scholarly journals Workshop on the Development and Evaluation of Digital Therapeutics for Health Behavior Change: Science, Methods, and Projects

10.2196/16751 ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e16751 ◽  
Author(s):  
Alan J Budney ◽  
Lisa A Marsch ◽  
Will M Aklin ◽  
Jacob T Borodovsky ◽  
Mary F Brunette ◽  
...  
Keyword(s):  
Health Care ◽  
Health Behavior ◽  
Behavior Change ◽  
Behavioral Health ◽  
Digital Technology ◽  
Behavioral Science ◽  
Care Delivery ◽  
Digital Health ◽  
Health Behavior Change ◽  
Dartmouth College

The health care field has integrated advances into digital technology at an accelerating pace to improve health behavior, health care delivery, and cost-effectiveness of care. The realm of behavioral science has embraced this evolution of digital health, allowing for an exciting roadmap for advancing care by addressing the many challenges to the field via technological innovations. Digital therapeutics offer the potential to extend the reach of effective interventions at reduced cost and patient burden and to increase the potency of existing interventions. Intervention models have included the use of digital tools as supplements to standard care models, as tools that can replace a portion of treatment as usual, or as stand-alone tools accessed outside of care settings or direct to the consumer. To advance the potential public health impact of this promising line of research, multiple areas warrant further development and investigation. The Center for Technology and Behavioral Health (CTBH), a P30 Center of Excellence supported by the National Institute on Drug Abuse at the National Institutes of Health, is an interdisciplinary research center at Dartmouth College focused on the goal of harnessing existing and emerging technologies to effectively develop and deliver evidence-based interventions for substance use and co-occurring disorders. The CTBH launched a series of workshops to encourage and expand multidisciplinary collaborations among Dartmouth scientists and international CTBH affiliates engaged in research related to digital technology and behavioral health (eg, addiction science, behavioral health intervention, technology development, computer science and engineering, digital security, health economics, and implementation science). This paper summarizes a workshop conducted on the Development and Evaluation of Digital Therapeutics for Behavior Change, which addressed (1) principles of behavior change, (2) methods of identifying and testing the underlying mechanisms of behavior change, (3) conceptual frameworks for optimizing applications for mental health and addictive behavior, and (4) the diversity of experimental methods and designs that are essential to the successful development and testing of digital therapeutics. Examples were presented of ongoing CTBH projects focused on identifying and improving the measurement of health behavior change mechanisms and the development and evaluation of digital therapeutics. In summary, the workshop showcased the myriad research targets that will be instrumental in promoting and accelerating progress in the field of digital health and health behavior change and illustrated how the CTBH provides a model of multidisciplinary leadership and collaboration that can facilitate innovative, science-based efforts to address the health behavior challenges afflicting our communities.

scholarly journals Workshop on the Development and Evaluation of Digital Therapeutics for Health Behavior Change: Science, Methods, and Projects (Preprint)

2019 ◽  
Author(s):  
Alan J Budney ◽  
Lisa A Marsch ◽  
Will M Aklin ◽  
Jacob T Borodovsky ◽  
Mary F Brunette ◽  
...  
Keyword(s):  
Health Care ◽  
Health Behavior ◽  
Behavior Change ◽  
Behavioral Health ◽  
Digital Technology ◽  
Behavioral Science ◽  
Care Delivery ◽  
Digital Health ◽  
Health Behavior Change ◽  
Dartmouth College

UNSTRUCTURED The health care field has integrated advances into digital technology at an accelerating pace to improve health behavior, health care delivery, and cost-effectiveness of care. The realm of behavioral science has embraced this evolution of digital health, allowing for an exciting roadmap for advancing care by addressing the many challenges to the field via technological innovations. Digital therapeutics offer the potential to extend the reach of effective interventions at reduced cost and patient burden and to increase the potency of existing interventions. Intervention models have included the use of digital tools as supplements to standard care models, as tools that can replace a portion of <i>treatment as usual</i>, or as stand-alone tools accessed outside of care settings or direct to the consumer. To advance the potential public health impact of this promising line of research, multiple areas warrant further development and investigation. The Center for Technology and Behavioral Health (CTBH), a P30 <i>Center of Excellence</i> supported by the National Institute on Drug Abuse at the National Institutes of Health, is an interdisciplinary research center at Dartmouth College focused on the goal of harnessing existing and emerging technologies to effectively develop and deliver evidence-based interventions for substance use and co-occurring disorders. The CTBH launched a series of workshops to encourage and expand multidisciplinary collaborations among Dartmouth scientists and international CTBH affiliates engaged in research related to digital technology and behavioral health (eg, addiction science, behavioral health intervention, technology development, computer science and engineering, digital security, health economics, and implementation science). This paper summarizes a workshop conducted on the <i>Development and Evaluation of Digital Therapeutics for Behavior Change</i>, which addressed (1) principles of behavior change, (2) methods of identifying and testing the underlying mechanisms of behavior change, (3) conceptual frameworks for optimizing applications for mental health and addictive behavior, and (4) the diversity of experimental methods and designs that are essential to the successful development and testing of digital therapeutics. Examples were presented of ongoing CTBH projects focused on identifying and improving the measurement of health behavior change mechanisms and the development and evaluation of digital therapeutics. In summary, the workshop showcased the myriad research targets that will be instrumental in promoting and accelerating progress in the field of digital health and health behavior change and illustrated how the CTBH provides a model of multidisciplinary leadership and collaboration that can facilitate innovative, science-based efforts to address the health behavior challenges afflicting our communities.

scholarly journals The Intersection of Behavioral Science and Digital Health: The Case for Academic–Industry Partnerships

2018 ◽  
Vol 46 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Melanie Hingle ◽  
Heather Patrick ◽  
Paul M. Sacher ◽  
Cynthia Castro Sweet
Keyword(s):  
Health Behavior ◽  
Behavioral Medicine ◽  
Behavioral Science ◽  
Care Delivery ◽  
Digital Health ◽  
Health Behavior Change ◽  
Product Portfolio ◽  
Collaborative Models ◽  
Develop Technology ◽  
The Impact

A decade after the first health app became available, the field of digital health has produced a range of health behavior insights and an expanding product portfolio. Despite sustained interest and growth fueled by academic and industry interests, the impact of digital health on health behavior change and related outcomes has been limited. This underperformance relative to expectations may be partially attributed to a gap between industry and academia in which both seek to develop technology-driven solutions but fail to converge around respective, unique strengths. An opportunity exists for new and improved collaborative models of research, innovation, and care delivery that disrupt the field of behavioral medicine and benefit academic and industry interests. For those partnerships to thrive, recognizing key differences between academic and industry roles may help smooth the path. Here we speak specifically to concerns particular to academics and offer suggestions for how to navigate related challenges.

scholarly journals Peer Support: a Human Factor to Enhance Engagement in Digital Health Behavior Change Interventions

2019 ◽  
Vol 4 (2) ◽  
pp. 152-161 ◽  
Author(s):  
Karen L. Fortuna ◽  
Jessica M. Brooks ◽  
Emre Umucu ◽  
Robert Walker ◽  
Phillip I. Chow
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Peer Support ◽  
Human Factor ◽  
Digital Health ◽  
Health Behavior Change ◽  
Behavior Change Interventions

scholarly journals Early Psychosis Service User Views on Digital Technology: Qualitative Analysis (Preprint)

2018 ◽  
Author(s):  
Sandra Bucci ◽  
Rohan Morris ◽  
Katherine Berry ◽  
Natalie Berry ◽  
Gillian Haddock ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Digital Technology ◽  
Service User ◽  
Care Delivery ◽  
Digital Health ◽  
Early Psychosis ◽  
Treatment Modalities ◽  
Future Research ◽  
Service Users

BACKGROUND Digital technology has the potential to improve outcomes for people with psychosis. However, to date, research has largely ignored service user views on digital health interventions (DHIs). OBJECTIVE The objective of our study was to explore early psychosis service users’ subjective views on DHIs. METHODS Framework analysis was undertaken with data obtained from 21 semistructured interviews with people registered with early intervention for psychosis services. Robust measures were used to develop a stable framework, including member checking, triangulation, independent verification of themes, and consensus meetings. RESULTS The following 4 themes were established a priori: acceptability of technology in psychosis and mental health; technology increasing access to and augmenting mental health support; barriers to adopting DHIs; and concerns about management of data protection, privacy, risk, and security of information. The following 2 themes were generated a posteriori: blending DHIs with face-to-face treatment and empowerment, control, and choice. DHIs were also viewed as potentially destigmatizing, overcoming barriers faced in traditional service settings, facilitating communication, and empowering service users to take active control of their health care. CONCLUSIONS In the first study of its kind, early psychosis service users’ were largely positive about the potential use of DHIs supporting and managing mental health. Overall, service users felt that DHIs were a progressive, modern, and relevant platform for health care delivery. Concerns were expressed around privacy and data security and practical barriers inherent within DHIs, all of which require further attention. Future research should explore whether findings transfer to other service user groups, other technology delivery formats, and across a range of treatment modalities.

scholarly journals Acceptability and Potential Effectiveness of eHealth Tools for Training Primary Health Workers From Nigeria at Scale: Mixed Methods, Uncontrolled Before-and-After Study (Preprint)

2020 ◽  
Author(s):  
Joseph Paul Hicks ◽  
Matthew John Allsop ◽  
Godwin O Akaba ◽  
Ramsey M Yalma ◽  
Osasuyi Dirisu ◽  
...  
Keyword(s):  
Health Care ◽  
Technology Acceptance ◽  
Digital Technology ◽  
Health Workers ◽  
Care Delivery ◽  
Digital Health ◽  
Clinical Knowledge ◽  
Potential Effectiveness ◽  
Primary Health ◽  
Service Training

BACKGROUND The in-service training of frontline health workers (FHWs) in primary health care facilities plays an important role in improving the standard of health care delivery. However, it is often expensive and requires FHWs to leave their posts in rural areas to attend courses in urban centers. This study reports the implementation of a digital health tool for providing video training (VTR) on maternal, newborn, and child health (MNCH) care to provide in-service training at scale without interrupting health services. The VTR intervention was supported by satellite communications technology and existing 3G mobile networks. OBJECTIVE This study aims to determine the feasibility and acceptability of these digital health tools and their potential effectiveness in improving clinical knowledge, attitudes, and practices related to MNCH care. METHODS A mixed methods design, including an uncontrolled pre- and postquantitative evaluation, was adopted. From October 2017 to May 2018, a VTR mobile intervention was delivered to FHWs in 3 states of Nigeria. We examined changes in workers’ knowledge and confidence in delivering MNCH services through a pre- and posttest survey. Stakeholders’ experiences with the intervention were explored through semistructured interviews that drew on the technology acceptance model to frame contextual factors that shaped the intervention’s acceptability and usability in the work environment. RESULTS In total, 328 FHWs completed both pre- and posttests. FHWs achieved a mean pretest score of 51% (95% CI 48%-54%) and mean posttest score of 69% (95% CI 66%-72%), reflecting, after adjusting for key covariates, a mean increase between the pre- and posttest of 17 percentage points (95% CI 15-19; <i>P</i>&lt;.001). Variation was identified in pre- and posttest scores by the sex and location of participants alongside topic-specific areas where scores were lowest. Stakeholder interviews suggested a wide acceptance of VTR Mobile (delivered via digital technology) as an important tool for enhancing the quality of training, reinforcing knowledge, and improving health outcomes. CONCLUSIONS This study found that VTR supported through a digital technology approach is a feasible and acceptable approach for supporting improvements in clinical knowledge, attitudes, and reported practices in MNCH. The determinants of technology acceptance included ease of use, perceived usefulness, access to technology and training contents, and the cost-effectiveness of VTR, whereas barriers to the adoption of VTR were poor electricity supply, poor internet connection, and FHWs’ workload. The evaluation also identified the mechanisms of the impact of delivering VTR Mobile at scale on the micro (individual), meso (organizational), and macro (policy) levels of the health system. Future research is required to explore the translation of this digital health approach for the VTR of FHWs and its impact across low-resource settings to ameliorate the financial and time costs of training and support high-quality MNCH care delivery. CLINICALTRIAL ISRCTN Registry 32105372; https://www.isrctn.com/ISRCTN32105372

scholarly journals Perceptions of negative health-care experiences and self-reported health behavior change in three racial and ethnic groups

2016 ◽  
Vol 22 (2) ◽  
pp. 156-168 ◽  
Author(s):  
Rebecca J. Schwei ◽  
Timothy P. Johnson ◽  
Alicia K. Matthews ◽  
Elizabeth A. Jacobs
Keyword(s):  
Health Care ◽  
Health Behavior ◽  
Behavior Change ◽  
Ethnic Groups ◽  
Health Behavior Change ◽  
Health Care Experiences ◽  
Reported Health

Facilitating the Adoption of Digital Health Technologies by Older Adults to Support Their Health

2021 ◽  
pp. 164-179
Author(s):  
Maurita T. Harris ◽  
Wendy A. Rogers
Keyword(s):  
Older Adults ◽  
Health Behavior ◽  
Behavior Change ◽  
Technology Acceptance ◽  
Digital Health ◽  
Theoretical Models ◽  
Health Behavior Change ◽  
The United States ◽  
Positive Health ◽  
Health Technologies

With over 50% of older adults in the United States managing at least one chronic condition, it is crucial to understand how to promote their self-management of positive health behaviors. Health interventions through digital health technologies are becoming more commonplace. Theoretical models related to health behavior change and technology acceptance can guide the design of these healthcare tools and lead to adoption by older adults to support their health. This chapter provides an overview of health behavior change and technology acceptance models to inform the development of digital health technology for older adults. This chapter illustrates the application of these models by describing two design personas that represent human factors designers. This chapter discusses the lack of inclusion of technology adoption and other long-term concepts and the need for further exploration that could inform understanding of technology integration into everyday health activities.

scholarly journals The Role of Behavioral Science in Personalized Multimodal Prehabilitation in Cancer

2021 ◽  
Vol 12 ◽  
Author(s):  
Chloe Grimmett ◽  
Katherine Bradbury ◽  
Suzanne O. Dalton ◽  
Imogen Fecher-Jones ◽  
Meeke Hoedjes ◽  
...  
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Psychological Health ◽  
Behavioral Science ◽  
Health Behavior Change ◽  
Clinical Settings ◽  
Nutritional Interventions ◽  
Physical And Psychological Health ◽  
Primary Focus

Multimodal prehabilitation is increasingly recognized as an important component of the pre-operative pathway in oncology. It aims to optimize physical and psychological health through delivery of a series of tailored interventions including exercise, nutrition, and psychological support. At the core of this prescription is a need for considerable health behavior change, to ensure that patients are engaged with and adhere to these interventions and experience the associated benefits. To date the prehabilitation literature has focused on testing the efficacy of devised exercise and nutritional interventions with a primary focus on physiological and mechanistic outcomes with little consideration for the role of behavioral science, supporting individual behavior change or optimizing patient engagement. Changing health behavior is complex and to maximize success, prehabilitation programs should draw on latest insights from the field of behavioral science. Behavioral science offers extensive knowledge on theories and models of health behavior change to further advance intervention effectiveness. Similarly, interventions developed with a person-centered approach, taking into consideration individual needs and preferences will increase engagement. In this article, we will provide an overview of the extent to which the existing prehabilitation literature incorporates behavioral science, as well as studies that have explored patient's attitudes toward prehabilitation. We will go on to describe and critique ongoing trials in a variety of contexts within oncology prehabilitation and discuss how current scientific knowledge may be enhanced from a behavioral science perspective. We will also consider the role of “surgery schools” and detail practical recommendations that can be embedded in existing or emerging clinical settings.

Sign in / Sign up

Export Citation Format

Share Document