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. 2024 Jun 17:10:20552076241260974.
doi: 10.1177/20552076241260974. eCollection 2024 Jan-Dec.

Making it transparent: A worked example of articulating programme theory for a digital health application using Intervention Mapping

Tamika A Marcos  1   2 , Rik Crutzen  2   3 , Veronika Leitner  2 , Jan D Smeddinck  2 , Eva-Maria Strumegger  2 , Daniela Wurhofer  2 , Stefan T Kulnik  2
Affiliations

Making it transparent: A worked example of articulating programme theory for a digital health application using Intervention Mapping

Tamika A Marcos et al. Digit Health. .

Abstract

Objective: Digital health interventions for behaviour change are usually complex interventions, and intervention developers should 'articulate programme theory', that is, they should offer detailed descriptions of individual intervention components and their proposed mechanisms of action. However, such detailed descriptions often remain lacking. The objective of this work was to provide a conceptual case study with an applied example of 'articulating programme theory' for a newly developed digital health intervention.

Methods: Intervention Mapping methodology was applied to arrive at a detailed description of programme theory for a newly developed digital health intervention that aims to support cardiac rehabilitation patients in establishing heart-healthy physical activity habits. Based on a Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) logic model of the problem, a logic model of change was developed. The proposed mechanisms of action were visualised in an acyclic behaviour change diagram.

Results: Programme theory for this digital health intervention includes 4 sub-behaviours of the main target behaviour (i.e. habitual heart-healthy physical activity), 8 personal determinants and 12 change objectives (i.e. changes needed at the determinant level to achieve the sub-behaviours). These are linked to 12 distinct features of the digital health intervention and 12 underlying behaviour change methods.

Conclusions: This case study offers a worked example of articulating programme theory for a digital health intervention using Intervention Mapping. Intervention developers and researchers may draw on this example to replicate the method, or to reflect on most suitable approaches for their own behaviour change interventions.

Keywords: Behavior and behavior mechanisms; Cardiac rehabilitation; Cardiovascular diseases; Digital health; Health promotion; Public health; Secondary prevention; Telemedicine.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The healthcare professional's view of the aktivplan application: (a) overview of the healthcare professional's caseload, with traffic light display indicating patient adherence; and (b) physical activity planning page with calendar view for individual patient.
Figure 2.
Figure 2.
The patient's view of the aktivplan application: (a) physical activity plan; (b) confirming completion of a planned activity; (c) short video with exercise instruction; and (d) automated messages.
Figure 3.
Figure 3.
The six steps of Intervention Mapping.
Figure 4.
Figure 4.
Logic model of the problem.
Figure 5.
Figure 5.
Acyclic behaviour change diagram (ABCD) for the aktivplan digital health intervention.
See this image and copyright information in PMC

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