Supporting every day behaviour change with digital interventions (Lecture…
Supporting every day behaviour change with
digital interventions (Lecture 2)
Multi-phase intervention development process (Craig et al. 2008).
Identifying theories and evidence base (e.g. systematic reviews, exploratory studies)
Pilot testing the intervention (e.g. recruitment, retention)
Evaluating effectiveness and cost effectiveness
Implementing the intervention in the intended context with continued evaluation (e.g. long-term effects)
Understand COM-B analysis and BCW
BUT ALSO:The Person-based approach places more emphasis on user involvement from the initial planning stage of a digital intervention to its implementation (Yardley et al., 2015) .
Establishing an in-depth understanding
of the users’ needs and their context
through extensive qualitative research
(among the target population and relevant
Identifying guiding principles to inform
the intervention design and content
provide a framework for understanding and systematically addressing the problem
allow that all influences on behaviour are considered (automatic and reflective processes, and the context)
help to identify important intervention components
explain mechanisms of action in interventions
• More extensive use of theory in digital interventions has been associated with greater interventions effects compared with little or no use of theories (Webb et al., 2010).
• 83 theories of behaviour or behaviour change (Davis et al., 2015)
• Only a few provide integrative models of behaviour
Evidence based underpinnings
Potential sources of evidence:
systematic reviews and/or meta-analyses
randomised controlled trials
high quality observational and/or experimental studies
Digital interventions across behavioural domains (e.g.
smoking, physical activity, diet) rarely adhere to evidencebased
guidelines for best practice treatments or include
evidence-based behaviour change techniques (Abroms et al.,
2011; Azar et al., 2013).
Usable and engaging design
What are the characteristics that would make you download/use a smartphone app?
In order for an intervention to be effective it has to be engaged with and deliver evidence-based BCTs effectively
Engagement with digital interventions is generally low – most users disengage after a few logins
Digital interventions have to be usable, visually appealing, easy to navigate, accessible, provide rewarding experience, and well-promoted (it is a very competitive environment)
Transparency in reporting the development and content of the intervention
Lack of transparency in reporting the development process and content of digital interventions is very common (Civljak et al, 2013).
Without a full description of the content and the ways in
which theory and evidence were translated into
intervention components, it is difficult to:
Replicate the intervention
Implement the intervention as intended
Evaluate how the intervention might have influenced the behavioural outcome
Adopt the intervention to different context/population
(Michie and Aberdeen, 2012)
Transparency in reporting the development and content of the SmokeFree Baby intervention
Theory and evidence base
• Evidence from smoking and behavioural science
• Exploratory research (both qualitative and quantitative)
• Principles from the COM-B model and PRIME theory (West & Brown, 2013)
42 distinct BCTs from the BCT Taxonomy v1 (Michie et al., 2013)
Usability and Engagement
Design principles were adopted from previous digital interventions to aid smoking cessation
Usability testing within the research team
Subsequent think-aloud studies with pregnant smokers
A systematic application of theory and evidence from the
scientific literature is needed to inform the development of digital behaviour change interventions.
However, most interventions are developed and populated
without rigorous evaluation of effectiveness.
Frameworks for the development of digital interventions emphasize the iterative, multi-phase nature of intervention development process.
User engagement with digital interventions is key for