Incorporating Health Behavior Theory into mHealth: an Examination of Weight Loss, Dietary, and Physical Activity Interventions

Abstract

Health behavior interventions are effective for many modifiable lifestyle behaviors. In some cases, remotely-delivered behavioral interventions, particularly those that include some form of contact with a clinician and strong behavioral strategies, have been shown to be as effective as traditional in-person interventions; they are also more flexible, disseminable, and cost-effective. With ubiquitous increases in mobile phone use, opportunities for remote delivery of health interventions (mHealth) have grown exponentially, particularly in the use of behavioral smartphone applications. Despite research suggesting that mHealth interventions can be effective at initiating and maintaining behavior changes, many mHealth interventions are not theoretically-based, and evidence-based behavioral strategies are not often adapted into the mobile format. Thus, there is a need for clear summaries of behavioral change theories and examples of theoretically driven behavioral strategies to unify and improve the field of mHealth. The authors review the existing literature on theories of behavior change, intervention, and systems for evaluating theoretical content. Specifically, the authors briefly summarize both traditional and contemporary theories of behavior change, evidence-based behavioral strategies, and the methods for evaluating the degree to which they are included in existing mHealth behavioral interventions, with an emphasis on weight loss, dietary, and physical activity interventions. Authors also include examples of integration of theory into both research and clinical practice. This research highlights the importance of incorporation of theory into behavior change interventions. The authors suggest specific theoretical considerations for the development of mHealth interventions within collaborative, interdisciplinary environments, and recommend future research areas.