Diagnosis Before Selection: A Co-Created Digital Nudging Framework for Health App Design

Document Type : Original Article

Authors

1 Department of Industrial Design, Kish International Campus, University of Tehran, Kish Island, Iran.

2 Variety Dynamics, Love Services Pty Ltd., Perth, Australia

Abstract

Digital nudging is a promising approach for supporting health-related behaviour change through mobile applications, yet existing design frameworks focus on selecting nudge mechanisms while offering little guidance on identifying users' cognitive states beforehand. This study reports the third phase of a three-phase mixed-methods research programme examining how behavioural design frameworks can better support practitioners in applying digital nudges effectively and ethically. Building on prototype testing with 88 users and a mixed-methods study of 38 UX/UI designers, Framework Version 1.0 was refined through a participatory co-creation workshop with ten professional designers; workshop data were analysed using reflexive thematic analysis in MAXQDA. Findings indicate that practitioners require explicit support for diagnosing users' cognitive states before selecting interventions, that ethical evaluation should consider how a nudge influences decision-making rather than only its intended outcome, and that behavioural design frameworks must align with the time constraints of commercial practice. The workshop also identified identity-threat reactance as a distinct consideration in mindfulness-related design. These findings informed Framework Version 2.0, a practitioner-oriented framework integrating cognitive state diagnosis, mechanism-based ethical evaluation, and a sprint-compressed implementation mode into a unified design process. While further validation is needed, the framework offers an initial contribution toward bridging behavioural theory and professional UX practice.

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References

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Journal of Design Thinking
Volume 7, Issue 1
June 2026
Pages 163-175

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