Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Apr 27, 2022
Date Accepted: Apr 27, 2023
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A Smartphone-Based Implicit Theories Intervention for Health Behavior Change: A Randomized Trial
ABSTRACT
Background:
Implicit theories of health are beliefs about whether health is perceived as malleable (incremental theory) or fixed (entity theory). Research has shown that an incremental theory of health is connected to many health-promoting outcomes. However, research on its influence on actual health-promoting behaviors is scarce.
Objective:
The objective of our study was to investigate whether a smartphone-based ecological momentary intervention designed to promote an incremental theory of health increases the frequency of performing health-promoting behaviors in daily life.
Methods:
In this two-arm, single-blind, delayed intervention, 149 German participants (mean[age]=30.58, SD 9.71; 79 female) were asked daily over a period of three weeks to indicate whether they had performed 10 health-promoting behaviors throughout the day. Either after one week (early intervention; n=72) or two weeks (delayed intervention; n=77) of baseline behavior measurement, participants were presented with intervention materials designed to strengthen an incremental theory of health. Data collection for this study ran between September and October 2019.
Results:
Multilevel analyses revealed that across conditions, participants reported to engage in health-promoting behaviors more often after being confronted to the intervention materials compared to baseline (b=0.14, t[146.65]=2.06, SE 0.07, P=.04, 95% CI 0.01-0.28). When analyzed separately, this intervention effect was only present for the delayed intervention group (b=0.27, t[492.37]=3.50, SE 0.08, P<.001, 95% CI 0.12-0.42) while no significant increase in health-behaviors occurred for the early intervention group (b=0.02, t[69.23]=0.14, SE 0.11, P=.89, 95% CI -0.2 to 0.23).
Conclusions:
This intervention shows that a smartphone-based intervention promoting an incremental theory of health can serve as a time- and cost-efficient approach to increase the frequency of performing health-promoting behaviors. We discuss why the intervention's effectiveness differs between intervention groups. In addition, implications are derived that may guide future digital health interventions that focus on implicit theories to achieve health behavior change. Clinical Trial: DRKS – German Clinical Trials Register DRKS00017379; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017379
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