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Application of the Supportive Accountability Model in Digital Health Interventions: Scoping Review.

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Summary

Human support in digital health interventions (DHIs) can improve user engagement and adherence. However, the Supportive Accountability Model (SAM) is inconsistently applied, with a need to focus on all its components for maximum DHI impact.

Keywords:
digital health interventionhuman supportintervention adherenceintervention engagementmHealthsupportive accountability

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Area of Science:

  • Digital Health
  • Health Informatics
  • Behavioral Science

Background:

  • Digital health interventions (DHIs) face challenges with user engagement and adherence.
  • The Supportive Accountability Model (SAM) offers a framework to enhance adherence through structured human support.

Purpose of the Study:

  • To review the extent of research on human support factors influencing DHI engagement and adherence.
  • To assess the application of SAM constructs (accountability, bond, legitimacy) in DHIs.

Main Methods:

  • Scoping review following PRISMA-ScR guidelines.
  • Searched 6 databases (MEDLINE, PsycINFO, Embase, CINAHL, Scopus, ClinicalTrials.gov).
  • Included 36 empirical, peer-reviewed articles on human-supported DHIs.

Main Results:

  • Human support varied in source, delivery, frequency, and duration.
  • Inconsistent application of SAM, with limited focus on bond and legitimacy beyond accountability.
  • Human support was sometimes the primary intervention, not an adjunct.

Conclusions:

  • Gaps exist in applying SAM to human-supported DHIs.
  • Future research should integrate all SAM components and use human support adjunctively.
  • Optimizing SAM application can enhance DHI effectiveness and health outcomes.