the possibility (and the ability) to modify one's
actions to achieve the objectives. In fact, in individual behaviour, the actions put into practice are not
always consistent with the resolution of the task and the achievement of objectives. In other words, the
possibility of error and therefore of failure is part of the learning process. In our case, therefore, it is
important to offer the game user the opportunity to "correct himself". Actually, the two previous
functions allow to reach the final moment of the self-regulation process which allows not only to correct
one's own behavior in the future (if it has proved unsuitable in the previous phase), but also to "return
to one's own steps”, correcting one's learning path from within [11]. Obviously, this is a typical
possibility of gamification which, unlike the real world, allows you to easily return to your work to
modify your existence according to the achievement of objectives [12].</p>
      <p>In our case, the Stop games consist in sorting the presented foods in descending order following a
ratio (food property or and nutrient). Each game consists of three levels of increasing difficulty, with
each mistake it is necessary to start over (Figure 3).</p>
      <p>A new game is automatically unlocked every day. Every week the ratio of the game changes: in the
first week it will be calories, in the second cholesterol, in the third the sugars, etc. The Game Menu
reports games that have been successfully completed; however, it is always possible to play the games
unlocked in the previous days or weeks (Figure 4).</p>
    </sec>
    <sec id="sec-6">
      <title>3. Conclusion</title>
      <p>The use of new technologies within projects and courses of training and psycho-social
intervention is now a pervasive phenomenon. Gamification, in this area, is currently a rapidly expanding
phenomenon. It is therefore important to pay specific attention not only to the technological
characteristics of the games implemented, but above all to dwell in a timely and in-depth manner on the
design of the App. This attention should be even more focused when gamification aims to change the
behavior of individuals, thus feeding on complex psychological dimensions and processes.
Elsewhere, too, the importance of a design approach as the first phase of a gamification that wants to
use technology and the advantages associated with its use for psychological purposes has been
emphasized [13] [14]. In the case of the development of the SToP App, an application of integration of
technology and psychology has been proposed since the design phases and with widespread attention
not only in the selection of the contents to be developed in the games, but also in the definition of the
entire game process. In this study, a concise description of the application of this model was proposed
in accordance with the objectives of the project to promote healthy behaviors. It was therefore illustrated
how the App was designed and developed to promote a specific psychological process that underlies
the behavioral changes: self-regulation.</p>
      <p>The one illustrated in this study represents only one of the possible applications of psychological
theoretical frameworks to the design of digital tools, usable in formal and informal training contexts.</p>
    </sec>
    <sec id="sec-7">
      <title>4. Acknowledgements</title>
      <p>This project has received funding from the European Union’s Horizon 2020 Research and
Innovation programme under the Marie Skaodowska-Curie Grant Agreement 823978.
10. Mekler, E. D., Brühlmann, F., Tuch, A. N., &amp; Opwis, K. (2017). Towards understanding the
effects of individual gamification elements on intrinsic motivation and performance.</p>
      <p>Computers in Human Behavior, 71, 525-534.
11. McClelland, M., Geldhof, J., Morrison, F., Gestsdóttir, S., Cameron, C., Bowers, E., ... &amp;</p>
      <p>Grammer, J. (2018). Self-regulation. Handbook of life course health development, 275-298.
12. Sardi, L., Idri, A., &amp; Fernández-Alemán, J. L. (2017). A systematic review of gamification in
e-Health. Journal of biomedical informatics, 71, 31-48.
13. Miglino, O., Ponticorvo, M., &amp; Sica, L. S. (2015). Theoretical perspectives of hands-on
educational practices—From a review of psychological theories to block magic and INF@
NZIA DIGI. Tales 3.6 projects. E-learning-instructional design, organizational strategy and
management.
14. Sica, L. S., Veneri, A. D., &amp; Miglino, O. (2012). Exploring new technological tools for
education: Some prototypes and their pragmatical classification. Methodologies, Tools and
New Developmements for ELearning, 107-128.</p>
    </sec>
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