JMIR Publications

ABSTRACT

Background:

Alcohol and tobacco use frequently co-occur and contribute significantly to the global burden of disease. Despite the well-established benefits of addressing both behaviours simultaneously, healthcare providers often face substantial challenges in delivering integrated interventions, including limited time, training, and resources. Digital health interventions offer a promising avenue to directly support patients in reducing alcohol and tobacco use, bypassing some of the barriers encountered in clinical settings. However, there is a lack of consensus on the key behaviour change techniques (BCTs) that must be incorporated to ensure interventions are evidence-based, contextually appropriate and thus effective.

Objective:

To identify expert opinions about the most suitable and effective BCTs to be included in a direct-to-patient one-time digital intervention.

Methods:

We conducted a two-round modified Delphi study with 14 panellists with expertise in behavioural science, alcohol and tobacco treatment, and digital interventions. Panellists rated 20 BCTs identified in a previous rapid review using the APEASE criteria (acceptability, practicability, effectiveness, affordability, safe, and equity). BCTs were deemed “appropriate” if at least 70% of panellists rated them as agreeing on all criteria.

Results:

Six BCTs were identified as appropriate for implementation: goal setting, action planning (individualized change plan), action planning (reduction strategies), feedback on behaviour, re-attribution, and pros and cons. These BCTs were considered effective in promoting behaviour change through structured planning and personalized strategy. The panel reached partial consensus on several BCTs, while eight were deemed inappropriate for a one-time, unsupervised digital intervention.

Conclusions:

The results of the study offer a consensus-based view on the BCTs that should be included in a one-time digital intervention to address co-occurring alcohol and tobacco use.