Theories Applied to m-Health Interventions for Behavior Change in Low- and Middle-Income Countries: A Systematic Review
Background: Recently there has been dramatic increase in the use of mobile technologies for health (m-Health) in both high and low- and middle-income countries (LMICs). However, little is known whether m-Health interventions in LMICs are based on relevant theories critical for effective implementati...
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Veröffentlicht in: | Telemedicine journal and e-health 2018-10, Vol.24 (10), p.727-741 |
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Format: | Artikel |
Sprache: | eng |
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Zusammenfassung: | Background:
Recently there has been dramatic increase in the use of mobile technologies for health (m-Health) in both high and low- and middle-income countries (LMICs). However, little is known whether m-Health interventions in LMICs are based on relevant theories critical for effective implementation of such interventions. This review aimed to systematically identify m-Health studies on health behavioral changes in LMICs and to examine how each study applied behavior change theories.
Materials and Methods:
A systematic review was conducted using the standard method from the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guideline. By searching electronic databases (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials [CENTRAL]), we identified eligible studies published in English from inception to June 30, 2017. For the identified m-Health studies in LMICs, we examined their theoretical bases, use of behavior change techniques (BCTs), and modes of delivery.
Results:
A total of 14 m-Health studies on behavioral changes were identified and, among them, only 5 studies adopted behavior change theory. The most frequently cited theory was the health belief model, which was adopted in three studies. Likewise, studies have applied only a limited number of BCTs. Among the seven BCTs identified, the most frequently used one was the social support (practical) technique for medication reminder and medical appointment. m-Health studies in LMICs most commonly used short messaging services and phone calls as modes of delivery for behavior change interventions.
Conclusions:
m-Health studies in LMICs are suboptimally based on behavior change theory yet. To maximize effectiveness of m-Health, rigorous delivery methods as well as theory-based intervention designs will be needed. |
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ISSN: | 1530-5627 1556-3669 |
DOI: | 10.1089/tmj.2017.0249 |