Abstract
BackgroundSocial media are an increasingly commonly used platform for delivering health promotion interventions. Although recent research has focused on the effectiveness of social media interventions for health promotion, very little is known about the optimal content within such interventions, and the active ingredients to promote health behavior change using social media are not clear. Identifying which behavior change techniques (BCTs) are reported may help to clarify the content of interventions using a generalizable terminology that may facilitate future intervention development.ObjectiveThis study aimed to identify which BCTs are reported in social media interventions for promoting health behavior change in adults.MethodsWe included 71 studies conducted with adult participants (aged ≥18 years) and for which social media intervention was considered interactive in a Cochrane review of the effectiveness of such interventions. We developed a coding manual informed by the Behavior Change Technique Taxonomy version 1 (BCTTv1) to identify BCTs in the included studies. We identified BCTs in all study arms (including control) and described BCTs in the group and self-directed components of studies. We characterized the dose of delivery for each BCT by low and high intensity. We used descriptive analyses to characterize the reported BCTs.ResultsOur data consisted of 71 studies published from 2001 to 2017, mainly conducted in high-income countries (n=65). Most studies (n=31) used tailored, interactive websites to deliver the intervention; Facebook was the most used mainstream platform. In developing our coding manual, we adapted some BCTTv1 instructions to better capture unique nuances of how BCTs were operationalized in social media with respect to likes, retweets, smiles, congratulations, and badges. Social support (unspecified), instruction on how to perform the behavior, and credible source were most frequently identified BCTs in intervention arms of studies and group-delivery settings, whereas instruction on how to perform the behavior was most commonly applied in self-directed components of studies, control arms, and individual participant settings. Instruction on how to perform the behavior was also the most frequently reported BCT in both intervention and control arms simultaneously. Instruction on how to perform the behavior, social support (unspecified), self-monitoring of behavior, information about health consequences, and credible source were identified in the top 5 BCTs delivered with the highest intensity.ConclusionsThis study within a review provides a detailed description of the BCTs and their dose to promote behavior change in web-based, interactive social media interventions. Clarifying active ingredients in social media interventions and the intensity of their delivery may help to develop future interventions that can more clearly build upon the existing evidence.
Highlights
BackgroundWith more than 4 billion users worldwide and a projected yearly growth of 7% [1], the internet has become a central means of delivering health promotion interventions [2,3]
We developed a coding manual informed by the Behavior Change Technique Taxonomy version 1 (BCTTv1) to identify behavior change technique (BCT) in the included studies
In developing our coding manual, we adapted some BCTTv1 instructions to better capture unique nuances of how BCTs were operationalized in social media with respect to likes, retweets, smiles, congratulations, and badges
Summary
BackgroundWith more than 4 billion users worldwide and a projected yearly growth of 7% [1], the internet has become a central means of delivering health promotion interventions [2,3]. The active ingredient of an intervention that aims to change behavior can be defined as a behavior change technique (BCT), which consists of “an observable, replicable, and irreducible component of an intervention designed to alter or redirect causal processes that regulate behaviour” [16] It is, important to describe the content of interventions delivered in social media and unpack their active ingredients to determine (1) what is being delivered in both intervention and control groups, (2) gaps and opportunities to consider integrating underrepresented BCTs, and (3) if this delivery mode of social media presents new BCTs or novel ways of operationalizing BCTs. Using a shared language to describe the intervention content, including which BCTs are used and how they are employed within an intervention, can help elucidate the development of future effective interventions. Identifying which behavior change techniques (BCTs) are reported may help to clarify the content of interventions using a generalizable terminology that may facilitate future intervention development
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