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We describe this phenomenon as the sustainability paradox: the same design features that maximize behavioral success during use, such as automated guidance, real-time feedback, and gamified rewards, may undermine the conditions necessary for the behavior to persist once the intervention is terminated. This viewpoint introduces narrative ownership as a conceptual framework for understanding and addressing this paradox. Narrative ownership refers to the extent to which individuals experience behavior change as an ongoing, interpretable, and self-authored process and comprises 3 components: process framing, narrative repair, and authorship. We argue that many contemporary DBCI architectures unintentionally displace these experiential processes by automating lapse correction, redirecting behaviors without interpretation, and externalizing the attribution of success. We map these tendencies onto 3 structural mechanisms\u2014the erosion of process framing, the foreclosure of narrative repair, and the hollowing of authorship\u2014and distinguish narrative ownership from adjacent constructs such as engagement, self-efficacy, and autonomy support. We also note that narrative ownership is double-edged: the same reflective processes can consolidate negative self-attributions, and its expression varies across cultural contexts, taking a familial or communal rather than strictly individual form in relational settings. Therefore, to translate this framework into practice, we outline 3 design principles for sustainable digital interventions: reflective pauses that support process framing, lapse reinterpretation features that enable narrative repair, and meaning-linking interfaces that strengthen authorship. For each principle, we derive testable propositions\u2014for example, that reflective pauses will improve behavioral maintenance after the intervention ends and that meaning-linking interfaces will sustain behavior after app use is discontinued\u2014along with candidate outcome measures and directions for empirical validation. Together, these principles reposition the user not merely as the recipient of behavioral guidance but also as the author of their own story of change in digital health interventions.<\/jats:p>","DOI":"10.2196\/95781","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:55:05Z","timestamp":1792090505000},"page":"e95781-e95781","source":"Crossref","is-referenced-by-count":0,"title":["The Sustainability Paradox in Digital Behavior Change Interventions: Narrative Ownership as a Design Principle for Lasting Change"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6251-3587","authenticated-orcid":false,"given":"Tsuyoshi","family":"Okuhara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7877-9753","authenticated-orcid":false,"given":"Hiroko","family":"Okada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1431-4786","authenticated-orcid":false,"given":"Emi","family":"Furukawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"issue":"5","key":"R1","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.amepre.2016.06.015","article-title":"Understanding and promoting effective engagement with digital behavior change interventions","volume":"51","author":"Yardley","journal-title":"Am J Prev Med"},{"issue":"5","key":"R2","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/j.amepre.2016.06.008","article-title":"Evaluating digital health interventions: key questions and approaches","volume":"51","author":"Murray","journal-title":"Am J Prev Med"},{"issue":"10","key":"R3","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1093\/abm\/kaad041","article-title":"Effective behavior change techniques in digital health interventions for the prevention or management of noncommunicable diseases: an umbrella review","volume":"57","author":"Mair","journal-title":"Ann Behav Med"},{"issue":"4","key":"R4","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1080\/17437199.2020.1721310","article-title":"Self-regulatory behaviour change techniques in interventions to promote healthy eating, physical activity, or weight loss: a meta-review","volume":"15","author":"Spring","journal-title":"Health Psychol Rev"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s12160-013-9486-6","article-title":"The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions","volume":"46","author":"Michie","journal-title":"Ann Behav Med"},{"issue":"5","key":"R6","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1016\/j.amepre.2016.06.013","article-title":"Advancing models and theories for digital behavior change interventions","volume":"51","author":"Hekler","journal-title":"Am J Prev Med"},{"issue":"6","key":"R7","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7126","article-title":"Developing and evaluating digital interventions to promote behavior change in health and health care: recommendations resulting from an international workshop","volume":"19","author":"Michie","journal-title":"J Med Internet Res"},{"issue":"3","key":"R8","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1080\/17437199.2016.1151372","article-title":"Theoretical explanations for maintenance of behaviour change: a systematic review of behaviour theories","volume":"10","author":"Kwasnicka","journal-title":"Health Psychol Rev"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.2196\/54375","article-title":"Digital behavior change intervention designs for habit formation: systematic review","volume":"26","author":"Zhu","journal-title":"J Med Internet Res"},{"issue":"1","key":"R10","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7.1.e11","article-title":"The law of attrition","volume":"7","author":"Eysenbach","journal-title":"J Med Internet Res"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2019.08.025","article-title":"Abandonment of personal quantification: a review and empirical study investigating reasons for wearable activity tracking attrition","volume":"102","author":"Attig","journal-title":"Comput Human Behav"},{"issue":"3","key":"R12","doi-asserted-by":"publisher","DOI":"10.2196\/12053","article-title":"Can smartphone apps increase physical activity? 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