Gambling Prevention Mobile Applications: Understanding the Inclusion and Use of Behaviour Change Techniques

Online gambling is emerging as a significant health behaviour of concern at a population level. Mobile applications (apps) are a popular tool to target change in health behaviour. Behaviour change techniques (BCTs) can be included within such apps to change relevant psychological mechanisms along established pathways, yet the content of apps targeting gambling problems specifically is not currently known. The purpose of the review was to identify the BCTs included in gambling prevention apps. Apps were downloaded from the Apple App Store and Google Play Store in October 2020. Apps were included if they related to gambling problems, were freely downloadable, and available in English. Once downloaded, two researchers independently coded the apps in November 2020 using the behaviour change technique taxonomy version 1 (Michie et al., 2013). The screening led to forty apps meeting the inclusion criteria (12 Apple App Store, 28 Google Play). The analyses identified 32 BCTs (20 Apple apps, 28 Google Play apps), with apps including between 0 and 9 BCTs (mean = 2.82, median = 2). The BCTs included most frequently were “3.1. Social support (unspecified),” “2.3. Self-monitoring of behaviour,” and “7.4. Remove access to the reward.” The review provides important information on the BCTs used in apps developed to reduce gambling-related problems. A limited number of BCTs were adopted within apps. Developers of apps seeking to develop effective gambling reduction products should draw upon a greater variety of BCTs.

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An evaluation of behaviour change techniques in health and lifestyle mobile applications

Health Informatics Journal ◽

10.1177/1460458218813726 ◽

2018 ◽

Vol 26 (1) ◽

pp. 104-113 ◽

Cited By ~ 3

Author(s):

Gaston Antezana ◽

Anthony Venning ◽

Victoria Blake ◽

David Smith ◽

Megan Winsall ◽

...

Keyword(s):

Behaviour Change ◽

Mobile Applications ◽

Well Being ◽

Behaviour Change Techniques ◽

Behaviour Change Technique ◽

Systematic Classification ◽

App Design ◽

Current Popularity ◽

Potential Use

Despite the current popularity and potential use of mobile applications (apps) in the area of behaviour change, health promotion, and well-being for young people, it is unclear whether their design is underpinned by theory-based behaviour change techniques. Understanding the design of these apps may improve the way they can be used to support young people’s well-being.The objectives of this study were to investigate what behaviour change techniques are included in the content of health and lifestyle apps, and determine which of these are prominent in app design. Thirty of the top-listed health and lifestyle apps across three categories (physical activity, diet, and sleep) were freely downloaded from the two most popular app stores (GooglePlay™ and AppStore™). Selected apps were used by trained researchers and the features identified coded against the Behaviour Change Techniques Taxonomy 1, a systematic classification of techniques used in behaviour change interventions. It was found that 9 of the 93 behaviour change techniques listed in the Behaviour Change Techniques Taxonomy 1 were common across the chosen health and lifestyle apps. The app found to include the most behaviour change techniques had 20 (21%), while the app found to include the least had 1 behaviour change technique (1%). The most frequently used behaviour change techniques were related to goal setting and feedback. Entire categories in the Behaviour Change Techniques Taxonomy 1 were absent in the design of the selected apps.

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Mobile Applications for Health Management of Older Adults: A Scoping Review (Preprint)

10.2196/preprints.22823 ◽

2020 ◽

Author(s):

Nurul Asilah Ahmad ◽

Shahrul Azman Mohd Noah ◽

Arimi Fitri Mat Ludin ◽

Suzana Shahar ◽

Noorlaili Mohd Tohit

Keyword(s):

Older Adults ◽

Goal Setting ◽

Mobile Applications ◽

Health Management ◽

Mobile Apps ◽

Personalized Feedback ◽

Self Monitoring ◽

App Store ◽

Evidenced Based ◽

Google Play

BACKGROUND Currently, the use of smartphones to deliver health-related content has experienced a rapid growth, with more than 165,000 mobile health (mHealth) applications currently available in the digital marketplace such as iOS store and Google Play. Among these, there are several mobile applications (mobile apps) that offer tools for disease prevention and management among older generations. These mobile apps could potentially promote health behaviors which will reduce or delay the onset of disease. However, no review to date that has focused on the app marketplace specific for older adults and little is known regarding its evidence-based quality towards the health of older adults. OBJECTIVE The aim of this review was to characterize and critically appraise the content and functionality of mobile apps that focuses on health management and/or healthy lifestyle among older adults. METHODS An electronic search was conducted between May 2019 to December 2019 of the official app store for two major smartphone operating systems: iPhone operating system (iTunes App Store) and Android (Google Play Store). Stores were searched separately using predetermined search terms. Two authors screened apps based on information provided in the app description. Metadata from all included apps were abstracted into a standard assessment criteria form. Evidenced based strategies and health care expert involvement of included apps was assessed. Evidenced based strategies included: self-monitoring, goal setting, physical activity support, healthy eating support, weight and/or health assessment, personalized feedback, motivational strategies, cognitive training and social support. Two authors verified the data with reference to the apps and downloaded app themselves. RESULTS A total of 16 apps met the inclusion criteria. Six out of 16 (37.5%) apps were designed exclusively for the iOS platform while ten out of 16 (62.5%) were designed for Android platform exclusively. Physical activity component was the most common feature offered in all the apps (9/16, 56.3%) and followed by cognitive training (8/16, 50.0%). Diet/nutrition (0/16, 0%) feature, however, was not offered on all reviewed mobile apps. Of reviewed apps, 56.3% (9/16) provide education, 37.5% (6/16) provide self-monitoring features, 18.8% (3/16) provide goal setting features, 18.5% (3/16) provide personalized feedback, 6.3% (1/16) provide social support and none of the reviewed apps offers heart rate monitoring and reminder features to the users. CONCLUSIONS All reviewed mobile apps for older adults in managing health did not focused on diet/nutrition component, lack of functional components and lack of health care professional involvement in their development process. There is also a need to carry out scientific testing prior to the development of the app to ensure cost effective and its health benefits to older adults. Collaborative efforts between developers, researchers, health professionals and patients are needed in developing evidence-based, high quality mobile apps in managing health prior they are made available in the app store.

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Changing behaviour, ‘more or less’: do implementation and de-implementation interventions include different behaviour change techniques?

Implementation Science ◽

10.1186/s13012-021-01089-0 ◽

2021 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Andrea M. Patey ◽

Jeremy M. Grimshaw ◽

Jill J. Francis

Keyword(s):

Behaviour Change ◽

Implicit Theories ◽

Cochrane Library ◽

Behaviour Change Techniques ◽

Behaviour Change Technique ◽

Exact Test ◽

Continuity Correction ◽

Chi Squared ◽

Clinician Behaviour ◽

The Cochrane Library

Abstract Background Decreasing ineffective or harmful healthcare practices (de-implementation) may require different approaches than those used to promote uptake of effective practices (implementation). Few psychological theories differentiate between processes involved in decreasing, versus increasing, behaviour. However, it is unknown whether implementation and de-implementation interventions already use different approaches. We used the behaviour change technique (BCT) taxonomy (version 1) (which includes 93 BCTs organised into 12 groupings) to investigate whether implementation and de-implementation interventions for clinician behaviour change use different BCTs. Methods Intervention descriptions in 181 articles from three systematic reviews in the Cochrane Library were coded for (a) implementation versus de-implementation and (b) intervention content (BCTs) using the BCT taxonomy (v1). BCT frequencies were calculated and compared using Pearson’s chi-squared (χ2), Yates’ continuity correction and Fisher’s exact test, where appropriate. Identified BCTs were ranked according to frequency and rankings for de-implementation versus implementation interventions were compared and described. Results Twenty-nine and 25 BCTs were identified in implementation and de-implementation interventions respectively. Feedback on behaviour was identified more frequently in implementation than de-implementation (Χ2(2, n=178) = 15.693, p = .000057). Three BCTs were identified more frequently in de-implementation than implementation: Behaviour substitution (Χ2(2, n=178) = 14.561, p = .0001; Yates’ continuity correction); Monitoring of behaviour by others without feedback (Χ2(2, n=178) = 16.187, p = .000057; Yates’ continuity correction); and Restructuring social environment (p = .000273; Fisher’s 2-sided exact test). Conclusions There were some significant differences between BCTs reported in implementation and de-implementation interventions suggesting that researchers may have implicit theories about different BCTs required for de-implementation and implementation. These findings do not imply that the BCTs identified as targeting implementation or de-implementation are effective, rather simply that they were more frequently used. These findings require replication for a wider range of clinical behaviours. The continued accumulation of additional knowledge and evidence into whether implementation and de-implementation is different will serve to better inform researchers and, subsequently, improve methods for intervention design.

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Breaking barriers: using the Behavior Change Wheel to develop a tailored intervention to overcome workplace inhibitors to breaking up sitting time

10.21203/rs.2.10405/v2 ◽

2019 ◽

Author(s):

Samson O Ojo ◽

Daniel P. Bailey ◽

Marsha L. Brierley ◽

David J. Hewson ◽

Angel M. Chater

Keyword(s):

Behaviour Change ◽

Theoretical Domains Framework ◽

Office Workers ◽

Sitting Time ◽

Mental Wellbeing ◽

Behaviour Change Techniques ◽

Tailored Intervention ◽

Structured Interviews ◽

Behaviour Change Technique ◽

Break Up

Abstract Background: The workplace is a prominent domain for excessive sitting. The consequences of increased sitting time include adverse health outcomes such as cardiovascular disease and poor mental wellbeing. There is evidence that breaking up sitting could improve health, however, any such intervention in the workplace would need to be informed by a theoretical evidence-based framework. The aim of this study was to use the Behaviour Change Wheel (BCW) to develop a tailored intervention to break up and reduce workplace sitting in desk-based workers. Methods: The BCW guide was followed for this qualitative, pre-intervention development study. Semi-structured interviews were conducted with 25 office workers (26-59 years, mean age 40.9 [SD=10.8] years; 68% female) who were purposively recruited from local council offices and a university in the East of England region. The interview questions were developed using the Theoretical Domains Framework (TDF). Transcripts were deductively analysed using the COM-B (Capability, Opportunity, Motivation – Behaviour) model of behaviour. The Behaviour Change Technique Taxonomy Version 1 (BCTv1) was thereafter used to identify possible strategies that could be used to facilitate change in sitting behaviour of office workers in a future intervention. Results: Qualitative analysis using COM-B identified that participants felt that they had the physical Capability to break up their sitting time, however, some lacked the psychological Capability in relation to the knowledge of both guidelines for sitting time and the consequences of excess sitting. Social and physical Opportunity was identified as important, such as a supportive organisational culture (social) and the need for environmental resources (physical). Reflective and automatic Motivation was highlighted as a core target for intervention. Seven intervention functions and three policy categories from the BCW were identified as relevant. Finally, 39 behaviour change techniques (BCTs) were identified as potential active components for an intervention to break up sitting time in the workplace. Conclusions: The TDF, COM-B model and BCW can be successfully applied through a systematic process to understand the drivers of behaviour of office workers to develop a co-created intervention that can be used to break up and decrease prolonged sitting in the workplace.

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Breaking barriers: using the Behavior Change Wheel to develop a tailored intervention to overcome workplace inhibitors to breaking up sitting time

10.21203/rs.2.10405/v4 ◽

2019 ◽

Author(s):

Samson O Ojo ◽

Daniel P. Bailey ◽

Marsha L. Brierley ◽

David J. Hewson ◽

Angel M. Chater

Keyword(s):

Behaviour Change ◽

Theoretical Domains Framework ◽

Office Workers ◽

Sitting Time ◽

Mental Wellbeing ◽

Behaviour Change Techniques ◽

Tailored Intervention ◽

Structured Interviews ◽

Behaviour Change Technique ◽

Break Up

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Systematic Review of Behaviour Change Techniques within Interventions to Reduce Environmental Tobacco Smoke Exposure for Children

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17217731 ◽

2020 ◽

Vol 17 (21) ◽

pp. 7731

Author(s):

Tracey J. Brown ◽

Sarah Gentry ◽

Linda Bauld ◽

Elaine M. Boyle ◽

Paul Clarke ◽

...

Keyword(s):

Systematic Review ◽

Behaviour Change ◽

Environmental Tobacco Smoke ◽

Tobacco Smoke ◽

Tobacco Smoke Exposure ◽

Controlled Trials ◽

Behaviour Change Techniques ◽

Cochrane Central Register ◽

Behaviour Change Technique ◽

Self Help

Children are particularly vulnerable to environmental tobacco smoke (ETS). There is no routine support to reduce ETS in the home. We systematically reviewed trials to reduce ETS in children in order to identify intervention characteristics and behaviour change techniques (BCTs) to inform future interventions. We searched Medline, EMBASE, CINAHL, PsycINFO, ERIC, Cochrane Central Register of Controlled Trials, and Cochrane Tobacco Addiction Group Specialised Register from January 2017 to June 2020 to update an existing systematic review. We included controlled trials to reduce parent/caregiver smoking or ETS in children <12 years that demonstrated a statistically significant benefit, in comparison to less intensive interventions or usual care. We extracted trial characteristics; and BCTs using Behaviour Change Technique Taxonomy v1. We defined “promising” BCTs as those present in at least 25% of effective interventions. Data synthesis was narrative. We included 16 trials, of which eight were at low risk of bias. All trials used counselling in combination with self-help or other supporting materials. We identified 13 “promising” BCTs centred on education, setting goals and planning, or support to reach goals. Interventions to reduce ETS in children should incorporate effective BCTs and consider counselling and self-help as mechanisms of delivery.

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The application of psychological theory to nutrition behaviour change

Proceedings of The Nutrition Society ◽

10.1017/s0029665109001177 ◽

2009 ◽

Vol 68 (2) ◽

pp. 205-209 ◽

Cited By ~ 19

Author(s):

M. Barker ◽

J. A. Swift

Keyword(s):

Behaviour Change ◽

Health Behaviour ◽

Eating Behaviour ◽

Health Behaviours ◽

Psychological Theory ◽

Theory And Practice ◽

Behaviour Change Techniques ◽

Attitudes And Beliefs ◽

Psychological Determinants ◽

Integrated Research

Changing individuals' health behaviour seems to be the key to solving many of the world's health problems. Although there is a multitude of potential influences, many interventions to improve health seek to change intrinsic psychological determinants of health behaviour. To date, most attention has been paid to cognitions, such as attitudes and beliefs, and a number of social cognition models (SCM) are in current use. SCM all describe cognitions as determinants of behaviour, thereby implying that changes in cognitions will lead to changes in behaviour. Although SCM are widely used to predict a range of health behaviours, they are associated with a number of important limitations, including poor levels of predictive power, particularly in relation to eating behaviour, and limited guidance about the operationalisation of theoretical constructs. These limitations may explain why very few interventions to change behaviour are explicitly theory-based, despite the widely-held view that having a clear theoretical underpinning will improve effectiveness. Ultimately, advances in understanding and changing health behaviour will come about only if psychological theory and practice are integrated. The recently-published taxonomy of behaviour-change techniques used in interventions is a good example of integrated research, but more work of this type is essential and will require respectful collaboration between researchers and practitioners working from a range of different disciplines such as health psychology, public health nutrition and health promotion.

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Developing an evidence-based online method of linking behaviour change techniques and theoretical mechanisms of action: a multiple methods study

Health Services and Delivery Research ◽

10.3310/hsdr09010 ◽

2021 ◽

Vol 9 (1) ◽

pp. 1-168

Author(s):

Susan Michie ◽

Marie Johnston ◽

Alexander J Rothman ◽

Marijn de Bruin ◽

Michael P Kelly ◽

...

Keyword(s):

Behaviour Change ◽

Mechanism Of Action ◽

Behavioural Change ◽

Complex Interventions ◽

Mechanisms Of Action ◽

Behaviour Change Techniques ◽

Active Components ◽

Behaviour Change Technique ◽

Policy Makers ◽

Change Technique

Background Many global health challenges may be targeted by changing people’s behaviour. Behaviours including cigarette smoking, physical inactivity and alcohol misuse, as well as certain dietary behaviours, contribute to deaths and disability by increasing the risk of cancers, cardiovascular diseases and diabetes. Interventions have been designed to change these health behaviours with a view to reducing these health risks. However, the effectiveness of these interventions has been quite variable and further information is needed to enhance their success. More information is needed about the specific processes that underlie the effectiveness of intervention strategies. Aim Researchers have developed a taxonomy of 93 behaviour change techniques (i.e. the active components of an intervention that bring about behavioural change), but little is known regarding their potential mechanisms of action (i.e. the processes through which a behaviour change technique affects behaviour). We therefore aimed to examine links between behaviour change techniques and mechanisms of action. Method First, we conducted a literature synthesis study of 277 behaviour change intervention studies, from which we extracted information on links, described by authors, between behaviour change techniques and mechanisms of action, and identified an average of 10 links per intervention report. Second, behaviour change experts (n = 105) were engaged in a three-round consensus study in which they discussed and rated their confidence in the presence/absence of ‘links’ and ‘non-links’ between commonly used behaviour change techniques (n = 61) and a set of mechanisms of action (n = 26). Ninety links and 460 ‘non-links’ reached the pre-set threshold of 80% agreement. To enhance the validity of these results, a third study was conducted that triangulated the findings of the first two studies. Discrepancies and uncertainties between the studies were included in a reconciliation consensus study with a new group of experts (n = 25). The final results identified 92 definite behaviour change technique–mechanism of action links and 465 definite non-links. In a fourth study, we examined whether or not groups of behaviour change techniques used together frequently across interventions revealed shared theoretical underpinnings. We found that experts agreed on the underlying theory for three groups of behaviour change techniques. Results Our results are potentially useful to policy-makers and practitioners in selecting behaviour change techniques to include in behaviour change interventions. However, our data do not demonstrate that the behaviour change techniques are effective in targeting the mechanism of action; rather, the links identified may be the ‘best bets’ for interventions that are effective in changing mechanisms of action, and the non-links are unlikely to be effective. Researchers examining effectiveness of interventions in either primary studies or evidence syntheses may consider these links for further investigation. Conclusion To make our results usable by researchers, practitioners and policy-makers, they are available in an online interactive tool, which enables discussion and collaboration (https://theoryandtechniquetool.humanbehaviourchange.org/); accessed 1 March 2020. This work, building on previous work to develop the behaviour change technique taxonomy, is part of an ongoing programme of work: the Human Behaviour Change Project (www.humanbehaviourchange.org/; accessed 1 March 2020). Funding This project was funded by the Medical Research Council via its Methodology Panel: ‘Developing methodology for designing and evaluating theory-based complex interventions: an ontology for linking behaviour change techniques to theory’ (reference MR/L011115/1).

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The impact of nature-based interventions on public health: a review using pathways, mechanisms and behaviour change techniques from environmental social science and health behaviour change

Journal of the British Academy ◽

10.5871/jba/009s7.033 ◽

2021 ◽

Vol 9s7 ◽

pp. 33-61

Author(s):

Stephanie Wilkie ◽

Nicola Davinson

Keyword(s):

Public Health ◽

Social Science ◽

Health Outcomes ◽

Behaviour Change ◽

Health Behaviour ◽

Behaviour Change Techniques ◽

Change Models ◽

Health Behaviour Change ◽

The Impact ◽

Environmental Social Science

The aim of this narrative review is to explore whether nature-based interventions improved individual public health outcomes and health behaviours, using a conceptual framework that included pathways and pathway domains, mechanisms, and behaviour change techniques derived from environmental social science theory and health behaviour change models. A two-stage scoping methodology was used to identified studies published between 2000 and 2021. Peer reviewed, English-language reports of nature-based interventions with adults (N = 9) were included if the study met the definition of a health�behaviour change intervention and reported at least one measured physical/mental health outcome. Interventions focused on the restoring or building capacities pathway domains as part of the nature contact/experience pathway; varied health behaviour change mechanisms and techniques were present but environmental social-science-derived mechanisms to influence health outcomes were used less. Practical recommendations for future interventions include explicit statement of the targeted level of causation, as well as utilisation of both environmental social science and health behaviour change theories and varied public health outcomes to allow simultaneously testing of theoretical predictions.

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Remote delivery of alcohol and/or substance misuse interventions for adults: A systematic review protocol

PLoS ONE ◽

10.1371/journal.pone.0259525 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0259525

Author(s):

Neil Howlett ◽

Jaime Garcia-Iglesias ◽

Gavin Breslin ◽

Suzanne Bartington ◽

Julia Jones ◽

...

Keyword(s):

Behaviour Change ◽

Public Involvement ◽

Substance Misuse ◽

World Health ◽

Cochrane Library ◽

Behaviour Change Techniques ◽

Service Users ◽

Narrative Synthesis ◽

Behaviour Change Technique ◽

Face To Face

Introduction Alcohol and substance misuse are a public health priority. The World Health Organisation (WHO) estimates that harmful alcohol use accounts for 5.1% of the global burden of disease and that 35.6 million people worldwide are affected by substance misuse. The Coronavirus Disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has disrupted delivery of face-to-face alcohol and substance misuse interventions and has forced the development of alternative remote interventions or adaptation to existing ones. Although existing research on remote interventions suggests they might be as effective as face-to-face delivery, there has been a lack of systematic exploration of their content, the experience of service users, and their effectiveness for behavioural outcomes. This review will provide a narrative synthesis of the behaviour change techniques (BCT) contained in interventions for alcohol and/or substance misuse and their association with effectiveness. Methods and analysis Systematic searches will be conducted in MEDLINE, Scopus, PsycINFO (ProQuest), and the Cochrane Library. Included studies will be those reporting remote interventions focusing on alcohol and/or substance misuse among adults living in the community and which have a primary behaviour change outcome (i.e., alcohol levels consumed). Data extraction will be conducted by one author and moderated by a second, and risk of bias and behaviour change technique (BCT) coding will be conducted by two authors independently. A narrative synthesis will be undertaken focussing upon the association of BCTs with intervention effectiveness using promise ratios. Patient and Public Involvement (PPI) The Public Involvement in Research Group (PIRG), part of the NIHR-funded PHIRST, will be involved in refining the review questions, eligibility criteria, data synthesis and dissemination. Dissemination Dissemination will be through an academic peer reviewed publication, alongside other outputs to be shared with non-academic policy, professional, and public audiences, including local authorities, service users and community organisations.

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