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Behavior Change Techniques in Digital Health Interventions for Midlife Women: Systematic Review
Hana Sediva1, Tina Cartwright2, Claire Robertson3
1Centre for Nutraceuticals, School of Life Sciences, University of Westminster, London, United Kingdom.
JMIR Mhealth and Uhealth
|November 9, 2022
Summary
Digital health interventions show promise for promoting healthy behaviors in midlife women. However, their effectiveness is limited by weak theoretical underpinnings and inconsistent application of behavior change techniques (BCTs).
Area of Science:
- Digital health interventions
- Behavior change techniques
- Midlife women's health
Background:
- Digital health interventions show efficacy in promoting health-enhancing behaviors and mitigating menopausal symptoms in midlife women.
- Knowledge regarding the mechanisms of change within these interventions remains unclear.
- This review focuses on behavior change techniques (BCTs) and mechanisms of change in digital health interventions for midlife women (aged 40-65).
Approach:
- Systematic literature search across major electronic databases (PubMed, Web of Science, PsycINFO, Cochrane).
- Independent review, data extraction, and BCT mapping by two reviewers.
- Evaluation of mechanisms of action and intervention functions using the Behavior Change Wheel framework and Theory Coding Scheme.
Key Points:
- Thirteen interventions utilized an average of 13 BCTs, with 'Shaping knowledge' and 'Repetition and substitution' being most common.
- 'Instructions on behaviour' was the most frequently used BCT.
- Interventions primarily targeted 'Capability' (50%) and 'Motivation' (42%), with 'Behavioural Regulation' as the main mechanism of action (15%).
- Web-based (69%) and phone/SMS (62%) were dominant delivery modes.
- Only 69% of interventions mentioned a psychological theory, with weak evidence of demonstrated application.
Conclusions:
- Current digital health interventions for midlife women exhibit weak theoretical integration, low fidelity, and insufficient reporting.
- These limitations present an opportunity to enhance the design of future lifestyle interventions.
- Improved theoretical grounding and explicit links between BCTs and psychological constructs are needed for greater efficacy.
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