Persuasive, engaging, and accessible: Using behavioral science, communication, and technology development principles to design a mobile phone intervention for female sex workers in Kenya

Document Type

Conference Paper

Conference Name

APHA 2017 Annual Meeting & Expo

Publication (Name of Journal)

APHA 2017 Annual Meeting & Expo


Population Health (East Africa)


Purpose: Principles from behavioral science, health communication design, and technology development are essential for creating engaging and effective mobile phone interventions for health improvement (mHealth). However, global mHealth interventions seldom use a systematic development approach that is based in evidence and best practices from all three disciplines. This presentation will highlight key principles used to develop a mHealth intervention for female sex workers (FSW) that is being evaluated in a cluster-randomized controlled trial with approximately 800 women in Mombasa, Kenya.

Methods: First, we conducted an extensive review of the literature and several meetings with FSW peer educators. Second, participatory development workshops were conducted to gauge recommendations for intervention content and delivery and reactions to draft messages. Third, we implemented one-on-one usability testing interviews where FSW sent and received near-final messages on their personal mobile phones.

Results: Behavior change constructs from social cognitive and stages of change theories informed message content targeting self-efficacy, social support, norms, barriers, benefits, and processes of change. Health communication principles specifying attention to language, tone, relevance, identification, and appeal were investigated in formative research and considered in crafting of final content. Usability testing ensured the mHealth system was functional, comprehensible, and easy to use for women.

Conclusions: A systematic approach to mHealth intervention development that pulls on vital disciplines is valuable for crafting an engaging, accessible, and persuasive mHealth program. Following key principles for mHealth intervention design may yield more effective behavior change communication programs and stronger impacts on health and behavior.


This work was published before the author joined Aga Khan University.