Currently submitted to: JMIR mHealth and uHealth
Date Submitted: Jun 8, 2026
Open Peer Review Period: Jun 8, 2026 - Aug 3, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Digital Health-Based Behavior Change Technologies for Dietary Intervention and Exerscise in People with Prediabetes: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
Prediabetes is a critical stage for preventing type 2 diabetes mellitus. Digital health interventions incorporating behavior change techniques (BCTs) have shown promise in promoting dietary and physical activity changes. However, the specific BCTs associated with effective glycemic outcomes in individuals with prediabetes remain unclear.
Objective:
This systematic review and meta-analysis aimed to identify the BCTs used in digital health interventions targeting diet and exercise among individuals with prediabetes and to determine which BCTs are associated with improved glycemic outcomes.
Methods:
A systematic search of PubMed, Web of Science, Cochrane Library, CINAHL, Embase, CNKI, Wanfang, VIP, and CBM was conducted from inception to December 2025. Randomized controlled trials evaluating digital health interventions with BCTs for prediabetes were included. Risk of bias was assessed using RoB 2. Meta-analysis was performed using RevMan 5.4. BCTs were coded using the BCT Taxonomy v1 and compared between effective and less effective groups.
Results:
Fifteen RCTs involving 2,384 participants were included. The most frequently used BCTs were goal setting (behavior) (1.1), self-monitoring of outcome(s) of behavior (2.4), self-monitoring of behavior (2.3), instruction on how to perform the behavior (4.1), information about health consequences (5.1), and prompts/cues (7.1). The effective group (showing significant glycemic improvement) used a higher mean number of BCTs than the less effective group (6.50 vs 4.75). BCTs such as goal setting (behavior) (1.1) and self-monitoring of outcome(s) of behavior (2.4) were more prevalent in the effective group.
Conclusions:
Digital health interventions incorporating a broader range of BCTs, particularly goal setting (behavior) and self-monitoring of outcomes, may enhance glycemic control in individuals with prediabetes. Future research should optimize BCT combinations and evaluate their long-term effectiveness in this population. Clinical Trial: CRD420261277122
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