Theory-based strategies for enhancing the impact and usage of digital health behaviour change interventions: A review

There is growing evidence that digital interventions can successfully effect meaningful changes in health-related behaviour. However, optimisation of digital intervention delivery is challenged by low usage, high attrition and small effect sizes. Whilst a number of conceptual frameworks and models exist to guide intervention planning and development, insufficient attention has been paid to how existing psychological theory could inform the optimal implementation and delivery of the design features commonly used in digital health behaviour change interventions. This paper provides a critical review of psychological theories and models in order to consider their implications for the design of digital interventions. The theories reviewed include theories of: persuasion and attitude change; motivation; volition and self-regulation; patient preferences for participation in medical decision making; and social support. A set of theory-based guidelines is provided to inform the development of future interventions.