JMIR Publications

ABSTRACT

Background:

Research into digital technologies for health behavior change has attracted increased attention of several research fields in the recent decades. Expectations for digital health technologies are high, but as a designer /researcher of digitally enabled behavior change interventions it is difficult to combine the knowledge and technologies from different areas. A comprehensive analysis that systematically maps and explores the use of knowledge within this emerging interdisciplinary field is required.

Objective:

This study provides an overview of the research area around the design and development of digital technologies for health behavior change and explores trends and patterns. A secondary aim is to identify and discuss the knowledge gaps in the area of digital technologies for behavior change.

Methods:

Bibliometrics as a quantitative measure is used to provide an overview of the field and a scoping review is presented to identify the recent trends and gaps. The study is based on the publications related to persuasive technologies and health behavior change published in the last 18 years and indexed by Web of Science and Scopus. For the query the keywords “persuas*”, “ehealth”, “mhealth” with “ICT”, “prototype”, “techno*”, ”system”, and “behavio* change” were used. The query on Web of Science returned 317 articles and 325 articles on Scopus database. The first part of the study uses bibliographic data to analyze the geographical and time-based publication trends, the research fields & keyword co-occurrence networks, influential journals and the collaboration network among influential authors, countries, and institutions. The second part presents a scoping review based on a quantitative content analysis method that allows comparison, distinction and categorization of data according to different themes and ideas.

Results:

The literature reviewed shows a clear and emerging trend after 2001/2002 in technology-based behavior change, which later grew exponentially after the introduction of the smartphone in 2008/2009. Authors from the USA, Europe, and Australia have the highest number of publications in the field. The three most active research areas were computer science, public and occupational health, and psychology. The keyword ’mhealth’ was the dominant term and predominantly use together with the term ‘physical activity’ and ‘ehealth’. Three strong clusters of co-authors have been found. The top three journals published almost half of the total articles reported. The USA, the UK and the Netherlands have the highest collaboration between authors and a strong network between their institutions. Furthermore, mobile phones were mostly used as a technology platform, irrespective of the targeted behavioral domain. The most frequently targeted behavior domains were physical activity and healthy eating. Most studies omit the use of theoretical foundations for the design of digital behavior change interventions. We have found that most papers do not report about the behaviour changes techniques that are applied. Among the reported behavior change techniques, goal-setting and self-management are most frequently reported.

Conclusions:

More collaboration and connections are required between behavior sciences and digital behavior change designers to link the theoretical knowledge with new technological advancements and vice-versa. This could lead to higher societal impact and may increase the effectiveness of digital technologies for healthy behavior change and a better insight in the relation between the behavior change strategies and the effectiveness of the persuasive technologies.