Creating evidence-based health and wellness programmes for your customers and employees

How to create a health app that sticks

Transform your body and your life.
Create a new you in 30 days.
Reach your weight goals through healthy eating. Simple.

These are the alluring promises made to us by some of the most downloaded health apps currently on the market. It seems easy: use the app and transform your health in an instant. Unfortunately, changing our habits isn't that simple.

Research shows that giving people access to more information doesn't necessarily lead to more significant results. This approach borrows from traditional medical models of health. The doctor provides information for an acute condition, and the patient applies that knowledge to alleviate the symptoms.

This information exchange model doesn't necessarily work well for chronic conditions, and as the evidence base demonstrates, works even less well for the prevention of chronic conditions. Many of us know that vegetables are good for us, that we need to be eating more, sleeping more, exercising more, and getting a handle on our stress levels. Yet how many of us still find it a struggle to fit it all into our busy lives?

Providing lots of information upfront (which so many wellbeing programmes do) does not allow people to change. Instead, it makes them feel like they have already failed and that they don't have enough motivation or willpower as others.

Changes in health behaviours are rarely a one-off triggered by the share of information alone. They are processes, not outcomes, built through a series of small, subtle changes in behaviours over time. It's not that people don't know what they need to change; they don't know how to apply the advice in their hectic lives.

To create changes in our health and our lives, we need the knowledge, skills and confidence in our ability to make change happen. All of us are complex beings, and our health needs vary greatly. We need support, encouragement and actionable tools to build the relevant skills. Programs have to give us the confidence to use these tools in our daily lives whilst having fun - only then we will stick to it.

These are some of the considerations when supporting companies in developing digital wellbeing programmes. Before we wireframe ideas, we need to understand the clients' needs.

When creating apps, there are two buckets of behaviours we need to address:

A. How do we support people to develop a habit of using the app?

B. Once they are using the app, how do we then support them with the skills, knowledge and confidence needed to create healthy habits outside of it?

The first (yet unfortunately often overlooked point) is crucial. If users don't form habits around using the app, how then can they get all of the delightful life-enhancing benefits that it holds? Here are seven tips:

  1. App designers can prompt users with the suggestion of putting the app on their home screen. That reduces the cognitive friction of finding the app amongst all of the tempting noise on our devices. Just like the fruit bowl in the kitchen, that gives it a pride of place, acting as a reminder to you to make a healthy choice.
  2. Allow users to decide how often they want to receive notifications and engage with the app. Self-selection of the frequency gives a feeling of autonomy, and the user becomes a co-creator in their journey. They are also less likely to get annoyed with the app.
  3. Making any notifications valuable to the user is essential. Meditation apps do this well by outlining the value of engaging with the practice at that moment.
  4. Create "implementation intentions" within your app. These are self-regulatory plans that help turn intentions into more concrete actions. An example could be providing an option that supports users to specify when and where it is best to use the app. Such an option can make people significantly more likely to carry out that behaviour.
  5. Support experimentation with the above. We often don't know what's best for us until we notice what isn't working. Therefore, we must follow up with our users to check if the plans they have put in place are working. Experimentation is an essential process in habit change yet is often overlooked. We aim for perfection rather than learning from the times things don't work to find out what is suitable. Since many people are afraid of experimentation as they see it as synonymous with failure, we must emphasise that we are on a learning journey together, permitting our users to experiment from the start. That way, we are personalising their experience and making it more likely that changes will happen.
  6. Try not to overload users with too many unnecessary questions at the beginning. Getting to know them a bit first helps provide the suggestions that best suit their lives but don't overload them. It is best to drip-feed questions as they go along, remaining interested and supportive as the relationship grows. A good question to ask at the start is: What might get in the way of you engaging in this programme? Spotting any possible challenges from the beginning can be of enormous support to you and the user.
  7. Finally, designers must note that users don't always act in predictable ways. We need to test each step of the process to know how we can best support future users. A flexible approach works best.

When we support people to get started using our programme, we need to make it as easy and as appealing as possible to them by overcoming any barriers that might be in their way.

I help companies design apps and digital wellbeing programmes to help give them the best chance of creating lasting health behaviour changes. If you'd like to chat about your app or digital health programme, you can message me on LinkedIn or through the contact form on my website.

Published on 29th Apr 2021 at 11:26 by Dr Heather McKee

"Heather has so generously contributed to so many areas of our work this year, her thoughtful feedback and insights have allowed us to evolve our work and product in profound and impactful ways. I speak on behalf of all of us when I say we can’t imagine having done it without her unique, informed perspective and diverse voice. She has made an incredible amount of impact on our work in a small amount of time and we are so grateful for her."

Sara Rice, lululemon HQ

"When you work with Dr Heather McKee you know you are in the presence of a true professional. You cannot ignore the passion she has for her field of behaviour change, especially around healthy living. She is committed to making sure that you -- client, patient or project partner -- understand the key facts, appreciate the context and embrace the decisions you made together."

Edna Kissman, CEO The Wonder of Me

"Heather’s academic and applied understanding of behavioural psychology has been invaluable in helping us mould our proposition to the corporate wellbeing market over the last 12 months. Heather was a perfect fit with our culture; enthusiastic, diligent and highly skilled in everything that she does. We look forward to working with Heather on future projects"

Richard Westman, CEO KAIDO

"Heather's practical knowledge and expertise around behaviour change have been an enormous value-add for the Welltodo audience. By incorporating her tools and insights into our course curriculum, we were able to add a whole new layer of credibility. Heather is professional, reliable and an absolute pleasure to work with!"

Lauren Armes, CEO Welltodo

"Heather is a ninja when it comes to behaviour change, and a delight to work with. She has been invaluable to BetterSpace in working out how to nudge people into more mentally health lifestyles."



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Copyright ©2024 Dr. Heather McKee

Dr. Heather McKee is registered in Ireland Reg. No. 687397 with the registered address at 314 Mother Teresa House, Loreto Abby, Rathfarnham, D14 NR20, Co. Dublin, Ireland

This work is in no way meant to replace any medical advice. Dr. McKee is Non-HCPC-registered. Photography by Dylan Madden.

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