Table 2.
Study author, year and title | Theory stated and behavioural principles | How tailoring conducted; when; how often | Tailoring based on … | Tailored output: type and mode of delivery | Engagement |
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Mouttapa et al., 2011The Personal Nutrition Planner: A 5-week, computer-tailored intervention for women | Social Cognitive TheoryEducation on diet and nutrition; goal setting (long- and short-term); self-efficacy (identifying short-term goal over next 7 days); provision of facilitators of diet change: shopping list; meal planner; recipe suggestions; advice for overcoming barriers | Static computer-tailoring via online questionnaire at baseline | Input 1: age, height, weight, sex, level of physical activity, and weight goals | Output 1: participants’ body mass index and estimated energy expenditure are calculated (evaluative feedback)Output 2: specific nutrition information using MyPyramid guidelines used to recommend amounts for all food groups and how nutrients in each food group benefit health (Content-matching); mode: website.Output 3: personalised newsletter based on their selection of long-term and short-term goals (content-matching, self-tailoring/customisation),mode: (if opt in) emailed newsletter | Not explicitly defined.Registration rate of intervention group to access intervention profile: 79%. Questionnaire for opinions of the intervention (not given to control) |
Tate et al., 2006A randomised trial comparing human email counselling, computer-automated tailored counselling, and no counselling in an Internet weight-loss programme | Cognitive Behavioural TheoryEducation (principles of behavioural weight-loss: diet exercise and behaviour change); orientation to website (differed by group); instruction on meal replacement usage (440 kcals: coupons given) with unstructured third meal; increase exercise to 30 mins walking per day; self-monitor diet and exercise | Dynamic tailoring (weekly) via participants logging to a web-based diary Either computer-tailoring (CT) or human tailoring (HT), depending on intervention condition | Web-based diaries, including weekly weight, daily caloric intake, use of meal replacements and exercise | Human-tailoring group: weekly feedback – unstructured and based on clinical judgement (counsellors had behavioural weight-loss experience and degrees in nutrition, psychology, health education, exercise physiology) including answering questions, behavioural feedback on progress towards goals and weight loss (comparative-progress feedback; evaluative feedback), overcoming barriers and motivation.Mode: email.Computer tailoring: automated feedback based on behaviours from past week (comparative-progress feedback and evaluative feedback) for weight loss and calories consumed and burned compared with individualised diet and exercise goals, behavioural strategies for improving adherence to self-monitoring diet and exercise, overcoming barriers, and motivation or praise depending on logging frequency (evaluative feedback). Mode: website | Not explicitly defined. Log-in frequency and site component usage (number of weeks of online diary submission)Median no. of total log-ins to website. Control=34; CT=20; HT= 32.5 timesThose in the HT group submitted diaries for 17.2 weeks (SD=8.7) more than the CT group, 11.4 weeks (SD= 9.2), p<0.001Online diary submissions associated with greater weight loss for both active intervention groups (HT:r= –0.56; CT: r= –0.69, p <0.001) |
Van Genugten et al., 2012Results from an online computer-tailored weight management intervention for overweight adults: randomised controlled trial | Self-Regulation Theory; Theory of Planned Behaviour; Precaution Adoption Process Model.Based on main steps for self-regulation for weight control: self-monitoring (weight, diet and PA), goal setting, action planning, evaluation, adaptation); aimed to support decision making/goal setting around behaviour change; comprised education about behaviour-health link; a review of current behaviours and feedback; social support and peer modelling; support intention formation; prompt cues; decisional balance; behavioural feedback; support for preparing and enacting behaviour change: action planning; analysing lapses in behaviours; relapse prevention; coping planning; behavioural contract | Dynamic computer-tailoring (asked to visit website every 2 weeks) Tailored website made using TailorBuilder software | Module 1: Input 1:assessments based on personal details and future weight goals; Input 2:assessment of personal advantages and disadvantages of weight-gain prevention; Input 3: assessment of confidence and willingness for weight-gain prevention; Input 4: assessment of diet and PA; Input 5: goal-setting tool and preparation tool.Modules 2 and 3: Input 1: assessment of weight and behaviours over past week; Input 2: assessment of high-risk situations in past or future; Input 3: when insufficient perceived behavioural control.Module 4: Input 1: assessment of weight; Input 2: asked to describe their personal rewards when goals are accomplished | Module 1:Output 1: graphs depicting weight history and predicted weight (comparative-progress feedback; evaluative feedback); tailored feedback on participants’ reasons for weight management and alternate views, instruction to consider both and reweigh pros and cons.Output 2: feedback decisional balance of advantages and disadvantages (descriptive feedback;content-matching); Output 3: if not confident to change behaviour receive a peer story; if not willing, anticipated regret (content-matching); Output 4: feedback on diet and PA and recommendations for change (evaluative feedback); Output 5: overall module output: summary and tailored plan.Modules 2 and 3: Output 1: factual and visual feedback on performance (comparative-progress feedback; evaluative feedback); if poor performance, decisional balance on old/new behaviours; if negative feelings reported about the person/their change, output was discussion of their feelings during failure and replacing them with positive feelings (descriptive feedback; content-matching); Output 2: guided, situation specific coping plan (content-matching); Output 3: option to change behaviour goal (self-tailoring/customisation); overall modules 2 and 3:Output 4: summary of coping plan.Module 4: Output 1: written and visual feedback on weight progress (comparative-progress feedback;); personalised normal weight range (evaluative feedback); Output 2: personal reward plan (personalisation); Output 3: overall module output: personalised certificate (identification).Mode: website | Not explicitly defined.Log-in data for each intervention moduleTailored vs control: Visited Module 1: 93.3% vs 81.5%; Module 2: 74.1% vs 66.7%; Module 3: 26.7% vs46.1%, Module 4: 15.2% (no generic Module 4)Process measures:(item-specific rating scale, summary of differences reported): Tailored group rated intervention as morepersonally relevant and novel than those receiving the generic information, ps<0.01, but read less of the information, p<0.001, and perceived the length of the information as less appropriate than those in the generic group p =0.01. There was no differenceamong groups in their ratings of usefulness of the information, attractiveness of the design, appreciation of the tool, whether they would recommend to others, and overall rating |
Godino et al., 2016;Patrick et al., 2014Using social and mobile tools for weight loss in overweight and obese young adults (Project SMART): a 2-year, parallel-group, randomised, controlled trial | Abraham and Michie (2008) taxonomy of 26 behaviour change techniques (which they cite draws on: Social Cognitive Theory; Control Theory; and operant conditioning); Ecological Theory; Social Network Theory.Intention formation, goal setting, self-monitoring, feedback, and goal review; techniques to increase self-efficacy for diet and physical activity, relay the benefits of, and remove barriers to, healthy changes in physical activity and diet; blog posts that were educational; Patrick (2014) adds: social support and accountability (friends, participants, health coach via social network); formation of healthy social norms about health weight-related behaviour; location based support and prompts; problem solving | Dynamic tailoring (daily/weekly). Combination of computertailoring and human tailoring.Unclear specifically when and how due to flexible nature of intervention delivery: choice of six modes including Facebook, three study-designed mobile applications, text messaging, emails, a website with blog posts, and technology-mediated communication with a health coach (up to 10 brief (5–15 min) interactions) | Input 1: physical location; Input 2: physical activity and diet goals; preferred frequency/time of tracking, feedback and participation in goal review; Input 3: physical activity, diet and weight | Output 1: text relaying behaviour-change information according to where the participant was (e.g. at home or university-based exercise) (location-tailoring). Mode: text.Output 2: customisation of programme delivery according to preferences (self-tailoring/customisation).Output 3: Trend-setter app-issued automated feedback (comparative-progress); health coaches issued feedback on self-monitored physical activity, diet and weight-performance and progress towards goals and usage of intervention modes (e.g. apps and Facebook) (comparative-progress feedback; evaluative feedback; contextualisation of health messages by time of year).Mode: text, apps, Facebook, website, instant messenger, telephone call, or video call | Engagement operationalised as: sum of a participant’s recorded interactions on the study Facebook page (e.g. a post, comment, or like) and mobile apps (e.g. entry of the number of steps taken per day), text messages sent and replied to, and communication with the health coach between each study measurement.Intervention group: median (inter-quartile range) = 98 (9–265) interactions at 6 months, 76 (0–222) at 12 months, 41 (0–198) at 18 months, and 12 (0–161) at 24 months. Control: NR |
Napolitano et al., 2013Using Facebook and text messaging to deliver a weight-loss programme to college students | None stated.Goal setting (weight-loss goal set with study staff member); self-monitoring (given advice on how, given tools including scales, book and pedometer, measuring utensils), and social support (via their selected non-study-related ‘buddy’ and daily text messages); educational content sent weekly via handout/ podcast, video demonstrations, one topic per week, topics of: self-monitoring and navigating campus; planning and nutrition; internal vs external hunger and eating triggers; physical activity; stress and distorted thinking; social support; special occasions, dining out and holidays; relapse prevention | Dynamic tailoring (daily/ weekly) Unclear how devised – appears to be automated/computer-tailored feedback (via daily text and weekly summary report) (‘messages were programmed at random intervals’ p. 26) | Input 1: whether they monitored (general and behaviour specific, e.g. diet and PA) on that day; Input 2: daily PA, calories, and weight; Input 3: baseline reported high-risk habits | Output 1: feedback on performance of self-monitoring (e.g. whether or not they monitored each behaviour, diet only, PA only, both, or neither) (descriptive feedback); Output 2: immediate feedback by text (e.g. acknowledgement of submitting self-monitoring data); (descriptive feedback); Output 3: advice on habits (e.g. late night snacking, liquid calories); Output 4: weekly tailored feedback summary reports (based on collated Input 2), which are compiled into personalised reports that summarised progress (included text and visual feedback (graphs) of average weekly weight, calories and physical activity), as well as feedback on progress towards reaching one’s behavioural goals and progress in the skills training for the week (evaluative feedback; comparative-progress feedback).Mode: SMS message, external link to secure page accessed via Facebook | Level of engagement was examined for the Facebook groups (intervention group and active control) by quantifying the number of times participants ‘liked’ a study-related post, posted a comment, and RSVP’d to an event. Active control: 4/17 participants 'liked’ study-related posts (M=1.25 likes each); 7/17 commented on study-related content at least once (M=3.05 posts per commenter); 15/17 responded to event invite (average RSVPs, M=6.54).Intervention group: 4/18 ‘liked’ study-related posts (M= 1 like each); 14/18 posted on study-related content at least once (M = 1.3 posts per commenter); 13/18 responded to event invitations (M=8.56 RSVPs of those who responded);79.7% of all general monitoring texts receiving a response |
Rothert et al., 2006Web-based weight management programmes in an integrated health care setting: Arandomised, controlled trial | None stated.Social support (optional participant-nominated 'buddy' who received email prompts to provide support); educational content (initial guide); action plans (weeks 1, 3 and 6); positive reinforcement of dietary and physical activity improvements, address specific barriers, and provide support and self-monitoring resources | Static computer-tailoring algorithm (tailored expert system): Balance a self-help weight management programme developed by HealthMedia, Inc.) via baseline questionnaire | Input: demographic information; personal and family health history; former weight-loss experiences (including former use of specific weight-loss treatments and outcomes from weight-loss attempts); general self-care activities (including tobacco, physical examinations, flossing, seat belt use, and stress management); physical activity, ability to be physically active, and barriers to being physically active; perceived difficulty in controlling diet and physical activity; worry regarding body image; barriers to weight management; psychosocial stress and coping; general dietary preferences (e.g. consumption of alcoholic beverages, desserts, fast food, high-fat dairy products, fried food); foods typically consumed when stressed; weight-loss goals and motivation to lose weight; source of motivation (e.g. personal choice, pressure from others); a typological assessment of eating behaviour (e.g. whether the subject eats in response to certain emotions, restricts food intake, then eats because of hunger, etc.); attitudes regarding overweight individuals (e.g. that they lack willpower, are unattractive, cannot be physically fit, etc.); weight-related self-efficacy; weight-loss expectations (e.g. looking and feeling younger, reducing risk of disease, having clothes fit better, reassuring others, getting people to stop nagging them to lose weight, etc.); and perceived social support | Output 1: an individually tailored weight management plan in line with behavioural strategies, e.g.participants who reported greater ability to change diet than physical activity received more dietary advice; specifically cited barriers and lack of efficacy were addressed with messages tailored to those issues (content-matching).Output 2: tailored action plans delivered at 1, 3 and 6 weeks into the programme to reinforce initial plan (content-matching). Mode: website | Not explicitly defined. Process measures (% positive): tailored vs control Read information completely 82% vs 67%; materials helpful 75% vs 57%; information easy to understand 93% vs 82%; materials were personally relevant 78% vs 61%; would recommend programme to others 75% vs 59%, all ps =0.0001 |
Note: CT = computer tailoring; HT= human tailoring; PA = physical activity; M = mean; SD = standard deviation; SMS= short message service (text); NR= not reported.