JMIR Publications

ABSTRACT

Background:

The UK Medical Research Council’s (MRC) Guidance on Developing and Evaluating Complex Interventions outlines a four-phase framework for structuring research programs on interventions: development, feasibility, evaluation, and implementation. However, the fast-paced and rapidly evolving nature of digital health interventions (DHIs) presents challenges for applying this framework in practice.

Objective:

This scoping review examined which research phases were conducted and how researchers progressed through them in DHI research, with the aim of informing the design of future research programs.

Methods:

We searched PubMed, EMBASE, CINAHL, PsycINFO, and ClinicalTrials.gov to identify DHIs promoting health among adolescents and young adults, implemented between 2017 and 2023. For each eligible intervention, all related protocols, preprints, and published articles were retrieved to reconstruct the full research program. For each program, we analyzed the presence of each research phase, their organization (i.e. phase arrangements), the mechanisms guiding progression between phases (i.e. progression mechanisms), and overall program duration.

Results:

Thirty-one research programs, covering 31 interventions and reported in 126 articles, were included. Development, feasibility, evaluation, and implementation phases were reported in 26, 24, 31, and 7 research programs, respectively. Three phase arrangements were identified: sequential, iterative, and overlapping. Progression mechanisms between phases included: automatic progression, conditional progression based on researchers’ appraisal of findings without pre-specified criteria, and progression based on predefined quantitative criteria. Five main research program structures were observed, combining phase arrangements and progression mechanisms. Iterative arrangements were most common, observed in 20 research programs, followed by overlapping (n=11) and strictly sequential structures (n=7). Most progressions relied on researchers’ appraisal of findings without pre-specified criteria. Justifications for phase iteration, omission, or progression decisions were rarely reported. The median program duration was 5.8 years (n=13).

Conclusions:

By synthesizing common configurations of phase arrangements and progression mechanisms identified in current practices, this study develops a novel operational framework and visualization tools to guide the design, planning, and evaluation of digital and health promotion interventions. This framework aims to enhance transparency, reduce research waste, and improve context-specific program planning. Clinical Trial: PROSPERO Registration number CRD42023401979.