Characterizing Active Ingredients of eHealth Interventions Targeting Persons With Poorly Controlled Type 2 Diabetes Mellitus Using the Behavior Change Techniques Taxonomy: Scoping Review

Abstract

BackgroundThe behavior change technique taxonomy v1 (BCTTv1; Michie and colleagues, 2013) is a comprehensive tool to characterize active ingredients of interventions and includes 93 labels that are hierarchically clustered into 16 hierarchical clusters.ObjectiveThe aim of this study was to identify the active ingredients in electronic health (eHealth) interventions targeting patients with poorly controlled type 2 diabetes mellitus (T2DM) and relevant outcomes.MethodsWe conducted a scoping review using the BCTTv1. Randomized controlled trials (RCTs), studies with or pre-post-test designs, and quasi-experimental studies examining efficacy and effectiveness of eHealth interventions for disease management or the promotion of relevant health behaviors were identified by searching PubMed, Web of Science, and PsycINFO. Reviewers independently screened titles and abstracts for eligibility using predetermined eligibility criteria. Data were extracted following a data extraction sheet. The BCTTv1 was used to characterize active ingredients of the interventions reported in the included studies.ResultsOf the 1404 unique records screened, 32 studies fulfilled the inclusion criteria and reported results on the efficacy and or or effectiveness of interventions. Of the included 32 studies, 18 (56%) were Web-based interventions delivered via personal digital assistant (PDA), tablet, computer, and/or mobile phones; 7 (22%) were telehealth interventions delivered via landline; 6 (19%) made use of text messaging (short service message, SMS); and 1 employed videoconferencing (3%). Of the 16 hierarchical clusters of the BCTTv1, 11 were identified in interventions included in this review. Of the 93 individual behavior change techniques (BCTs), 31 were identified as active ingredients of the interventions. The most common BCTs identified were instruction on how to perform behavior, adding objects to the environment, information about health consequences, self-monitoring of the outcomes and/or and prefers to be explicit to avoid ambiguity. Response: Checked and avoided of a certain behavior Author: Please note that the journal discourages the use of parenthesis to denote either and/or and prefers to be explicit to avoid ambiguity. Response: Checked and avoided “and/or” and prefers to be explicit to avoid ambiguity. Response: Checked and avoided, and feedback on outcomes of behavior.ConclusionsOur results suggest that the majority of BCTs employed in interventions targeting persons with T2DM revolve around the promotion of self-regulatory behavior to manage the disease or to assist patients in performing health behaviors necessary to prevent further complications of the disease. Detailed reporting of the BCTs included in interventions targeting this population may facilitate the replication and further investigation of such interventions.

Using Behaviour Change Theories to Understand Pediatric Emergency Discharge Communication Interventions

“…We identified 20 out of a possible 93 BCTs across all studies, indicating that less than a quarter of the available BCTs are commonly used in interventions to improve ED discharge communication. This low percentage of identified BCTs is consistent with other reviews of BCTs in diabetes care [17,66] and medication adherence literature [67].…”

“…This is not surprising as discharge communication is meant to instruct patients and caregivers on how to perform behaviours specific to managing care of their child at home. This finding is also consistent with BCTs identified in the diabetes [17,66], cardiovascular disease [68], and physical activity [69] literature. Interestingly, many of the common BCTs used to address other health behaviours,, including action planning [67], goal setting [66,68,70], self-monitoring of behaviours [67,[69][70][71], problem solving [70,72] and reducing negative emotions [68,70] have not been widely used in discharge communication interventions to date.…”

“…The BCTTv1 includes 93 individual techniques with labels and definitions organized into 16 BCT categories [10]. The BCTTv1 has been used to evaluate and design a number of health care interventions in varying clinical settings, including medication adherence [11], weight management [12], physical activity [13,14], antimicrobial resistance [15], and diabetes care [16,17]. Previous research has found the BCTTv1 to be a useful tool for classifying intervention components and standardizing intervention language [15][16][17][18].…”

Using Behaviour Change Theories to Understand Pediatric Emergency Discharge Communication Interventions

“…We identi ed 20 out of a possible 93 BCTs across all studies, indicating that less than a quarter of the available BCTs are commonly used in interventions to improve ED discharge communication. This low percentage of identi ed BCTs is consistent with other reviews of BCTs in diabetes care [17,66] and medication adherence literature [67].…”

“…The BCTTv1 includes 93 individual techniques with labels and de nitions organized into 16 BCT categories [10]. The BCTTv1 has been used to evaluate and design a number of health care interventions in varying clinical settings, including medication adherence [11], weight management [12], physical activity [13,14], antimicrobial resistance [15], and diabetes care [16,17]. Previous research has found the BCTTv1 to be a useful tool for classifying intervention components and standardizing intervention language [15][16][17][18].…”