State-of-the-Art and Emerging Trends in Digital Behavior Change Interventions for Stress Management: A Roadmap for Future Research

The application of persuasive technology to promote positive behaviors has gained increasing prominence in health and wellness, particularly in addressing stress in today’s fast-paced society. Understanding how persuasive mechanisms interact with therapeutic foundations and technological delivery is essential for designing effective stress-management interventions. This systematic review, spanning 2003–2025, analyzes 138 peer-reviewed studies on Persuasive Technology Interventions for Stress Management (PTISM). Four objectives guide this study: (I) identify emerging PTISM trends, including therapeutic frameworks, behavioral theory adoption, digital platforms, and methodological characteristics; (II) examine frequently implemented persuasive strategies and their operationalization; (III) evaluate overall PTISM effectiveness and explore relationships between outcomes and design features; and (IV) identify research gaps and propose future directions. Key findings indicate that Mindfulness-Based Stress Reduction (MBSR) and Cognitive Behavioral Therapy (CBT) remain the dominant therapeutic foundations, while mobile applications represent the most prevalent delivery mode. Self-monitoring, reminders, and tunneling emerge as the most frequently implemented persuasive strategies. Overall, PTISM demonstrate predominantly positive outcomes, although effectiveness varies across design approaches. Notably, limited integration of behavioral theory, short evaluation durations, and underrepresentation of diverse populations persist as structural gaps in the field. Based on these findings, we propose actionable design and research recommendations to advance theory-informed, adaptive, and inclusive persuasive stress-management systems within HCI and digital health research.