Perceived benefits of digital interventions for behavioral health: A qualitative interview study (Preprint)

BACKGROUND Digital interventions have been gaining momentum in behavioral health. There are no standard approaches or tools for creating digital behavioral interventions, so many clinical researchers find their own way to realize them. There is likely variability in how researchers conceive of digital interventions. Even when grounding these interventions in similar behavioral theory and existing clinical approaches, there will not be a direct or obvious translation into a digital form of delivery. Moreover, the challenges of developing technology remain a significant barrier to use of digital interventions. Effective implementation of digital interventions in behavioral research, and improving the availability of tools and guidance for researchers, will require a thorough understanding of the motivations and needs of researchers seeking to create digital interventions. OBJECTIVE This investigation sought to understand the perceptions of behavioral researchers toward digital interventions, and inform use of these interventions, by documenting (a) reasons why researchers are increasingly focusing their efforts on digital interventions, and (b) their perspectives on the perceived benefits that digital approaches can provide for researchers and intervention recipients. METHODS We conducted semi-structured qualitative interviews with 18 researchers who had experience designing digital behavioral interventions or running studies with them. A convenience sample of interviewees was recruited from among users of the Computerized Intervention Authoring System (CIAS) platform, a web-based tool that facilitates the process of creating and deploying digital interventions in behavioral research. Interviews were conducted over teleconference between February and April 2020. Recordings from interviews were transcribed and thematically analyzed by multiple coders. RESULTS Interviews were completed with 18 individuals and lasted between 24-65 minutes (mean = 46.9 minutes; SD = 11.3 minutes). Interviewees were predominantly female (94.4%; 17/18) and represented different job roles ranging from researcher to project/study staff. Four major themes came out of the interviews concerning benefits of digital interventions for behavioral health: convenience and flexibility for interventionists and recipients; support for implementing evidence-based interventions with fidelity; scaling and improving access to interventions; “getting a foot in the door” despite stigma and disenfranchisement. CONCLUSIONS Interviewees described a number of important potential benefits of digital interventions, particularly with respect to scientific rigor, scalability, and overcoming barriers to reaching more people. There are complex considerations with regard to translating behavior change strategies into digital forms of delivery, and interventionists make individual, sometimes unexpected, choices with minimal evidence of their relative effectiveness. Future research should investigate how behavioral researchers can be supported in making these choices toward usability, ease of access, and approachability with digital interventions. Our study underscores the need for authoring platforms that can facilitate the process of creating and deploying digital interventions to reach their full potential for interventionists and recipients alike.