Mapping Behavior Change Wheel Techniques to Digital Behavior Change Interventions: Review

Aims: Digital health interventions (DHIs) use different strategies to deliver behavior change techniques (BCTs). There is a lack of understanding on how BCTs can be strategized in DHIs to optimize users' experience and effectiveness of the intervention. This review aimed to explore how behavior change techniques are strategized/operationalized in DHIs de-facto. Method: Thirty-five studies were included in the review. Data related to behavior change strategies were extracted and coded using the taxonomy of behavior change techniques. Results: Overall, 125 strategies were extracted from studies and coded into 33 BCTs. Most of the studies were focused on physical activity and healthy food consumption. `Prompts and cues' (17/35 studies), `social support (unspecified technique)' (15/35 studies), `goal setting (behavior technique)' (11/35 studies), and `self-monitoring of behavior' (10/35 studies) were the most frequently used behavior change techniques. `Prompts and cues' was mostly strategized by sending reminders via text messages/email, mobile applications, or other digital systems. `Social support' such as encouragement or counseling was strategized by online support groups using social networking websites, text-message platforms, and counselors' phone calls. `Goal setting (behavior technique)' was strategized via in-app calculators to set goals, build-in app features, and digital coach/virtual agents. `Self-monitoring of behavior' was mainly strategized by transferring data in the mobile application (by users) and activity trackers. Conclusion: It is important to consider theories/frameworks of behavior change while selecting, strategizing, and reporting BCTs to produce effective and sustainable results. Furthermore, innovative ways of strategizing various BCTs are needed to be implemented in DHI.