Theory Driven Mobile-Based Interventions: A Scoping Review

Abstract

Background:Mobile technology is a rapidly evolving field allowing healthcare providers to reach patients outside of a traditional face-to-face setting. Fortunately, interventions are now becoming readily available via mobile devices such as mobile phones, smart phones, and tablets, yet there has been little attention to the design of these interventions so that they are theoretically-driven (informed according to a behavioral theory or model) and ethically performed.Objective: To provide data on theoretically-driven interventions that were empirically tested and to analyze the features and strategies used to implement these interventions. Review Methods: This study employed a scoping review methodology according to the Joann BriggsInstitute. An electronic database search yielded 20 eligible articles. Results:The participants spanned various health domains: cardiovascular (weight control, physical activity, diabetes), cancer (pap testing), prenatal care, substance use (alcohol recovery, smoking cessation), and HIV and/or sexual risk assessment. Social Cognitive Theory, Health Belief Model, and Transtheoretical Model were applied most frequently to guide interventions. Conclusion:Future work should focus on the application of theory and how various implementation techniques translate to the overall effectiveness of the intervention. Mobile technologies have extended the physical boundaries of care beyond the traditional healthcare setting through the incorporation of real-time data capture, exchange and personalization of the interventions 4 . Mobile interventions can be used to target key self-management behaviors like medication adherence, adversities, and barriers, which importantly reinforces the patient's role as an active agent in management of their health 5 . Additionally, these interventions can be designed based on evidence-based principles shown to promote health by connecting individuals to receive social support via discussion forums and personalizing interventions to one's individual needs through the use of tailored text messages [6][7][8][9] . Importantly, at a time where the cost of chronic disease is rising, mobile technologies may provide a cost-effective opportunity capable of reaching larger target populations spanning diverse health domains 8,10,11 . Nearly 90% of American adults own a cell phone, and of these individuals, 64% own a smartphone 12 . Since 2011, there has been a 30% increase in ownership of smartphones with nearly 62% of smartphone owners report using their cellphone to seek health information within the past year 13 . In 2015, there were 500 million smartphone users downloading mobile health applications 14 . While increased access to health information and tools for self-management are desired, the majority of these apps have not undergone rigorous trials for efficacy 14 . There has been little attention to the design of these interventions so that they are theoretically-driven (informed and guided by behavioral theories and/or models) and ethically perform (yield the benefit...