The Use of Behavior Change Techniques and Theory in Technologies for Cardiovascular Disease Prevention and Treatment in Adults: A Comprehensive Review

Winter, Sandra J.; Sheats, Jylana L.; King, Abby C.

doi:10.1016/j.pcad.2016.02.005

Cited by 71 publications

(51 citation statements)

References 43 publications

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“…The development context may influence the assessment and reporting of engagement, acceptability, usability, and effectiveness of the apps and wearables. Commercially-developed apps, for example, often do not incorporate behavior change techniques that improve effectiveness [ 199 - 202 ] and may focus more on enhancing user experience: therefore, industry professionals may be more likely to assess engagement, acceptability, and usability rather than effectiveness. Finally, to understand whether studies employed in-device sensors to measure physical activity, studies were included only if they evaluated apps and wearables that provide sensor-based feedback on physical activity.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Impact of Physical Activity Apps and Wearables: Interdisciplinary Review

McCallum¹,

Rooksby²,

Gray³

2018

JMIR Mhealth Uhealth

106

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BackgroundAlthough many smartphone apps and wearables have been designed to improve physical activity, their rapidly evolving nature and complexity present challenges for evaluating their impact. Traditional methodologies, such as randomized controlled trials (RCTs), can be slow. To keep pace with rapid technological development, evaluations of mobile health technologies must be efficient. Rapid alternative research designs have been proposed, and efficient in-app data collection methods, including in-device sensors and device-generated logs, are available. Along with effectiveness, it is important to measure engagement (ie, users’ interaction and usage behavior) and acceptability (ie, users’ subjective perceptions and experiences) to help explain how and why apps and wearables work.ObjectivesThis study aimed to (1) explore the extent to which evaluations of physical activity apps and wearables: employ rapid research designs; assess engagement, acceptability, as well as effectiveness; use efficient data collection methods; and (2) describe which dimensions of engagement and acceptability are assessed.MethodAn interdisciplinary scoping review using 8 databases from health and computing sciences. Included studies measured physical activity, and evaluated physical activity apps or wearables that provided sensor-based feedback. Results were analyzed using descriptive numerical summaries, chi-square testing, and qualitative thematic analysis.ResultsA total of 1829 abstracts were screened, and 858 articles read in full. Of 111 included studies, 61 (55.0%) were published between 2015 and 2017. Most (55.0%, 61/111) were RCTs, and only 2 studies (1.8%) used rapid research designs: 1 single-case design and 1 multiphase optimization strategy. Other research designs included 23 (22.5%) repeated measures designs, 11 (9.9%) nonrandomized group designs, 10 (9.0%) case studies, and 4 (3.6%) observational studies. Less than one-third of the studies (32.0%, 35/111) investigated effectiveness, engagement, and acceptability together. To measure physical activity, most studies (90.1%, 101/111) employed sensors (either in-device [67.6%, 75/111] or external [23.4%, 26/111]). RCTs were more likely to employ external sensors (accelerometers: P=.005). Studies that assessed engagement (52.3%, 58/111) mostly used device-generated logs (91%, 53/58) to measure the frequency, depth, and length of engagement. Studies that assessed acceptability (57.7%, 64/111) most often used questionnaires (64%, 42/64) and/or qualitative methods (53%, 34/64) to explore appreciation, perceived effectiveness and usefulness, satisfaction, intention to continue use, and social acceptability. Some studies (14.4%, 16/111) assessed dimensions more closely related to usability (ie, burden of sensor wear and use, interface complexity, and perceived technical performance).ConclusionsThe rapid increase of research into the impact of physical activity apps and wearables means that evaluation guidelines are urgently needed to promote efficiency through the use of rapid res...

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Section: Discussionmentioning

confidence: 99%

Evaluating the Impact of Physical Activity Apps and Wearables: Interdisciplinary Review

McCallum¹,

Rooksby²,

Gray³

2018

JMIR Mhealth Uhealth

106

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“…This strategy for health self-management is based on social cognitive theory, and it has been successfully applied in mobile health technologies. [ 55 ]…”

Section: Ethodsmentioning

confidence: 99%

Quality Measurement and Improvement Study of Surgical Coronary Revascularization

Liu¹,

Du²,

Rao³

et al. 2018

Chinese Medical Journal

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Background:Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting (CABG). However, medication adherence after CABG is often poor, and conventional interventions for improving adherence have limited success. With increasing penetration of smartphones, health-related smartphone applications might provide an opportunity to improve adherence. Carefully designed trials are needed to provide reliable evidence for the use of these applications in patients after CABG.Methods:The Measurement and Improvement Studies of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) study is a multicenter randomized controlled trial, aiming to randomize 1000 CABG patients to the intervention or control groups in a 1:1 ratio. We developed the multifaceted, patient-centered, smartphone-based Heart Health Application to encourage medication adherence in the intervention group through a health self-management program initiated during hospital admission for CABG. The application integrated daily scheduled reminders to take the discharge medications, cardiac educational materials, a dynamic dashboard to review cardiovascular risk factors and secondary prevention targets, and weekly questionnaires with interactive feedback. The primary outcome was secondary preventive medication adherence measured by the Chinese version of the 8-item Morisky Medication Adherence Scale at 6 months after randomization. Secondary outcomes included all-cause death, cardiovascular rehospitalization, and a composite of death, myocardial infarction, stroke, and repeat revascularization.Discussion:Findings will not only provide evidence regarding the feasibility and effectiveness of the described intervention for improving adherence to CABG secondary preventive therapies but also explore a model for outpatient health self-management that could be translated to various chronic diseases and widely disseminated across resource-limited settings.Trial Registration:https://clinicaltrials.gov(NCT02432469).

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“…Community-based physical activity interventions using informational approaches have demonstrated some success in increasing physical activity behavior across populations (4,5). These approaches include providing information to motivate and enable people to increase and maintain physical activity behaviors (4,6). Community programs that deliver informational approaches through diverse media including email, newspaper, and radio have demonstrated effectiveness in increasing physical activity among adults (4,5,7).…”

Section: Introductionmentioning

confidence: 99%

Statewide Dissemination of an Evidenced-Based Email Walking Program Delivered Through Cooperative Extension

Richards

Woodcox

Förster

2020

Front. Public Health

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Using the RE-AIM framework, this study evaluates the statewide dissemination of an evidenced-based, email-delivered physical activity intervention implemented through Cooperative Extension. The Get WalkIN' program is comprised of 16 email messages sent over 12 weeks. Email messages target social cognitive theory constructs of self-efficacy, goal-setting, self-monitoring, and social support. Program reach, effectiveness, adoption, implementation, and maintenance were assessed with quantitative measures in a pre-post design. Findings indicate that within the Extension system, program adoption was high and program maintenance was moderate. Program effectiveness was demonstrated with an increase of 77.1 ± 49.9 min in weekly walking post-program. This increase in walking was maintained 3 months post-program. Capturing data on the implementation process was challenging. Overall, the results indicate success in program adoption and maintenance with further efforts needed to improve follow-up data collection from participants.

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The Use of Behavior Change Techniques and Theory in Technologies for Cardiovascular Disease Prevention and Treatment in Adults: A Comprehensive Review

Cited by 71 publications

References 43 publications

Evaluating the Impact of Physical Activity Apps and Wearables: Interdisciplinary Review

Evaluating the Impact of Physical Activity Apps and Wearables: Interdisciplinary Review

Quality Measurement and Improvement Study of Surgical Coronary Revascularization

Statewide Dissemination of an Evidenced-Based Email Walking Program Delivered Through Cooperative Extension

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