Behavior change beyond intervention: an activity-theoretical perspective on human-centered design of personal health technology.

Introduction: Modern personal technologies, such as smartphone apps with artificial intelligence (AI) capabilities, have a significant potential for helping people make necessary changes in their behavior (e.g., adopt healthier lifestyles). Current research highlights that realizing this potential through the design and use of personal technologies calls for a critical reappraisal of the role of healthcare interventions as the driving force of behavior change and requires a more explicit focus on human agency and experience. Methods: This paper contributes to this line of investigation by developing and presenting a conceptual framework, informed by activity theory, which views behavior change as an outcome of the combined agencies of healthcare professionals, technology designers, and, most importantly, the persons themselves. Results: According to the framework, the process of behavior change can be represented as a transformation, achieved through an interplay between the activity systems of intervention, development, and empowerment. In addition to presenting the conceptual framework, we offer insights into how these ideas can be implemented through examples of digital companions. Discussion: Implications of the analysis for the design of personal technologies for supporting healthier lifestyles, with a special focus on intelligent digital companions, are discussed.