scholarly journals Participants’ enactment of behavior change techniques: A call for increased focus on what people do to manage their motivation and behaviour

2018 ◽  
Author(s):  
Nelli Hankonen
Keyword(s):  
Behavior Change ◽  
Intervention Effectiveness ◽  
Intervention Participant ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Intervention Delivery ◽  
Change Behavior ◽  
Starting Point ◽  
Trial Outcomes ◽  
And Behavior

Intervention effectiveness does not only depend on fidelity of intervention delivery, but also the enactment, or use, of behavior change techniques (BCTs) by the participants. For example, it is not sufficient that intervention provider prompts an intervention participant to self-monitor their physical activity, but crucially, the participant enacts self-monitoring. Theoretical and conceptual work integrating various strands of research into ‘what a person can do for oneself’ to change behavior is needed. This paper argues how this would aid in designing for, assessing, and promoting the use individuals’ self-management techniques, and ultimately, our understanding of sustained behavior change. The recently published, integrative compendium of self-enactable techniques to change and self-manage motivation and behavior can act as a useful starting point for this work. An increased focus on the enactment of BCTs would help clarify intervention processes, help explain trial outcomes, and potentially enhance intervention effectiveness.

scholarly journals Identifying effective intervention strategies to reduce children’s screen time: a systematic review and meta-analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Alexis Jones ◽  
Bridget Armstrong ◽  
R. Glenn Weaver ◽  
Hannah Parker ◽  
Lauren von Klinggraeff ◽  
...  
Keyword(s):  
Behavior Change ◽  
Sample Size ◽  
Screen Time ◽  
Behavioral Interventions ◽  
Meta Analysis ◽  
Intervention Effectiveness ◽  
Behavior Change Techniques ◽  
Behavioral Techniques ◽  
Study Characteristics ◽  
And Behavior

Abstract Background Excessive screen time ($$\ge$$ ≥ 2 h per day) is associated with childhood overweight and obesity, physical inactivity, increased sedentary time, unfavorable dietary behaviors, and disrupted sleep. Previous reviews suggest intervening on screen time is associated with reductions in screen time and improvements in other obesogenic behaviors. However, it is unclear what study characteristics and behavior change techniques are potential mechanisms underlying the effectiveness of behavioral interventions. The purpose of this meta-analysis was to identify the behavior change techniques and study characteristics associated with effectiveness in behavioral interventions to reduce children’s (0–18 years) screen time. Methods A literature search of four databases (Ebscohost, Web of Science, EMBASE, and PubMed) was executed between January and February 2020 and updated during July 2021. Behavioral interventions targeting reductions in children’s (0–18 years) screen time were included. Information on study characteristics (e.g., sample size, duration) and behavior change techniques (e.g., information, goal-setting) were extracted. Data on randomization, allocation concealment, and blinding was extracted and used to assess risk of bias. Meta-regressions were used to explore whether intervention effectiveness was associated with the presence of behavior change techniques and study characteristics. Results The search identified 15,529 articles, of which 10,714 were screened for relevancy and 680 were retained for full-text screening. Of these, 204 studies provided quantitative data in the meta-analysis. The overall summary of random effects showed a small, beneficial impact of screen time interventions compared to controls (SDM = 0.116, 95CI 0.08 to 0.15). Inclusion of the Goals, Feedback, and Planning behavioral techniques were associated with a positive impact on intervention effectiveness (SDM = 0.145, 95CI 0.11 to 0.18). Interventions with smaller sample sizes (n < 95) delivered over short durations (< 52 weeks) were associated with larger effects compared to studies with larger sample sizes delivered over longer durations. In the presence of the Goals, Feedback, and Planning behavioral techniques, intervention effectiveness diminished as sample size increased. Conclusions Both intervention content and context are important to consider when designing interventions to reduce children’s screen time. As interventions are scaled, determining the active ingredients to optimize interventions along the translational continuum will be crucial to maximize reductions in children’s screen time.

scholarly journals Persuasive System Design Principles and Behavior Change Techniques to Stimulate Motivation and Adherence in Electronic Health Interventions to Support Weight Loss Maintenance: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Rikke Aune Asbjørnsen ◽  
Mirjam Lien Smedsrød ◽  
Lise Solberg Nes ◽  
Jobke Wentzel ◽  
Cecilie Varsi ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behavior Change ◽  
Goal Setting ◽  
Weight Loss Maintenance ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Support Weight ◽  
And Behavior ◽  
Weight Loss Interventions

BACKGROUND Maintaining weight after weight loss is a major health challenge, and eHealth (electronic health) solutions may be a way to meet this challenge. Application of behavior change techniques (BCTs) and persuasive system design (PSD) principles in eHealth development may contribute to the design of technologies that positively influence behavior and motivation to support the sustainable health behavior change needed. OBJECTIVE This review aimed to identify BCTs and PSD principles applied in eHealth interventions to support weight loss and weight loss maintenance, as well as techniques and principles applied to stimulate motivation and adherence for long-term weight loss maintenance. METHODS A systematic literature search was conducted in PsycINFO, Ovid MEDLINE (including PubMed), EMBASE, Scopus, Web of Science, and AMED, from January 1, 2007 to June 30, 2018. Arksey and O’Malley’s scoping review methodology was applied. Publications on eHealth interventions were included if focusing on weight loss or weight loss maintenance, in combination with motivation or adherence and behavior change. RESULTS The search identified 317 publications, of which 45 met the inclusion criteria. Of the 45 publications, 11 (24%) focused on weight loss maintenance, and 34 (76%) focused on weight loss. Mobile phones were the most frequently used technology (28/45, 62%). Frequently used wearables were activity trackers (14/45, 31%), as well as other monitoring technologies such as wireless or digital scales (8/45, 18%). All included publications were anchored in behavior change theories. Feedback and monitoring and goals and planning were core behavior change technique clusters applied in the majority of included publications. Social support and associations through prompts and cues to support and maintain new habits were more frequently used in weight loss maintenance than weight loss interventions. In both types of interventions, frequently applied persuasive principles were self-monitoring, goal setting, and feedback. Tailoring, reminders, personalization, and rewards were additional principles frequently applied in weight loss maintenance interventions. Results did not reveal an ideal combination of techniques or principles to stimulate motivation, adherence, and weight loss maintenance. However, the most frequently mentioned individual techniques and principles applied to stimulate motivation were, personalization, simulation, praise, and feedback, whereas associations were frequently mentioned to stimulate adherence. eHealth interventions that found significant effects for weight loss maintenance all applied self-monitoring, feedback, goal setting, and shaping knowledge, combined with a human social support component to support healthy behaviors. CONCLUSIONS To our knowledge, this is the first review examining key BCTs and PSD principles applied in weight loss maintenance interventions compared with those of weight loss interventions. This review identified several techniques and principles applied to stimulate motivation and adherence. Future research should aim to examine which eHealth design combinations can be the most effective in support of long-term behavior change and weight loss maintenance.

scholarly journals Behavior change techniques in mobile applications for sedentary behavior

2018 ◽  
Vol 4 ◽  
pp. 205520761878579 ◽  
Author(s):  
Emily E Dunn ◽  
Heather L Gainforth ◽  
Jennifer E Robertson-Wilson
Keyword(s):  
Physical Activity ◽  
Behavior Change ◽  
Sedentary Behavior ◽  
Mobile Applications ◽  
Health Behavior Change ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Behavior Change Interventions ◽  
And Behavior ◽  
Keyword Searches

Objective Mobile applications (apps) are increasingly being utilized in health behavior change interventions. To determine the presence of underlying behavior change mechanisms, apps for physical activity have been coded for behavior change techniques (BCTs). However, apps for sedentary behavior have yet to be assessed for BCTs. Thus, the purpose of the present study was to review apps designed to decrease sedentary time and determine the presence of BCTs. Methods Systematic searches of the iTunes App and Google Play stores were completed using keyword searches. Two reviewers independently coded free ( n = 36) and paid ( n = 14) app descriptions using a taxonomy of 93 BCTs (December 2016–January 2017). A subsample ( n = 4) of free apps were trialed for one week by the reviewers and coded for the presence of BCTs (February 2017). Results In the free and paid app descriptions, only 10 of 93 BCTs were present with a mean of 2.42 BCTs (range 0–6) per app. The BCTs coded most frequently were “prompts/cues” ( n = 43), “information about health consequences” ( n = 31), and “self-monitoring of behavior” ( n = 17). For the four free apps that were trialed, three additional BCTs were coded that were not coded in the descriptions: “graded tasks,” “focus on past successes,” and “behavior substitution.” Conclusions These sedentary behavior apps have fewer BCTs compared with physical activity apps and traditional (i.e., non-app) physical activity and healthy eating interventions. The present study sheds light on the behavior change potential of sedentary behavior apps and provides practical insight about coding for BCTs in apps.

scholarly journals Evaluación de aplicaciones para la deshabituación tabáquica con elementos de gamificación: elaboración y aplicación de un check-list = Evaluation of gamification apps in smoking cessation: development and application of a check-list

2018 ◽  
Vol 9 (2) ◽  
pp. 152
Author(s):  
Rubén Andújar-Espinosa ◽  
Lourdes Salinero-González ◽  
Manuel Castilla-Martínez ◽  
Carlos Castillo-Quintanilla ◽  
Rocío Ibañez-Meléndez ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Behavior Change ◽  
Check List ◽  
Tobacco Use Cessation ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Pubmed Search ◽  
And Behavior ◽  
Access Policies

Resumen: Introducción. El uso de la gamificación en salud es una herramienta útil para incrementar la motivación cuan­do se aplica a salud. Los objetivos fueron realizar una revisión sobre evidencias científicas de aplicaciones con elementos de gamificación en salud, identificar características de calidad, elaborar un check-list y aplicarlo a apli­caciones para la deshabituación tabáquica con elementos de gamificación. Métodos. Se realizó una búsqueda bibliográfica en Pubmed sobre gamificación en salud y una búsqueda de apps de cese tabáquico con elementos de gamificación. Se elaboró un check-list para evaluar la calidad, elementos de gamificación y técnicas de cambio de comportamiento utilizados, posteriormente se aplicó a las apps seleccionadas. Resultados. Se incluyeron 14 apps sobre gamificación en deshabituación tabáquica. Solo 4 (28,6%) identificaron fuentes de información fiables y solo 2 (14,3%) informaron sobre políticas de acceso y tratamiento de datos. Las técnicas de cambio de comportamiento identificadas fueron retroalimentación en todas las apps, automonitorización en 12 (85,7%) y cambios basados en los éxitos pasados en 13 (92,9%). Conclusiones. Existen pocos estudios sobre aplica­ciones para la deshabituación tabáquica con elementos de gamificación, con gran variabilidad en metodología, variables medidas y escasas evidencias. La creación de un check-list sobre calidad de las aplicaciones podría disminuir esta variabilidad y mejorar la calidad de los estudios futuros. Son necesarios nuevos estudios.Palabras clave: Deshabituación tabáquica; Aplicaciones móviles; Terapia de comportamiento; Cese tabáquico.Abstract: Introduction. The use of health gamification has proven to be a useful tool to increase motivation and com­mitment when applied to health. The objectives were to review the scientific evidences of health gamification applications, to identify the quality characteristics, to develop a check list to evaluate it and to apply it to the appli­cations in smoking cessation. Methodology. PubMed search on health gamification and a search for smoking cessation apps with gamification elements in the most important application stores. A checklist was developed to evaluate the quality, gamification elements and behavior change techniques used, and was applied to the selected apps. Results. We included 14 apps on gamification in smoking cessation. Only 4 (28.6%) identified reliable sou­rces of information and only 2 (14.3%) reported on access policies and data processing. Behavior change techni­ques identified were feedback in all apps, self-monitoring in 12 (85.7%) and changes based on past successes 13 (92.9%). Conclusions. There are few studies on gamification applications in smoking cessation, with a high variabi­lity in the methodology, measured variables and with little evidence. Creating a checklist on the quality of smoking cessation apps could decrease this variability and improve the quality of future studies. Further studies are needed.Keywords: Tobacco Use Cessation; Mobile Applications; Behavior Therapy; Smoking Cessation.

scholarly journals Methods of Health Behavior Change

2017 ◽  
Author(s):  
Ildiko Tombor ◽  
Susan Michie
Keyword(s):  
Behavior Change ◽  
Healthcare Professionals ◽  
Direct Methods ◽  
Health Behavior Change ◽  
Systematic Method ◽  
Behavior Change Techniques ◽  
Change Behavior ◽  
Behavior Change Wheel ◽  
High Level ◽  
And Behavior

People’s behavior influences health, for example, in the prevention, early detection, and treatment of disease, the management of illness, and the optimization of healthcare professionals’ behaviors. Behaviors are part of a system of behaviors within and between people in that any one behavior is influenced by others. Methods for changing behavior may be aimed at individuals, organizations, communities, and/or populations and at changing different influences on behavior, e.g., motivation, capability, and the environment. A framework that encapsulates these influences is the Behavior Change Wheel, which links an understanding of behavior in its context with methods to change behavior. Within this framework, methods are conceptualized at three levels: policies that represent high-level societal and organizational decisions, interventions that are more direct methods to change behavior, and behavior change techniques that are the smallest components that on their own have the potential to change behavior. In order to provide intervention designers with a systematic method to select the policies, interventions, and/or techniques relevant for their context, a set of criteria can be used to help select intervention methods that are likely to be implemented and effective. One such set is the “APEASE” criteria: affordability, practicability, effectiveness, acceptability, safety, and equity.

scholarly journals Barriers and Facilitators That Influence Providers’ Ability to Educate, Monitor, and Treat Substance Use in First-Episode Psychosis Programs Using the Theoretical Domains Framework

2021 ◽  
pp. 104973232199344
Author(s):  
Oladunni Oluwoye ◽  
Elizabeth Fraser
Keyword(s):  
Substance Use ◽  
Behavior Change ◽  
Theoretical Domains Framework ◽  
First Episode Psychosis ◽  
Barriers And Facilitators ◽  
First Episode ◽  
Evidence Based ◽  
Behavior Change Techniques ◽  
Episode Psychosis ◽  
And Behavior

In this qualitative study, we explore providers’ experiences with addressing substance use among individuals with first-episode psychosis (FEP) enrolled in coordinated specialty care (CSC) programs. Three focus groups were conducted with 24 providers from CSC programs for FEP in Washington. Questions were focused on barriers and facilitators to addressing substance use using the Theoretical Domains Framework (TDF) as a guide. Thematic analysis was used to code all transcripts. Identified TDF domains were then mapped onto the COM-B (Capability, Opportunity, Motivation, Behavior) intervention functions and behavior change techniques. Seven theoretical domains were identified as the most relevant to addressing substance use: “Knowledge,” “Skills,” “Environmental Context and Resources,” “Social Influences,” “Social and Professional Role and Identity,” “Beliefs about Capabilities,” and “Reinforcement.” The use of the TDF provides a framework to explore barriers and facilitators for targeting substance use and suggestions for behavior change techniques when considering implementation of evidence-based strategies to enhance CSC models.

scholarly journals Adults’ Preferences for Behavior Change Techniques and Engagement Features in a Mobile App to Promote 24-Hour Movement Behaviors: Cross-Sectional Survey Study (Preprint)

2019 ◽  
Author(s):  
Ann DeSmet ◽  
Ilse De Bourdeaudhuij ◽  
Sebastien Chastin ◽  
Geert Crombez ◽  
Ralph Maddison ◽  
...  
Keyword(s):  
Behavior Change ◽  
Repeated Measures ◽  
Self Regulation ◽  
Mobile App ◽  
User Preferences ◽  
Movement Behavior ◽  
Survey Study ◽  
User Engagement ◽  
Behavior Change Techniques ◽  
Self Monitoring

BACKGROUND There is a limited understanding of components that should be included in digital interventions for 24-hour movement behaviors (physical activity [PA], sleep, and sedentary behavior [SB]). For intervention effectiveness, user engagement is important. This can be enhanced by a user-centered design to, for example, explore and integrate user preferences for intervention techniques and features. OBJECTIVE This study aimed to examine adult users’ preferences for techniques and features in mobile apps for 24-hour movement behaviors. METHODS A total of 86 participants (mean age 37.4 years [SD 9.2]; 49/86, 57% female) completed a Web-based survey. Behavior change techniques (BCTs) were based on a validated taxonomy v2 by Abraham and Michie, and engagement features were based on a list extracted from the literature. Behavioral data were collected using Fitbit trackers. Correlations, (repeated measures) analysis of variance, and independent sample <italic>t</italic> tests were used to examine associations and differences between and within users by the type of health domain and users’ behavioral intention and adoption. RESULTS Preferences were generally the highest for information on the health consequences of movement behavior self-monitoring, behavioral feedback, insight into healthy lifestyles, and tips and instructions. Although the same ranking was found for techniques across behaviors, preferences were stronger for all but one BCT for PA in comparison to the other two health behaviors. Although techniques fit user preferences for addressing PA well, supplemental techniques may be able to address preferences for sleep and SB in a better manner. In addition to what is commonly included in apps, sleep apps should consider providing tips for sleep. SB apps may wish to include more self-regulation and goal-setting techniques. Few differences were found by users’ intentions or adoption to change a particular behavior. Apps should provide more self-monitoring (<italic>P</italic>=.03), information on behavior health outcome (<italic>P</italic>=.048), and feedback (<italic>P</italic>=.04) and incorporate social support (<italic>P</italic>=.048) to help those who are further removed from healthy sleep. A virtual coach (<italic>P</italic><.001) and video modeling (<italic>P</italic>=.004) may provide appreciated support to those who are physically less active. PA self-monitoring appealed more to those with an intention to change PA (<italic>P</italic>=.03). Social comparison and support features are not high on users’ agenda and may not be needed from an engagement point of view. Engagement features may not be very relevant for user engagement but should be examined in future research with a less reflective method. CONCLUSIONS The findings of this study provide guidance for the design of digital 24-hour movement behavior interventions. As 24-hour movement guidelines are increasingly being adopted in several countries, our study findings are timely to support the design of interventions to meet these guidelines.

Motivating Adolescents to Participate in Literacy Intervention: A Case Example From Telepractice

2021 ◽  
pp. 1-15
Author(s):  
Ginger G. Collins
Keyword(s):  
Behavior Change ◽  
Self Determination Theory ◽  
Literacy Skills ◽  
Language Intervention ◽  
Self Determination ◽  
Literacy Intervention ◽  
Behavior Change Techniques ◽  
Language Interventions ◽  
And Behavior ◽  
Motivation To Participate

Purpose: Motivation declines as children reach adolescence. Poor motivation inhibits participation and engagement in language-based interventions. The purpose of this tutorial is to demonstrate how intervention can be designed to increase client motivation to participate while improving language-based literacy skills. Method: Motivation and behavior change techniques based on self-determination theory are presented, as are examples of how to integrate these techniques into contextualized language intervention with adolescent clients. Conclusion: Incorporating motivation and behavior change techniques into contextualized language interventions with adolescents promotes self-determination and motivation through satisfaction of their need for autonomy, relatedness, and competence while simultaneously addressing language-based literacy deficits.

Content analysis of behavior change techniques in maternal and infant health apps

2020 ◽  
Author(s):  
Rizwana Biviji ◽  
Joshua R Vest ◽  
Brian E Dixon ◽  
Theresa Cullen ◽  
Christopher A Harle
Keyword(s):  
Decision Making ◽  
Health Education ◽  
Behavior Change ◽  
Infant Health ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Final Sample ◽  
Maternal And Infant Health ◽  
Health Expert ◽  
App Design

Abstract Maternal and infant health (MIH) mobile applications (apps) are increasingly popular and frequently used for health education and decision making. Interventions grounded in theory-based behavior change techniques (BCTs) are shown to be effective in promoting healthy behavior changes. MIH apps have the potential to be useful tools, yet the extent to which they incorporate BCTs is still unknown. The objective of this study was to assess the presence of BCTs in popular MIH apps available in the Apple App and Google Play stores. Twenty-nine popular MIH apps were coded for the presence of 16 BCTs using the mHealth app taxonomy. Popular MIH apps whose purpose was to provide health education or decision-making support to pregnant women or parents/caregivers of infants were included in the final sample. On an average, the reviewed apps included seven BCTs (range 2–16). Techniques such as personalization, review of general or specific goals, macro tailoring, self-monitoring of goals, and health behavior linkages were most frequently present. No differences in the presence of BCTs between paid and free apps were observed. Popular MIH apps typically included only a minority of BCTs found to be useful for health promotion. However, apps developed by healthcare developers incorporated a higher number of BCTs within the app content. Therefore, app developers and policymakers may consider strategies to increase health expert involvement in app design and content delivery.

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