Table 1.
An overview of how the person-based approach can be incorporated at each stage of the development of digital health-related behavior change interventions.
| Intervention stagea | Target output of the person-based approach | Specific person-based approach processes undertaken | Activities that may be undertaken as part of wider intervention development context |
| Planning (months 0-6) | Identification of key behavioral issues, needs, and challenges the intervention must address | Synthesize previous qualitative studies of user experiences of similar interventions | Consultation with experts, members of user groups, other stakeholders (eg, purchasers of health care services) |
| Carry out primary qualitative research using open-ended questions to elicit user views of the planned behavior changes (including relevant previous experience, barriers and facilitators) | Examination of relevant theory and evidence from previous trials (complex intervention development) | ||
| Observation of real-life context of intended health care product (user-centered design) | |||
| Design (months 3-9) | Creation of guiding principles to help developers summarize and easily refer to features of the intervention identified as central to achieving the intervention objectives | Create guiding principles, comprising: key intervention design objectives (addressing key behavioral issues, needs, challenges identified in Step 1), and key (distinctive) features of the intervention needed to achieve objectives (drawing on intervention planning in Step 1) | Theoretical modeling (complex intervention development) eg, creation of logic model describing hypothesized mechanisms of action of intervention, and/or intervention mapping of behavioral determinants and behavior change techniques |
| Creation of personas, scenarios, use cases (user-centered design) | |||
| Development and evaluation of acceptability and feasibility (months 6-18) | All intervention components evaluated in detail and optimized from user perspective | Elicit, observe and analyze user reactions to every intervention element (eg, using think-aloud techniques), iteratively modifying intervention to optimize from user perspective | Development of detailed procedures for intervention plus information/advice, manuals, scripts, training, etc, for patients and/or health professionals |
| Carry out detailed longitudinal mixed methods case studies to evaluate and optimize independent usage of intervention | Mixed methods evaluation of acceptability, feasibility (complex intervention development) | ||
| Creation and usability testing of prototype product (user-centered design) | |||
| Implementation and trialing (starting from months 12-18) | Intervention evaluated in real-life context(s), modified to improve implementation in future contexts | Use mixed methods process analyses to identify further modifications to improve acceptability, feasibility, and effectiveness of intervention for future implementation, or for use in different contexts | Effectiveness and cost-effectiveness evaluated using experimental methods (eg, randomized controlled trials), audits, etc |
| Mixed methods process analyses of implementation (reach, fidelity, context effects, etc), mediators, and moderators of intervention effectiveness |
aTimelines given for each stage are indicative only.