Table 1 Overview of behavior change techniques, mechanisms of action and implementation modes
Behavior Change Technique | Mechanism of action | Implementation mode |
|---|---|---|
Stage 1 – motivational | ||
Goal setting (1.1) Goal setting outcome (1.3) | Behavioral regulation (intention) Goals | During the initial wizard, intended to tailor the app’s content at best possible to participants’ needs, work and private situation, participants are asked to set an individual health goal. An interactive goal setting worksheet is available to support participants in setting goals correctly. Note, participants are not specifically guided to differentiate between behavioral (e.g., set the goal of eating 5 pieces of fruit per day) and outcome goals (i.e., set a weight loss goals of 0.5 kg per week) but to choose a personally relevant health goal |
Instruction on how to perform the behavior (4.1) Demonstration of the behavior (6.1) | Knowledge (self-efficacy) Beliefs about capability skills Social learning/imitating | The within-app exercise and task catalogue offers videos, written information and instructions on how to perform physical activity, and mindfulness behaviors. The videos feature a nurse executing the behavior correctly. By observing and imitating the nurse, self-efficacy is enhanced and beliefs are built that participants are able to achieve what the role model (i.e. nurse) achieved, raising expectations of success and motivating participants to work hard towards their goals |
Information about health (5.1) and emotional (5.6) consequences | Knowledge Beliefs about consequences (positive, negative outcome expectancies) Attitude towards the behavior Perceived susceptibility/ vulnerability Intention Emotion | Blog articles (“highlights of the day”), covering different health topics related to physical activity, nutrition and mindfulness behaviors, are presented on the home screen and offering information about positive and negative health consequences, affecting participants’ knowledge, outcome expectancies, attitudes, perceived personal risk, emotional state and in turn their intentions. Additionally, “knowledge elements” of exercise and task suggestions included in within-app exercise catalogue offer information about health consequences that are supposed to have similar effects on aforementioned social-cognitive variables |
Stage 2—volitional | ||
Action planning (1.4) | Behavioral regulation (action initiation) | Based on the goal setting instructions upon the initial wizard, participants are prompted via a newsletter sent to participants approximately 3 weeks post-baseline (booking date + 25), to make a plan by specifying how they want to achieve their intended behavior, what they want to do, where they want to do it and when. Action planning helps people to act in favorable situations and by anticipating contexts suitable for behavioral execution, which facilitates developing cue-behavior associations. Action planning as such can make cues more easily accessible in memory so that when exposed to the cue, it is more likely that the behavior is executed |
Self-monitoring of behavior (2.3) Feedback on behavior (2.2) Discrepancy between current behavior and goal (1.6) Remove access to reward (7.4) | Behavioral regulation (action control) Knowledge | The home screen of the app features three progress bars (i.e., for physical activity, nutrition, mindfulness). Upon exercise/tasks completion a box can be ticked off. Ticking boxes (i.e., indicating completion of exercise/task) directly transfer to the progress bars, reflecting progress for the given behavior. Additionally, in case participants focus too much on one behavior and ignore another, negative progress is indicated in progress bars for the neglected behavior. Through this feedback and these gaming elements, participants can easily monitor their behaviors and goal progresses (positive, negative) |
Stage 3 – habit formation | ||
Prompts/cues (7.1) Behavioral practice/rehearsal (8.1) Habit formation (8.3) | Memory, attention, decision processes Behavioral cueing Beliefs about capabilities Behavioral regulation | Via a newsletter participants receive an interactive worksheet stressing the importance of determining specific contextual cues (e.g., reoccurring situation or context such as lunch breaks) in which they intend to execute the behavior (e.g., stretching neck). Selecting triggers facilitates developing cue-behavior associations, which fosters the habit formation process. Additionally, the feature “open tasks” on the home screen continuously remembers participants to practice their favorite exercises and tasks |
Stage independent | ||
Social support (unspecified) (3.1) | Social influences Social/professional role and identity | Participants have the possibility to contact a trained coach (via email or phone) in case of questions, concerns, problems. The coach could also function as a role model, providing information and knowledge on health-related topics or providing support for habit formation (e.g., provision of feedback) |