Digital intervention research at the UKSBM Annual Scientific Meeting 2018

By Laura M König – University of Konstanz, Germany

On the 12^th and 13^th of December 2018, the Annual Scientific Meeting of the UK Society for Behavioural Medicine (UKSBM) came to Edgbaston Cricket Ground, Birmingham. Around 170 delegates from the UK and beyond came together to present and discuss the latest advances in the fields of health psychology and behavioural medicine. Amongst others, the varied programme featured a number of presentations on the application of digital technologies in the field of health promotion.

A central theme of these presentations was engagement with digital interventions. As digital interventions are often distributed online and often without or with only limited further guidance or surveillance by a researcher or clinician, it is important to better understand what engagement is, how to measure it and, most importantly, how to promote it.

Dr Olga Perski from UCL presented the development and evaluation of the “DBCI Engagement Scale”, which aims to measure experiential and behavioural components of engagement. The sample consisted of first time users of the Drink Less app, which is freely available on the App Store. Although the scale was internally reliable, it was not related to engagement as measured by the number of logins within the first 14 days of use. This finding highlights a major challenge for the study of engagement with digital interventions; In a real-world trial, engagement might generally be high, because users are highly motivated to change their behaviour and actively looked for a digital intervention to use. These populations therefore might not be ideal to study levels of engagement due to a ceiling effect.

In the same session, Prof Annie Anderson from the University of Dundee, who presented on behalf of Dr Julia Sinclair from the University of Southampton, introduced “Abreast of Health”, a brief digital intervention designed to reduce alcohol intake in women who were referred to a symptomatic breast clinic. The intervention provides feedback on alcohol consumption and the need for reduction based on the AUDIT test for alcohol use disorders. Although the intervention aimed to frame messages positively, such as framing alcohol reduction in terms of gains, qualitative interviews revealed some negative reactions to the alcohol estimate and challenged its credibility. Moreover, some participants said that they found the information provided by the intervention too scary to look at them. The majority of participants, however, supported the intervention and liked its simple and factual nature. These findings demonstrate common challenges in developing intervention content and highlight the importance of designing risk feedback and information in (digital) interventions carefully.

Other presentations focused on effectivity and feasibility of digital interventions targeting various health behaviours. For example, I presented results of a smartphone-based intervention study which I conducted as part of my PhD research. We tested the effectivity and feasibility of using daily smartphone prompts to eat a colourful lunch meal to increase participants’ vegetable consumption. These prompts were tailored to participants’ individual lunch times to provide assistance for food choice in a teachable moment. The intervention was highly economical as only one single prompt was sent to participants each day, and this was sufficient to increase participants’ vegetable consumption. Furthermore, participants evaluated the prompt to be easy to follow and, most importantly, rated the intervention to eat colourful to be fun. Thus, we concluded that the intervention is both effective and feasible, and we are hoping to explore it further in larger samples.

In conclusion, the research on digital interventions that was presented at this year’s UKSBM Annual Scientific Meeting Evaluations shows that they are a valuable tool to promote change in a range of health-related behaviours. An important prerequisite is, however, that the intervention is feasible and that participants sufficiently engage with the intervention. The presentations provided exciting starting points for future research, which will surely help to improve digital interventions even further.

If you would like to learn more about these and the other presentations held at the meeting, slides are available for download here.

Questions:

·         How to study different levels of engagement with a digital intervention in an ecological setting?

·         How to provide acceptable risk information and feedback in a digital context?

·         Can we make digital interventions more feasible by shortening their duration without decreasing effectivity?

·         How can we design interventions that require minimal effort and are still effective?

 

Biography:

Dr Laura M König (@lauramkoenig) is a postdoctoral researcher at the University of Konstanz, Germany. Her research focuses on how to promote the uptake and prolonged use of mobile interventions for eating behaviour change. She is particularly interested in reducing participant burden by making interventions simpler and more fun.