Exploring users and non-users views of the Digital Twin on a mHealth app: a Thematic, qualitative approach

Figures & data

Figure 1. Generic and anthropomorphic digital Twins.

Figure 2. Overarching themes and sub-themes.

Table 1. Descriptive statistics of demographics, and BMI for users and non-users

Characteristic	Subcategory	Non-users	Users	Total
Gender	Female	13	9	22
	Male	7	11	18
Age	18–25	9	6	15
	26–35	8	10	18
	36–45	1	4	5
	>55	2	0	2
BMI	<18.5	0	1	1
	18.5–24.9	2	13	25
	25–29.9	12	5	17
	30–39.9	6	1	7
Interview Duration (minutes)	Mean interview time	54 (SD = 13.10	44 (SD = 7.62)	98
	Shortest Interview	40	32	72
	Longest Interview	89	62	151
Ethnicity	White British	10	8	18
	White Other	2	5	7
	Mixed	1	1	3
	Mixed Other	1	1	2
	Black African	2	1	2
	Black Caribbean	1	0	1
	Asian African	0	1	1
	Asian Pakistani	0	1	1
	Asian Indian	0	1	1
	Asian Chinese	0	1	1
	Asian Other	1	0	1
	Other	2	0	2
Preferred area of health management	Weight	16	9	25
	Fitness	18	17	35
	Chronic Illness	1	9	10
	Alcohol Consumption	2	5	7
	Smoking	3	1	4

Table 2. Summary of identified themes and sub-themes mapped to theoretical constructs

Theme/Subthemes	Construct in Theories
Facilitators of behaviour change
Autonomous choices	Perceived behavioural control and health beliefs (Health Belief Model; Janz & Becker, 1984); intrinsic motivation (Self Determination Theory; Deci & Ryan, 2012); Response effectiveness (Protection Motivation Theory; Rogers, 1975); Contemplation (Stages of Change; Prochaska & DiClemente, 1983); perceived behavioural control (TRA; TPB;); behavioural expectations (Social Cognitive Theory; Bandura, 1991); illness beliefs and emotional response (Self Regulatory Model; Leventhal et al., 1980)
Social influences on decision making	Descriptive and subjective norms (Theory of Reasoned Action; Theory of Planned Behaviour; Ajzen, 1991); upward comparisons (Social Comparison Theory; Goethals & Darley, 1987); social messages (Self Regulatory Model; Leventhal et al., 1980)
Personalisation and representativeness	Modelling (Social Cognitive Theory; Bandura, 1991); Tailoring (Kreuter et al., 2000; Noar et al., 2007); Maintenance (Stages of Change Model; Prochaska & DiClemente, 1983); Perceived behavioural control and compatibility (Theory of planned behaviour (Ajzen, 1991); appraisal (Self-Regulatory Model; Leventhal et al., 1980)
Monitoring progress	Cues to action (Health Belief Model; Janz & Becker, 1984); self-observation, modelling and self-efficacy (Social Cognitive Theory; Bandura, 1991); planning (Implementation Intentions; Gollwitzer, 1999); appraisal (Self-Regulatory Model; Leventhal et al., 1980)
Awareness and knowledge of health-related risks	Self-observation, self-efficacy, and upward comparisons (Social Cognitive Theory; Bandura, 1991); self-regulation (Leventhal et al., 1980; Baumeister et al., 2007); Descriptive and subjective norms (Theory of Reasoned Action; Theory of Planned Behaviour; Ajzen, 1991); social messages (Self Regulatory Model; Leventhal et al., 1980)
Barriers to behaviour change
Perceived adverse reactions	Perceived severity and perceived probability of occurrence (Protection Motivation Theory; Rogers & Prentice-Dunn, 1997); Health Belief Model; Janz & Becker, 1984); emotional response to threat (Self Regulatory Model; Leventhal et al., 1980)
Weight management norms, lack of motivation and impact on self-esteem restricting behaviour change.	Health beliefs (Health Belief Model; Janz & Becker, 1984); self-esteem (Self-Determination Theory; Deci & Ryan, 2012); downward comparisons (Social Comparison Theory; Goethals & Darley, 1987); Continuing unhealthy behaviours (Self Affirmation Theory; Steele, 1988); attitudes towards behaviour and the Digital Twin (TRA; TPB; Ajzen, 1991); emotional response to threat and social messages (Self Regulatory Model; Leventhal et al., 1980)

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Data availability statement

The data that support the findings of this study are openly available in Github at https://github.com/laurentaylorHP/UsersandnonusersDigitalTwin.git