The app to improve motivation

In real life it takes more than pictures of kittens to improve your motivation sustainably.  AiM is designed by clinicians who know what it takes to help make a positive difference to your life.  With AiM, you’re in control.  It’s as private as you need it to be and lets you share with friends when you want to.

If you could do with a motivational boost to quit smoking, get fitter, study smarter or any one of eight key areas of life, download AiM now.

If you’ve already downloaded AiM this website is your guide to making great progress with your motivation.  Why not start with ‘How it Works’.

How it works

AiM is designed by expert clinicians to help you improve your motivation.  Here you can find more details on how it works and what you need to do to get the most out of the app.

The process

In order to make AiM work for you to need to work through the different stages of the set-up process and regularly use the app’s features to improve and maintain your motivation to change.

  • The initial set-up involves inserting some information about you. You can opt out of this if you want to.
  • The next step is to select an area of lifestyle behaviour to work on. It is important to only work on one behaviour at a time because this has been shown to result in better outcomes. If you have multiple areas you would like to work on, try changing the one that you think would be the easiest first. Once you experience success in one area you will be more motivated to address other things.
  • Once a behaviour has been selected the next step is to consider the reasons for   changing and to break down the overall target into small achievable weekly aims.  Setting small steps reduces the likelihood of feeing daunted by the overall goal and makes it much more likely that we will succeed. Every small success moves us towards our ultimate targets.
  • The following stage is to score and explore three crucial areas of motivation: Importance, Confidence and Readiness.  Exploring and improving the areas of motivation helps ensure that people are willing, able and ready to make behavioural changes. Reviewing and being aware of these internal motivational factors will raise awareness about changes in motivation and help to identify tasks that will enable change. 
  • Regularly reviewing your progress has a number of benefits, including; celebrating success, reappraising unrealistic goals, viewing changes in motivation over time, finding out why you haven’t succeeded and encouraging yourself to maintain improvements. If you wish you can share successes via facebook/twitter;
  • The four motivational exercises should be used to keep you on track to change. Most people are usually able to identify motivational factors, but we tend to overlook these internal motivators because it’s easier and more comfortable to stay as we are; the exercises keep these things at the forefront of our awareness. They will help you solve specific problems, explore uncertainty about changing, cope with high risk situations and explore ideas which make it difficult to change.
  • The emergency button is designed to be pressed during episodes of low motivation in order to remind you of your personal reasons for changing. It should be set up with a motivational message and a picture/video file that has strong personal relevance. As people often need additional support to change the emergency button can also be used to automatically send a text message to someone who will help you through more difficult times.
  • AiM’s locations reminder feature is intended to be used to deliver a message when you arrive at certain locations. It is very common for people to associate behaviours with specific places and managing this phenomenon is a powerful way to change. The locations could be places where you need reminding to engage in certain behaviours (i.e. to exercise when you arrive home) or to avoid certain behaviours (i.e. not to drink alcohol when in a restaurant).
  • Here’s two ways to see AiM in action.  Take a look and get to know your app:
    http://www.appdemostore.com/m/4643981455523840 (phone demo), http://www.appdemostore.com/demo?id=4643981455523840 (desktop demo) and a demo video is available at http://178.62.33.106/files/videos/AIM_Features.mp4.
  • Online Forum - Improving your motivation can be a very private thing but you might want to share your thoughts and engage with like-minded people.  That’s why the AiM forum is an important and free support tool for AiM users.  Check it out in confidence and chat anonymously with other app users and our expert authors to help improve your motivation.
    http://my-aim.boards.net/

The brains behind the app

Dr Daniel Bressington RN (MH) RNT PhD PGCAP BSc (Hons) DipHe qualified as a UK Registered Mental Health Nurse from the Nightingale Institute, Kings College London. He currently works as an Assistant Professor at Hong Kong Polytechnic University and a Visiting Reader at Canterbury Christ Church University. For many years Dan has used and taught clinical counselling approaches that are designed to help people improve their health behaviours. Dan wanted to develop AiM so that the general public would have easy access to an app that utilises the clinical approaches that he has found effective for his patients. Dan is also interested in finding out how health care professionals can use the app to help with their clinical work on a day-to-day basis.

Harvey Wells, MSc MA FHEA FRSPH is a Senior Lecturer in Mental Health at Kingston University and St George’s, University of London. He is a visiting professor at the University of North Texas and a visiting lecturer at King’s College London. Harvey is a practicing psychotherapist with 18 years of clinical experience, primarily working with clients who have a dual diagnosis (mental health and substance misuse) and personality disorders. He routinely uses interventions to improve motivation in his clinical and educational practice. Harvey was keen to develop AiM because he is interested in public health interventions to help people lead healthier lifestyles that are personalised yet affordable.

The Theory Underpinning AIM

AiM is based on a counselling approach called ‘Motivational Interviewing’ (MI). MI was developed to help people change unhealthy behaviours and is now well established as an evidence-based approach to support healthy behaviour changes.

Thinking about changing can result in feelings of uncertainty; there may be things that are good about changing, such as feeling healthier or saving money, but there are often things about changing that aren’t so good, such as giving up things you enjoy. This can leave us with mixed feelings about changing and this in itself can stop us from taking action.

MI focuses on exploring and resolving this uncertainty so that motivation increases and change becomes more likely.  This approach differs from traditional approaches that aim to increase motivation by providing it externally, by advising, telling, or demanding that people change.  MI supports change by facilitating the person’s own motivation to change; helping the person to want to change, rather than telling the person that they should. MI is therefore much more successful at achieving change than other traditional approaches which is why AiM is built using the technique.

Anyone who has tried to change will know how difficult this is to achieve and maintain.  New behaviours require hard work and repetition for them to take hold, for them to become familiar and trusted.  Sometimes motivation decreases after a while and we struggle to maintain the new behaviour.  It can be helpful to understand how the process of health behaviour change works.

One very useful model to understand how people change is the ‘Cycle of Change’. It describes 6 stages that people go through:

Precontemplation is where the person is unaware, or in ‘denial’, that their behaviour is causing problems. 

Contemplation is when the person begins to recognise a problem with their behaviour.  Although the person is aware there is a problem, it doesn’t mean that he/she is ready to change it.

Preparation is when the person plans for what they need to do to change their behaviour.

Action is when an individual changes their behaviour.

Maintenance happens once a person has made the change and now has to keep it going.

Relapse is when the person slips back in to old behaviours. This is a common outcome of any behaviour change. Upon relapsing people can re-enter the cycle at any stage.

Cycle of Change

The Application to Improve Motivation - AiM

AiM is intended to work for someone in the contemplative stage or beyond, someone who is thinking about changing. It uses the key principles of MI to: ask open questions to allow the person to explore their own reasons for changing, affirm the efforts the person makes in trying to change, reflects back the person’s responses to encourage self-motivating statements, and summarises what the person says to clarify the situation and encourage solutions.

You can find out more about Motivational Interviewing here:

http://www.centerforebp.case.edu/practices/mi

http://learning.bmj.com/learning/module-intro/.html?moduleId=10051582

 http://motivationalinterview.net/

AiM Research into the future

AiM has been designed primarily to help people make health behaviour changes but it was also developed with research in mind.  We know that Motivational Interviewing works in clinical practice to help people make behavioural changes but we don’t know that a Smartphone application can achieve the same thing.  However, several studies seem to show that Smartphone applications can help people make health behaviour changes.

A 2012 study (Kirwan, et al) designed to measure the physical activity levels of a walking group showed interesting results. One subgroup used a Smartphone application to record the number of steps walked each day; the other subgroup continued as normal. The group that used the Smartphone application walked almost 50% more steps. This suggests that a Smartphone application can be used to help promote healthy behaviours.

Another study in 2013 (Carter, et al) randomised people with obesity into 3 intervention groups: a Smartphone application, a website intervention, or a paper diary intervention. The 6 month study found that the Smartphone intervention had much better retention in the study than the website or diary groups (93%, 55%, 53% retention respectively). Furthermore, the Smartphone group lost an average of 4.6kg compared with 2.9kg in the diary group and 1.3kg in the website group. This study shows that the interactive nature of Smartphone applications promote lasting engagement and can produce positive results in supporting behaviour change.

Finally, a 2014 study (Gustafson, et al) provided one group of clients in a substance use treatment facility in the US with a Smartphone application designed to help people change their drinking behaviour.  Another group of clients were given standard treatment without the Smartphone application.  After 12 months clients who had used the Smartphone application reported significantly fewer risky drinking days and had longer periods of sustained abstinence than clients in the standard treatment group. This study shows that Smartphone applications could be a useful addition to existing services when trying to help people change and maintain health behaviours.

As a result we are researching a number of different aspects of AiM:

  • Using AiM as a public health intervention to help the general population make positive health behaviour changes
  • The experience of making a health behaviour change using a Smartphone application: a qualitative study
  • The health economics of a Smartphone application to support health behaviour change
  • Using AiM as an adjunct to weekly counselling in a substance misuse service

As we complete our research we will add our findings here. All research data collected from AiM is anonymous and will never be linked to any individual user

References & Useful Info

Carter, M. C. et al (2013) Adherence to a Smartphone Application for Weight Loss Compared to Website and Paper Diary: Pilot Randomized Controlled Trial. J Med Internet Res. Apr 2013; 15(4): e32. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636323/)

Gustafson, D. et al (2014). A Smartphone application to support recovery from alcoholism: A randomized controlled trial. JAMA Psychiatry. 71(5): 566–572. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4016167/)

Kirwan, M. et al (2012). Using Smartphone Technology to Monitor Physical Activity in the 10,000 Steps Program: A Matched Case–Control Trial. J Med Internet Res. 2012 Mar-Apr; 14(2): e55. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376516/)

We’re all complex creatures which is why our motivation is so important to achieving the things we want in life.  AiM is a great tool to help you focus on the things you can do but there is so much more out there to help.

Here are some of our experts’ recommendations for more ideas and support.

 

Drinking

http://www.nhs.uk/Tools/Pages/Alcohol-unit-calculator.aspx?Tag=Alcohol). https://www.drinkaware.co.uk/register

http://www.nhs.uk/livewell/alcohol/Pages/Alcoholhome.aspx

https://www.drinkaware.co.uk/   Drinkline (UK tel:  0800 917 8282)

http://www.hscic.gov.uk/catalogue/PUB14184

http://www.bingebusters.com/index.cfm/benefits-of-reducing-your-drinking-27

 

Drug use

http://www.druginfo.adf.org.au/fact-sheets/fact-sheets#substances

http://www.justice.gov/dea/druginfo/factsheets.shtml

http://www.nlm.nih.gov/medlineplus/druginformation.html

 

Exercise

http://www.nhs.uk/Livewell/fitness/Pages/Whybeactive.aspx

http://www.nhs.uk/change4life/Pages/change-for-life.aspx

http://www.webmd.com/fitness-exercise/

http://www.cdc.gov/physicalactivity/

 

Smoking

http://www.patient.co.uk/health/smoking-the-facts http://www.nhs.uk/livewell/smoking/Pages/stopsmokingnewhome.aspx

http://www.quit.org.uk/

http://goo.gl/jixqTs

 

Taking medication as prescribed

http://www.fda.gov/forconsumers/consumerupdates/ucm164616.htm  

http://www.nice.org.uk/guidance/CG76

 

Weight loss

http://www.nhs.uk/conditions/Obesity/Pages/Introduction.aspx

http://www.bhf.org.uk/heart-health/prevention/your-weight/being-overweight.aspx

http://www.nhlbi.nih.gov/health/health-topics/topics/obe/risks.html

http://www.patient.co.uk/health/obesity-and-overweight-in-adults

Frequently asked questions

Why is this app going to work where others have failed?

This app is more likely to help you change your behaviours than other apps because it is based on proven counselling approaches. Most other motivational apps rely on external triggers for behaviour change (such as motivational messages or purely information giving); however, the most effective way to change is to explore and build your own motivation.

Why have the authors written the app?

They primarily wrote the app because they have found the techniques very useful in their clinical practice. The authors also found that many people do not have access to such counselling approaches and wanted to create an app that would put the tools for change in the public arena.

What happens to my information?

The detailed personal information that you enter into AiM is held securely on your phone. This information is for your eyes only.  We collect information on how the app is used, the frequency of use and progress over time. This information will help us to improve the app and give us an indication of how well it is working. There is no way to identify individuals from this data.

Should I see my doctor before using the app?

Most generally healthy people will have no risk when improving their lifestyle behaviours. However, if you have any known health problems, if you are very overweight, if you take non-prescribed drugs, experience side effects from prescribed medication, or are drinking very heavily we would suggest consulting a health care professional prior to making changes to your behaviours.

Can anyone else see what I enter into the app?

No one else (including the authors) will be able to see any of the details that you type into the app – it is 100% confidential. As mentioned above, the authors will only be able to see anonymised data about your motivational scores, achievement of aims and frequency of use.

How much will using the app cost?

The app will cost £1.99 from Google Play or the App store. There are no other costs for updates, in-app purchases etc. 

Is all the useful content include in the upfront cost?

Yes, there are no trapdoors, in-app purchases, extra costs or barriers to improving your motivation once you've purchased aim.

All our conditions for use are detailed in the End User Licensing Agreement, which is available here: http://178.62.33.106/files/eula.pdf

Is the app a quick fix?

No, changing lifestyle behaviours takes time and effort. The process of exploring and building motivation requires a close examination of your own motivational issues, this process is sometimes necessarily uncomfortable because people usually overlook these issues to stay the same.  You need to regularly engage with the app, use the features, work through the exercises, plan your targets realistically, set yourself rewards, share your successes and use reminders to be able to make slow but steady progress to make the changes you want to.