Systematic review of context-aware digital behavior change interventions to improve health

Craig, Kelly Jean Thomas; Morgan, Laura C; Chen, Ching-Hua; Michie, Susan; Fusco, Nicole; Snowdon, Jane L.; Scheufele, Elisabeth; Gagliardi, T.; Sill, Stewart

doi:10.1093/tbm/ibaa099

Cited by 51 publications

(22 citation statements)

References 43 publications

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“…As some authors suggest, the inclusion of BCTs contributes to improving the potential to promote behavior change [ 31 ]. This probably justifies the employment of different BCTs in digital behavior change interventions [ 32 ]. In this sense, Webb et al [ 33 ] conclude that the inclusion of BCTs is linked to the efficacy of interventions in which digital resources are used, a possible motivator for the potential incorporation of more specific BCTs by app developers.…”

Section: Discussionmentioning

confidence: 99%

Content, Behavior Change Techniques, and Quality of Pregnancy Apps in Spain: Systematic Search on App Stores

Muñoz-Mancisidor

Martín-Payo

González-Méndez

et al. 2021

JMIR Mhealth Uhealth

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Background Women consult information in mobile apps (apps) during pregnancy, and even obstetrics specialists highlight that pregnancy is the ideal moment for the use of apps as consultation sources. However, the high number of apps designed for pregnancy requires a careful assessment to determine their suitability before recommendation. Objective The aim of this study is to identify the apps available in Spanish that can be recommended based on their content, behavior change techniques (BCTs), and quality as a complementary tool during pregnancy. Methods A systematic search on app stores to identify apps was performed in the Apple App Store and Google Play with the subject term “pregnancy.” The apps meeting the following criteria were chosen: pregnancy-related content, free, and available in Spanish. An app was excluded if it was classified as a game or entertainment and thus lacking an educational or health aim and if it did not target the population under study. The selected apps were downloaded, and their quality was assessed using the Mobile Application Rating Scale (MARS), with the BCTs included evaluated using the BCT taxonomy version 1 and its content. Results A total of 457 apps were identified, 25 of which were downloaded for assessment (5.6%). The median for objective and subjective quality was 2.94 (IQR 2.71-3.46) and 1.75 (IQR 1.25-2.25), respectively. Regarding content, the median of topics included in the apps was 23 (IQR 16-23), with weight gain, nutrition, fetal development, and physical activity being the most common. The median number of BCTs was 12 (IQR 0.5-3.5). The most frequently identified BCTs in the apps were “Self-Monitoring of Outcomes,” followed by “Goal Behavior” and “Instructions.” Statistically significant correlations were observed between objective quality and content (ρ=0.624; P=.001), subjective quality and content (ρ=0.638; P=.001), objective quality and BCTs (ρ=0.672; P<.001), subjective quality and BCTs (ρ=0.623; P<.001), and BCTs and content (ρ=0.580; P=.002). Conclusions The results of this study suggest that only a small percentage of free pregnancy apps available in Spanish should be recommended. The apps with the best MARS scores were those that addressed a higher number of topics and included a higher number of BCTs. Those with the best content and quality, and a higher number of BCTs included could be recommended by health professionals.

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Section: Discussionmentioning

confidence: 99%

Content, Behavior Change Techniques, and Quality of Pregnancy Apps in Spain: Systematic Search on App Stores

Muñoz-Mancisidor

Martín-Payo

González-Méndez

et al. 2021

JMIR Mhealth Uhealth

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“…Consistent with a recent review on mobile apps for individuals with chronic diseases [ 14 ], this study identified that participants were engaged and empowered when using the app. An increase in the activation levels may encourage health-related behaviors, such as increasing physical activity, dietary behaviors, and medication adherence [ 39 , 40 ], as well as support closer monitoring of their disease symptoms [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Experiences of Using a Self-management Mobile App Among Individuals With Heart Failure: Qualitative Study

Schmaderer¹,

Miller²,

Mollard³

2021

JMIR Nursing

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Background Interventions that focus on the self-management of heart failure are vital to promoting health in patients with heart failure. Mobile health (mHealth) apps are becoming more integrated into practice to promote self-management strategies for chronic diseases, optimize care delivery, and reduce health disparities. Objective The purpose of this study was to explore the experience of using a self-management mHealth intervention in individuals with heart failure to inform a future mHealth intervention study. Methods This study used a qualitative descriptive design. Participants were enrolled in the intervention groups of a larger parent study using a mobile app related to self-management of heart failure. The purposive, convenient, criterion-based sample for this qualitative analysis comprised 10 patients who responded to phone calls and were willing to be interviewed. Inclusion criteria for the parent study were adults who were hospitalized at Nebraska Medical Center with a primary diagnosis and an episode of acute decompensated heart failure; discharged to home without services such as home health care; had access to a mobile phone; and were able to speak, hear, and understand English. Results Study participants were middle-aged (mean age 55.8, SD 12 years; range 36-73 years). They had completed a mean of 13.5 (SD 2.2) years (range 11-17 years) of education. Of the 10 participants, 6 (60%) were male. Half of them (5/10, 50%) were New York Heart Association Classification Class III patients and the other half were Class IV patients. The intervention revealed four self-management themes, including (1) I didn’t realize, and now I know; (2) It feels good to focus on my health; (3) I am the leader of my health care team; and (4) My health is improving. Conclusions Participants who used a self-management mHealth app intervention for heart failure reported an overall positive experience. Their statements were organized into four major themes. The education provided during the study increased self-awareness and promoted self-management of their heart failure. The mHealth app supported patient empowerment, resulting in better heart failure management and improved quality of life. Participants advocated for themselves by becoming the leader of their health, especially when communicating with their health care team. Finally, the mHealth app was used by the participants as a self-management tool to assist in symptom management and improve their overall health. Future research should study symptom evaluation, medication tracking, and possibly serve as a health provider communication platform to empower individuals to be leaders in their chronic disease management.

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“…Advances in eHealth technology have cultivated transactional opportunities for patients to access, share, and monitor health information [ 15 ]. Digital behavior change interventions use digital health technologies for behavior modification for the maintenance and improvement of health [ 16 ], and patients and health professionals tend to search the Internet for information about many health-related topics. In fact, 81% of all Internet users go online and search for information related to health [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Quality Analysis of YouTube Videos Presenting Pelvic Floor Exercises after Prostatectomy Surgery

Rodriguez-Rodriguez

Blanco‐Díaz

Lopez-Diaz

et al. 2021

JPM

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Background: Prostate cancer (PC) is a major cause of disease and mortality among men. Surgical treatment involving the removal of the prostate may result in temporary or permanent erectile dysfunction (ED) and urinary incontinence (UI), with considerable impact on quality of life. Pelvic floor muscle training (PFMT) is one of the recommended techniques for the prevention, treatment, and rehabilitation of postoperative complications. The aim of this observational study was to assess the quality of YouTube videos—accessible to any patient—related to exercises after prostatectomy surgery. Methods: A systematic search was performed on YouTube on 24 September 2020. One hundred and fifty videos were selected and analyzed. Two statistical analyses were conducted based on machine-learning techniques, and videos were classified as ‘Relevant’ or ‘Non-Relevant’ using Principal Component Analysis (PCA) models. Two reviewers conducted independent analyses. Inter-observer agreement and individual correlations of video data were evaluated with the Intraclass Correlation Coefficient (ICC). Information quality, reliability, and accuracy were measured using the DISCERN Scale and Global Quality Score (GQS), while video popularity was evaluated using the Video Power Index (VPI). Results: DISCERN scored a mean of 3.35 and GQS scored 3.38. Average number of views was 124,354, mean duration was 14:42 min, mean days online was 1777, mean view ratio was 138.30, mean Likes was 1082, mean Dislikes was 68.58, and mean VPI was 92.28. Conclusions: The quality of the videos available on YouTube regarding the recommended pelvic floor exercises in PC surgery, according to the scores obtained, is High. Educational and health institutions, health professionals, government health authorities, and policy makers need to be involved in the proper development of policies to improve the information available on the web in order to have a positive impact on the healthy behavior of the population.

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Systematic review of context-aware digital behavior change interventions to improve health

Cited by 51 publications

References 43 publications

Content, Behavior Change Techniques, and Quality of Pregnancy Apps in Spain: Systematic Search on App Stores

Content, Behavior Change Techniques, and Quality of Pregnancy Apps in Spain: Systematic Search on App Stores

Experiences of Using a Self-management Mobile App Among Individuals With Heart Failure: Qualitative Study

Quality Analysis of YouTube Videos Presenting Pelvic Floor Exercises after Prostatectomy Surgery

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