Behavior Change Techniques and the Effects Associated With Digital Behavior Change Interventions in Sedentary Behavior in the Clinical Population: A Systematic Review

Martín-Martín, Jaime; Roldán-Jiménez, Cristina; De-Torres, Irene; Muro-Culebras, Antonio; Escriche-Escuder, Adrián; Gónzalez-Sánchez, Manuel; Ruiz-Muñoz, María; Mayoral-Cleries, Fermín; Biró, Attila; Tang, Wen; Nikolova, Borjanka; Salvatore, Alfredo; Cuesta-Vargas, Antonio

doi:10.3389/fdgth.2021.620383

Cited by 20 publications

(9 citation statements)

References 36 publications

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“…“Self-monitoring,” “biofeedback,” and “goal setting of PA behaviour” were the most frequently used BCTs across the included studies. These findings concur with previous literature on digital behavior change interventions targeting PA, which also highlighted the role of “social support” in adults [ 103 - 105 ] and older adults [ 106 ]. In this review, “social support” was used in 67% (6/9) of the studies targeting both healthy [ 56 , 76 , 79 , 85 ] and clinical (ie, survivors of breast cancer) [ 81 , 83 ] midlife women.…”

Section: Discussionsupporting

confidence: 91%

Assessing the Acceptability and Effectiveness of Mobile-Based Physical Activity Interventions for Midlife Women During Menopause: Systematic Review of the Literature

AlSwayied¹,

Guo²,

Rookes³

et al. 2022

JMIR Mhealth Uhealth

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Background Midlife women with menopausal symptoms are less likely to meet the recommended level of physical activity (PA). Promoting PA among women in midlife could reduce their risk of cardiovascular diseases and perhaps improve menopausal symptoms. Mobile PA interventions in the form of smartphone apps and wearable activity trackers can potentially encourage users to increase PA levels and address time and resource barriers to PA. However, evidence on the acceptability and effectiveness of these interventions among midlife women is unclear. Objective This systematic review evaluated the effectiveness, acceptability, and active behavior change techniques (BCTs) of mobile PA technologies among midlife menopausal women. Methods A mixed methods systematic review of qualitative and quantitative studies was conducted. MEDLINE (Ovid), Embase, Scopus, CINAHL, Web of Science, SPORTDiscus, CENTRAL, PsycINFO, and the ProQuest Sports Medicine and Education Index were systematically searched. Studies were selected and screened according to predetermined eligibility criteria. In total, 2 reviewers independently assessed the risk of bias using the Mixed Methods Appraisal Tool and completed BCT mapping of the included interventions using the BCT Taxonomy v1. Results A total of 12 studies were included in this review. Overall risk of bias was “Moderate to high” in 58% (7/12) of the included studies and “low” in 42% (5/12) of the studies. Of the 12 studies, 7 (58%) assessed changes in PA levels. The pooled effect size of 2 randomized controlled trials resulted in a small to moderate increase in moderate to vigorous PA of approximately 61.36 weekly minutes among midlife women, at least in the short term (95% CI 17.70-105.01; P=.006). Although a meta-analysis was not feasible because of heterogeneity, positive improvements were also found in a range of menopause-related outcomes such as weight reduction, anxiety management, sleep quality, and menopause-related quality of life. Midlife women perceived mobile PA interventions to be acceptable and potentially helpful in increasing PA and daily steps. The average number of BCTs per mobile PA intervention was 8.8 (range 4-13) according to the BCT Taxonomy v1. “Self-monitoring of behaviour,” “Biofeedback,” and “Goal setting (behaviour)” were the most frequently described BCTs across the included interventions. Conclusions This review demonstrated that mobile PA interventions in the form of smartphone apps and wearable trackers are potentially effective for small to moderate increases in moderate to vigorous PA among midlife women with menopausal symptoms. Although menopause is a natural condition affecting half the population worldwide, there is a substantial lack of evidence to support the acceptability and effectiveness of mobile PA interventions on menopause-related outcomes, which needs further investigation. Trial Registration PROSPERO CRD42021273062; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=273062

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Section: Discussionsupporting

confidence: 91%

Assessing the Acceptability and Effectiveness of Mobile-Based Physical Activity Interventions for Midlife Women During Menopause: Systematic Review of the Literature

AlSwayied¹,

Guo²,

Rookes³

et al. 2022

JMIR Mhealth Uhealth

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“…The behavior change taxonomy is a conceptual framework offering this; characterizing 93 distinct behavior change techniques used in complex interventions [ 16 ]. Various systematic reviews apply the behavior change taxonomy to identify and gauge the effects of intervention elements in BBCI [ 6 , 17 , 18 , 19 ]. Due to the widespread usage of the behavior change taxonomy, this approach is conducive as it aids standardization.…”

Section: Introductionmentioning

confidence: 99%

What Intervention Elements Drive Weight Loss in Blended-Care Behavior Change Interventions? A Real-World Data Analysis with 25,706 Patients

Schirmann¹,

Kanehl²,

Jones³

2022

Nutrients

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Background: Blended-care behavior change interventions (BBCI) are a combination of digital care and coaching by health care professionals (HCP), which are proven effective for weight loss. However, it remains unclear what specific elements of BBCI drive weight loss. Objectives: This study aims to identify the distinct impact of HCP-elements (coaching) and digital elements (self-monitoring, self-management, and education) for weight loss in BBCI. Methods: Long-term data from 25,706 patients treated at a digital behavior change provider were analyzed retrospectively using a ridge regression model to predict weight loss at 3, 6, and 12 months. Results: Overall relative weight loss was −1.63 kg at 1 month, −3.61 kg at 3 months, −5.28 kg at 6 months, and −6.55 kg at 12 months. The four factors of BBCI analyzed here (coaching, self-monitoring, self-management, and education) predict weight loss with varying accuracy and degree. Coaching, self-monitoring, and self-management are positively correlated with weight losses at 3 and 6 months. Learn time (i.e., self-guided education) is clearly associated with a higher degree of weight loss. Number of appointments outside of app coaching with a dietitian (coach) was negatively associated with weight loss. Conclusions: The results testify to the efficacy of BBCI for weight loss-with particular positive associations per time point-and add to a growing body of research that characterizes the distinct impact of intervention elements in real-world settings, aiming to inform the design of future interventions for weight management.

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“…The application of BCTs has demonstrated beneficial effects on self-efficacy, adherence and quality of life. 39 In previous research the RACE instrument was validated with asthma patients. 12 This study also confirms its application for COPD patients with comparable patient recognition of the identified individual barrier profiles identified with the RACE questionnaire; 86.1% (±11.8%) in asthma and 81.8% (±13.7%) in COPD.…”

Section: Discussionmentioning

confidence: 99%

“…We therefore developed the RACE instrument to support self‐management in asthma and COPD with an integrated theoretical basis adopting TDF and BCTs to further enhance existing interventions in their effectiveness. The application of BCTs has demonstrated beneficial effects on self‐efficacy, adherence and quality of life 39 …”

Section: Discussionmentioning

confidence: 99%

Self‐management support with the Respiratory Adherence Care Enhancer instrument in asthma and chronic obstructive pulmonary disease: An implementation trial

Visser,

Antonisse,

Alleda

et al. 2024

Brit J Clinical Pharma

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AimSuboptimal self‐management with controller inhalation therapy in asthma and COPD is frequently observed with poor treatment outcomes. The developed ‘Respiratory Adherence Care Enhancer’ (RACE) instrument identifies and addresses individual barriers to self‐management with a theoretical underpinning. This study investigates the feasibility of pharmaceutical support with this instrument.MethodsAn implementation trial was conducted with asthma and COPD patients in 5 community pharmacies in the Netherlands. Patients were allocated to standard care or add‐on support with the RACE instrument. Patients were invited to complete the RACE questionnaire at baseline, 5‐week and 10‐week follow‐up. Barrier profiles were accessible for the intervention group with subsequent consultations at baseline and 5‐weeks. Experiences were collected from patients and consultants with a questionnaire and reported findings. Primary endpoints focused on the acceptability, practicality and implementation process. Secondary endpoints included between‐group differences in barrier and disease control outcomes from baseline at 10‐weeks follow‐up.ResultsIn total, 84 patients were included; 48 were assigned to intervention and 36 to standard care. Patient satisfaction of support with the RACE instrument was high (71%). Patients felt motivated, reassured and more confident about their disease management. Consultants reported an increase in awareness of patient barriers. Patient recognition of barrier profiles was 83.9% (±12.9%). The barrier inhaler techniques decreased significantly for the intervention group at follow‐up with odds ratio 0.30 (95% confidence interval, 0.10–0.91). No significant differences were observed for changes in number of barriers and disease control.ConclusionSelf‐management support with the RACE instrument is feasible and appreciated, facilitating behaviour change with patient‐centred pharmaceutical care in asthma and COPD.

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Behavior Change Techniques and the Effects Associated With Digital Behavior Change Interventions in Sedentary Behavior in the Clinical Population: A Systematic Review

Cited by 20 publications

References 36 publications

Assessing the Acceptability and Effectiveness of Mobile-Based Physical Activity Interventions for Midlife Women During Menopause: Systematic Review of the Literature

Assessing the Acceptability and Effectiveness of Mobile-Based Physical Activity Interventions for Midlife Women During Menopause: Systematic Review of the Literature

What Intervention Elements Drive Weight Loss in Blended-Care Behavior Change Interventions? A Real-World Data Analysis with 25,706 Patients

Self‐management support with the Respiratory Adherence Care Enhancer instrument in asthma and chronic obstructive pulmonary disease: An implementation trial

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