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AMIA 2013 Persuasive Performance Feedback: The Effect of Framing on Self-Efficacy Eun Kyoung Choe, University of Washington, USA Bongshin Lee / Microsoft Research, USA Sean Munson, Wanda Pratt, Julie A. Kientz / University of Washington, USA Eun

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Eun Kyoung Choe | AMIA 2013 1

Persuasive Performance Feedback: The Effect of Framing on Self-Efficacy

Eun Kyoung Choe, University of Washington, USA

Bongshin Lee / Microsoft Research, USA Sean Munson, Wanda Pratt, Julie A. Kientz / University of Washington, USA

AMIA 2013

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Eun Kyoung Choe | AMIA 2013 2

Self-monitoring technology

Activity Fitbit

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Eun Kyoung Choe | AMIA 2013 3

Self-monitoring technology

Sleep Zeo

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Eun Kyoung Choe | AMIA 2013 4

Self-monitoring technology

Activity & Sleep Lark

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Eun Kyoung Choe | AMIA 2013 5

Self-monitoring technology

Activity & Sleep BodyMedia

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Eun Kyoung Choe | AMIA 2013 6

Self-monitoring technology

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Eun Kyoung Choe | AMIA 2013 7

Feedback design is underexplored

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Eun Kyoung Choe | AMIA 2013 8

Example—fitbit’s step count

“Get 268 steps more to hit your daily goal”

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Eun Kyoung Choe | AMIA 2013 9

Framing Effects

half empty? half full?

[Tversky & Kahneman, 1981]

Inspiration

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Eun Kyoung Choe | AMIA 2013 10

“90 out of 100 patients are alive after five years” “10 out of 100 patients are dead after five years”

[Marteau, 1989]

Odds of a grueling operation

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Eun Kyoung Choe | AMIA 2013 11

“90 out of 100 patients are alive after five years” “10 out of 100 patients are dead after five years”

[Marteau, 1989]

Power of positive valence framing

“90 out of 100 patients are alive after five years”

✔

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Eun Kyoung Choe | AMIA 2013 12

Persuasive performance feedback to nudge people toward healthier behaviors

[Thaler & Sunstein, Nudge, 2008]

Goal

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Hypothetical scenario

10,000 steps

4:30 PM, weekday

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Eun Kyoung Choe | AMIA 2013 14

Achieved steps

10,000 steps 2,500 steps

I’ve walked 2,500 steps!

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Eun Kyoung Choe | AMIA 2013 15

Remaining steps

10,000 steps 7,500 steps

7,500 more steps to take!

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Three types of framing

Valence of Performance Presentation Type Data Unit

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Three types of framing

Valence of Performance

achieved vs. remaining

2,500 steps achieved 7,500 steps remaining

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Eun Kyoung Choe | AMIA 2013 18

Three types of framing

Valence of Performance Presentation Type

text-only vs. text with visual

2,500 steps achieved

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Eun Kyoung Choe | AMIA 2013 19

Three types of framing

Valence of Performance Presentation Type Data Unit

raw vs. percentage

2,500 steps achieved 25% achieved

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Distance to the goal

Low achievement vs. High achievement

25% 75%

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Eun Kyoung Choe | AMIA 2013 21

Feedback manipulation

Achieved Remaining Text-only Text-only Text with visual Raw Percentage Raw Percentage Text with visual Raw Raw Percentage Percentage

2,500 steps achieved 7,500 steps achieved 25% achieved 75% achieved 7,500 steps remaining 2,500 steps remaining 75% remaining 25% remaining

Distance to the goal

Low achievement (25%) High achievement (75%)

Valence Presentation Data Unit

Between-subjects Factors (2x2x2) Within-subjects Factor (x2)

Condition 1 Condition 2 Condition 3 Condition 4 Condition 5 Condition 6 Condition 7 Condition 8

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Eun Kyoung Choe | AMIA 2013 22

Dependent measures

Self-efficacy (per feed

(per feedback) back) Rate how confident you are that you can achieve your daily goal as of now (4:30 PM, weekday). 0 = Certain I cannot meet my goal 10 = Certain I can meet my goal

Interest level in taking 10,000 steps every day (per subject)

(per subject)

0 = Not at all interested

10 = Very interested

[Bandura, 1990]

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Filtering Q1-1 Interest level Q Filtering Q2 Self-efficacy Q1 Self-efficacy Q2 Filtering Q1-2 Demographic Q

Feedback A Feedback B

Study procedure

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Results

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Participants (N = 400)

Convenience sampling (N = 511)

  • Recruited from researchers’ social network (e.g., post on facebook, email)
  • Skewed toward highly educated, motivated, technical population

Removed 111 participants

  • Did not understand the feedback correctly (70 participants)
  • Outside of U.S. (25 participants)
  • Did not pay attention to the survey (9 participants)
  • iPhone/iPad user (7 participants)
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Eun Kyoung Choe | AMIA 2013 26

Participants’ ages ranged from 19 to 68 (M = 32.7)

Participants (N = 400)

Gender ¡Ra)o ¡

Female 47% Male 53%

Pedometer ¡Use ¡

No 57% Yes 43%

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Eun Kyoung Choe | AMIA 2013 27

Main effect of valence framing

p = .04

Distance to the Goal

25% 75%

Certain I can meet my goal Unsure if I can meet my goal Certain I cannot meet my goal

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Eun Kyoung Choe | AMIA 2013 28

2,500 steps achieved 7,500 steps remaining 25% achieved 75% remaining

Main effect of valence framing

… ¡ … ¡

Achieved framing Remaining framing

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Eun Kyoung Choe | AMIA 2013 29

Main effect of presentation type

p = .007

Distance to the Goal

25% 75%

Certain I can meet my goal Unsure if I can meet my goal Certain I cannot meet my goal

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Eun Kyoung Choe | AMIA 2013 30

Main effect of presentation type

2,500 steps achieved 25% achieved 7,500 steps remaining 75% remaining

… ¡ … ¡

Text-only Text with visual

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Eun Kyoung Choe | AMIA 2013 31

p = .002

Interaction effect:

Data Unit x Distance to the goal

Distance to the Goal

25% 75%

Certain I can meet my goal Unsure if I can meet my goal Certain I cannot meet my goal

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Eun Kyoung Choe | AMIA 2013 32

p = .02

Interaction effect:

Data Unit x Distance to the goal

Distance to the Goal

25% 75%

Certain I can meet my goal Unsure if I can meet my goal Certain I cannot meet my goal

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Eun Kyoung Choe | AMIA 2013 33

2,500 steps achieved 25% achieved

This effect was not observed for the distance to the goal at 75% level

Interaction effect:

Data Unit x Distance to the goal

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Eun Kyoung Choe | AMIA 2013 34

Discussion

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Discussion

Give feeling of bigger achievement for higher self-efficacy

Highlight what people achieved Data unit can contribute to this

High-interest sampling bias supports our findings further

Less likely to observe framing effects in intrinsically motivated people

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Eun Kyoung Choe | AMIA 2013 36

Future Work

Embedding persuasive performance feedback in real-world situations and testing through deployment studies Testing at more extreme cases toward the both ends of the goal (e.g., 5%, 95%) Using judgmental / exaggerated visuals for stronger framing effect

Sedentary - - - - - - - - - - - - - - - - - - - - - Active

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Eun Kyoung Choe | AMIA 2013 37

Contributions

Feedback design matters—context dependent Leverage framing effect Empirical guidance to create influential, persuasive feedback Many application domains

Health communication campaign Self-monitoring technology interface design Privacy…

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Eun Kyoung Choe | AMIA 2013 38

Thank you!

Eun Kyoung Choe (eunky@uw.edu)