Stern, Nora; (2022) Using Mobile Apps to Support the Implementation of Coping-relevant Behaviour Change Techniques for Self-management of Stress. Doctoral thesis (Ph.D), UCL (university College London).

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Abstract

Mobile apps have shown potential in early stress self-management interventions, yet they remain less beneficial than face-to-face therapies. One of the most effective ways people can cope with stress is to identify what their stressors are and take action in managing them. Coping-relevant behaviour change techniques (BCTs), such as self-monitoring, goal setting, and action planning, have the potential to support this process. Nevertheless, there is little guidance on how to incorporate such techniques into stress management apps. Drawing on mixed methods research, this thesis provides two contributions. First, it improves our understanding of how existing stress management apps support coping-relevant BCTs and suggests areas for improvements. An app functionality review and follow-up 3-week intervention using Welltory stress monitoring and Coach.me goal setting apps revealed that existing apps do not support users’ efforts with coping-relevant BCTs. Participants reported that Welltory did not yield sufficient data to gain insights into the factors affecting their stress. Relatedly, the way in which these apps implemented coping-relevant BCTs diminished peoples’ sense of autonomy and competence. Drawing on peoples’ experiences with existing apps and principles of positive computing, the second contribution of this thesis is the design and evaluation of Reffy - a chatbot prototype that integrates coping-relevant BCTs in a way that meets people’s stress management needs. Based on findings from a field evaluation study, we identify specific benefits and challenges of using a stress self-management chatbot. We find that chatbot-based reflective questioning helps people identify how factors impact their stress during early stages of self-tracking. Likewise, adding features that promote users’ sense of autonomy and competence improves Welltory’s ability to support coping strategies. This thesis advances our understanding of how behaviour change and stress coping techniques can be incorporated into mobile apps to effectively support stress self-management.

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