Using virtual representations in mHealth application interventions for health-related behaviour change: A systematic review (Preprint)

Abstract

UNSTRUCTURED Many mobile health application interventions include virtual representations of the self in varying forms, such as agents, or avatars to initiate behaviour change. This review aimed to determine: (i) which virtual representations and digital features are effective in mHealth application interventions, and (ii) whether if any studies implemented specific mechanisms (the psychological causes of change) and BCTs implemented to influence positive behaviour change were identified. Following PRISMA guidelines, a narrative systematic review of empirical studies from ten different databases (ranging from MEDLINE to Cochrane Library) from inception to October 2021, published from any time point, which included a virtual representation mHealth app intervention that addressed and reported a variety of outcome health behaviours. Out of the 2,579 original hits, five eligible studies (total participants = 509), with low to moderate quality were included. It was found that customisable avatar or agent-based interventions that included mechanisms such as motivation, feedback, self-image, and BCTs such as goal setting, and self-monitoring were effective in encouraging behaviour change and app adherence. However, there is limited evidence available to determine to which these influences are a result of the virtual representations, or the intervention design.