The Perceived Benefits of Digital Interventions for Behavioral Health: Qualitative Interview Study

Abstract

Background Digital interventions have gained momentum in terms of behavioral health. However, owing to lacking standard approaches or tools for creating digital behavioral interventions, clinical researchers follow widely varying conceptions of how best to go about digital intervention development. Researchers also face significant cost-, time-, and expertise-related challenges in digital intervention development. Improving the availability of tools and guidance for researchers will require a thorough understanding of the motivations and needs of researchers seeking to create digital interventions. Objective This study aims to understand the perceptions of behavioral researchers toward digital interventions, and inform the use of these interventions, by documenting the reasons why researchers are increasingly focusing their efforts on digital interventions and their perspectives on the perceived benefits that digital approaches can provide for researchers and intervention recipients. Methods We conducted semistructured qualitative interviews with 18 researchers who had experience designing digital behavioral interventions or running studies with them. A convenience sample of interviewees was recruited from among users of the Computerized Intervention Authoring System platform, a web-based tool that facilitates the process of creating and deploying digital interventions in behavioral research. Interviews were conducted over teleconference between February and April 2020. Recordings from the interviews were transcribed and thematically analyzed by multiple coders. Results Interviews were completed with 18 individuals and lasted between 24 and 65 (mean 46.9, SD 11.3) minutes. Interviewees were predominantly female (17/18, 94%) and represented different job roles, ranging from researcher to project or study staff. Four major themes came out of the interviews concerning the benefits of digital interventions for behavioral health: convenience and flexibility for interventionists and recipients, support for implementing evidence-based interventions with fidelity, scaling and improving access to interventions, and getting a foot in the door despite stigma and disenfranchisement. Conclusions Interviewees described a number of important potential benefits of digital interventions, particularly with respect to scientific rigor, scalability, and overcoming barriers to reaching more people. There are complex considerations with regard to translating behavior change strategies into digital forms of delivery, and interventionists make individual, sometimes unexpected, choices with minimal evidence of their relative effectiveness. Future research should investigate how behavioral researchers can be supported in making these choices toward usability, ease of access, and approachability of digital interventions. Our study underscores the need for authoring platforms that can facilitate the process of creating and deploying digital interventions to reach their full potential for interventionists and recipients alike.

Barriers and Considerations in the Design and Implementation of Digital Behavioral Interventions: Qualitative Analysis

“…The final barrier we found concerns the shift interventionists had to make from designing an in-person intervention to designing a digital intervention. Interventionists look to technology for many perceived advantages [ 18 ]; however, interviewees pointed to the difficulty of adapting person-delivered interventions to digital forms. For example, despite the capability to program a digital narrator in CIAS so that it can adjust content in reaction to input from the user, interventionists still missed the richness of other cues they were used to relying on during in-person interactions:…”

“…Despite access and literacy variability among intervention recipients, one of the potential benefits valued by researchers is the ability to reach more people through the use of digital interventions at scale [ 18 ]; however, this extended reach of digital interventions comes with added complexity for planning and implementing interventions. In addition to time zone considerations, there may be other regional or cultural factors that affect how the intervention will be experienced by recipients across geographic areas.…”

“…CIAS supports intervention building features such as multiple question types, natural language reflections, branching and tailoring, and integration of video content. Further details on CIAS can be found in the part 1 companion paper [ 18 ]. With support from the National Institutes of Health (EB028990), an all-new version of CIAS (3.0) is currently being developed as an open-source and noncommercial research resource.…”

“…In this paper (part 2), we seek to document common barriers reported by intervention developers, as well as key considerations, in the design and implementation of digital interventions. In a companion paper (part 1), we seek to document reasons why researchers who study behavioral health focus their efforts on digital interventions, as well as their perspectives on the perceived benefits that digital approaches afford researchers and their intervention recipients [ 18 ].…”

The Importance of Developing Online Counseling Services for Family Planning Programs in Indonesia

“…With face-to-face counseling, officers can directly see the verbal expressions or movements of the client, so that counselor can easily find out if the material presented has been understood by the client. However, face-to-face counseling has the disadvantage of not being able to reach all people who need information on family planning services, which is due to limited time and distance to visit health facilities conversely, there are limitations of family planning counselors to reach a large number of people, on the other hand, online or digital services can flexible and can reach the wider community (6). For this reason, an alternative strategy that can be implemented is to build online contraceptive services for family planning programs.…”