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.
Keywords: Behavior change technique; Digital health; Intervention components; Lifestyle behaviors; eHealth; mHealth.
Digital health interventions (DHIs) that use technology to deliver lifestyle support for the prevention or treatment of noncommunicable diseases (NCDs) have grown in popularity and number in recent years. However, it is unclear what aspects make a DHI effective in changing lifestyle behaviors and improving health. The aim of this study was to review the existing scientific evidence to identify effective components in DHIs that address the prevention or management of NCDs and summarize the best available evidence to date. We conducted a comprehensive electronic search for peer-reviewed systematic reviews and meta-analyses published in English between January 1, 2007 and December 31, 2022. We systematically extracted details of the reviews and the intervention components and summarized the effectiveness of components for each health domain, prioritizing the best available evidence. Eighty-five articles, spanning 12 health domains and summarizing evidence from over 865,000 individual participants, were included in the review. We found good evidence that DHIs are effective in preventing and treating NCDs. Specific intervention components that are effective and should be prioritized for inclusion in future DHIs include: using a credible source; social support; prompts and cues; graded tasks; goals and planning, feedback and monitoring, human coaching and personalization.
© The Author(s) 2023. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.