The Effectiveness of Interactivity in Improving Mediating Variables, Behaviors and Outcomes of Web-Based Health Interventions: A Meta-Analytic Review

Effective Behavior Change Techniques in Digital Health Interventions for the Prevention or Management of Noncommunicable Diseases: An Umbrella Review

BACKGROUND

Despite an abundance of digital health interventions (DHIs) targeting the prevention and management of noncommunicable diseases (NCDs), it is unclear what specific components make a DHI effective.

PURPOSE

This narrative umbrella review aimed to identify the most effective behavior change techniques (BCTs) in DHIs that address the prevention or management of NCDs.

METHODS

Five electronic databases were searched for articles published in English between January 2007 and December 2022. Studies were included if they were systematic reviews or meta-analyses of DHIs targeting the modification of one or more NCD-related risk factors in adults. BCTs were coded using the Behavior Change Technique Taxonomy v1. Study quality was assessed using AMSTAR 2.

RESULTS

Eighty-five articles, spanning 12 health domains and comprising over 865,000 individual participants, were included in the review. We found evidence that DHIs are effective in improving health outcomes for patients with cardiovascular disease, cancer, type 2 diabetes, and asthma, and health-related behaviors including physical activity, sedentary behavior, diet, weight management, medication adherence, and abstinence from substance use. There was strong evidence to suggest that credible source, social support, prompts and cues, graded tasks, goals and planning, feedback and monitoring, human coaching and personalization components increase the effectiveness of DHIs targeting the prevention and management of NCDs.

CONCLUSIONS

This review identifies the most common and effective BCTs used in DHIs, which warrant prioritization for integration into future interventions. These findings are critical for the future development and upscaling of DHIs and should inform best practice guidelines.

Can Extant Vaping Prevention Message Experiments Tell Us Something About What Works? A Response to O'Keefe

In his commentary, O'Keefe raises some interesting questions about the meaning of effect sizes in meta-analyses of experiments, focusing on our recent meta-analysis on vaping prevention messages. In this commentary, we respond to O'Keefe's comments and make several points. First, it is not uncommon to include experiments with different control conditions in a meta-analysis. Second, the set of studies in our meta-analysis were relatively homogenous, all being experiments testing messages to discourage vaping among adolescents and young adults. Third, the control conditions in each of the studies in the meta-analysis were appropriate for each given study, and our results show homogenous effects on most outcomes. Fourth, our meta-analysis finds meaningful effects that are timely and will be useful to researchers and practitioners alike. As this literature continues to grow, so too will knowledge about the effects of vaping prevention messages and moderators of those effects.