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1
Digital behavior change interventions produce near-term gains in physical activity, dietary behavior, medication adherence, and other health outcomes.
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2
Intervention effects often diminish after support ends or engagement wanes, and wearable tracker engagement seldom persists beyond 3 months.
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3
External rewards such as badges and streaks are common engagement strategies, but evidence does not show that their effects are sustainable long term.
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4
The article frames a sustainability paradox in which features that support short-term behavior change may weaken the conditions needed for long-term persistence.
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5
Self-determination theory proposes that behavior is more likely to endure when people experience it as autonomous and self-endorsed rather than externally controlled.
