The Efficacy of Just-In-Time Adaptive Interventions in Augmenting Behavioral Health: Protocol for a Systematic Review (Preprint)

Abstract

BACKGROUND Just-in-time adaptive interventions (JITAIs) use mobile, digital tools to provide individuals with personalized interventions at the optimal time and in the optimal context. Accordingly, JITAIs are promising for advancing accessible, equitable, and evidence-based treatment for behavioral health. To guide future work in this space, research is needed to examine the efficacy of JITAIs for behavioral health conditions and better understand their mechanisms of action. OBJECTIVE In the proposed systematic review, we will investigate the efficacy of JITAIs for improving (1) distal outcomes (here, behavioral health) and (2) proximal outcomes (eg, emotion regulation). METHODS This systematic review is being conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses Protocol. We developed our search strategy and executed the literature search in collaboration with biomedical librarians; five databases (PubMed, Embase, Cochrane Library, Web of Science: Core Collection, and APA PsycINFO) were searched and results were managed using EndNote 20. We are screening all records in duplicate in Covidence according to eligibility criteria; title/abstract screening is complete and full-text screening is ongoing. Data items will be extracted, and risk of bias will be assessed in duplicate from the included articles in Covidence. RESULTS We will summarize JITAI characteristics in tables and text. We will conduct meta-analyses for the distal and proximal outcomes conditional upon sufficient homogeneity in subgroups. Moderation (conditional upon sufficient heterogeneity of outcomes) and mediation (ie, whether changes in proximal outcomes mediate the relation between JITAIs and distal outcomes) will be conducted, as appropriate. We will investigate publication bias and use the Grading of Recommendations Assessment, Development and Evaluation to characterize the quality of evidence of our estimates. CONCLUSIONS Here, we propose a systematic review to assess the state of the literature on JITAIs for behavioral health. The insights derived from this study will reinforce JITAI definitions, clarify JITAI components, describe the efficacy of JITAIs in augmenting distal and proximal behavioral health outcomes, and inform the next steps in JITAI research.