JMIR Publications

ABSTRACT

Background:

Social media is an increasingly commonly used platform for delivering health promotion interventions. While recent research has focused on the effectiveness of social media interventions for health promotion, very little is known about the optimal content within such interventions; the active ingredients to promote health behaviour change using social media are not clear. Identifying which behaviour change techniques (BCTs) are reported may help to clarify the content of interventions using a generalizable terminology that may facilitate future intervention development.

Objective:

Identify which BCTs are reported in social media interventions for promoting health behaviour change in adults.

Methods:

We included all 71 studies conducted with adult participants (age>18 years) and for which social media intervention was considered interactive that were included in a Cochrane review of the effectiveness of such interventions. We developed a coding manual informed by the Behaviour Change Techniques Taxonomy version 1 (BCTTv1) to identify BCTs in included studies. We identified BCTs in all study arms (including control) and described BCTs in group and self-directed components of studies. We characterised the dose of delivery for each BCT by low and high intensity. We used descriptive analyses to characterise the BCTs reported.

Results:

Our data consisted of 71 studies published from 2001 to 2017, mainly conducted in high-income countries (n=65). Most studies (n=31) used tailored interactive websites to deliver the intervention; Facebook was the most used mainstream platform. In developing our coding manual, we adapted some BCTTv1 instructions to better capture unique nuances of how BCTs were operationalized in social media with respect to “likes”, “retweets”, “smiles”, “congratulations” and “badges”. ‘Social support (unspecified)’, ‘Instruction on how to perform the behaviour’, and ‘Credible source’ were most frequently identified in intervention arms of studies and group-delivery settings while ‘Instruction of how to perform the behaviour’ was most commonly applied in self-directed components of studies, control arms, and individual participant settings. ‘Instruction on how to perform the behaviour’ was also the most frequently reported BCT in both intervention and control arms simultaneously. ‘Instruction on how to perform the behaviour’, ‘Social support (unspecified)’, ‘Self-monitoring of behaviour’, ‘Information about health consequences’, ‘Credible source’ were identified in the top five BCTs delivered with highest intensity.

Conclusions:

This review provides a detailed description of the BCTs and their dose to promote behaviour change in online, interactive social media interventions. Clarifying active ingredients in social media interventions and the intensity of their delivery may help to develop future interventions that can more clearly build upon the existing evidence.