Theory-Based Digital Interventions to Improve Asthma Self-Management Outcomes: Systematic Review

Area of Science:

• Digital health interventions
• Behavioral science
• Asthma management

Background:

• Asthma requires effective self-management to prevent mortality.
• Digital interventions for asthma self-management are increasing.
• Limited knowledge exists on theory application in digital interventions and its impact on outcomes.

Purpose of the Study:

• To examine theory use and application in digital asthma self-management interventions.
• To evaluate the effectiveness of theory-based interventions on adherence, self-management, and clinical outcomes.

Main Methods:

• Systematic review of electronic databases (CENTRAL, MEDLINE, EMBASE, PsycINFO).
• Inclusion criteria screening, risk of bias assessment (Cochrane tool), and data extraction.
• Theory application assessed using the Theory Coding Scheme (TCS); effectiveness analyzed via narrative synthesis.

Main Results:

• Fourteen digital interventions were reviewed; Social Cognitive Theory, Health Belief Model, and Self-Efficacy Theory were common.
• Higher theory use in development correlated with effective outcomes (r=.657, P=.01).
• Studies meeting >60% TCS criteria were effective on all outcomes; fewer than 60% were partially or not effective.

Conclusions:

• Increased theory application in digital asthma interventions may enhance effectiveness.
• Theory application alone may not guarantee success; contextual factors are important.
• A systematic approach to theory is needed for designing and applying digital interventions.