How can we design better theory based interventions?

(This article was written in 2009. Since then Changetech has succeeded in creating the new generation of more efficient self help programs, now known as Easychange)


An extensive amount of cognitive and emotional processes are involved in any health behaviour change attempt, thus digital interventions that aim to help users quit smoking, reduce alcohol consumption, eat healthy etc. should be extensive and provide the right therapy at the right time.


The new generation of ePsychology interventions should take into account both cognitive processes involving self-regulation and emotional processes to prevent ego depletion and relapse. Furthermore, the new generation of digital interventions should be evaluated rigorously in long-term randomized controlled trials to gather more knowledge on what makes digital therapy programs effective.


Some important questions.

We are particularly interested in gaining knowledge about how psychological theory and research related to behavior change and maintenance, can be utilized in designing interventions. In particular, interesting questions are: How can we design interventions not only to motivate users to initiate change, but to maintain change as well? Which psychological change predictors should and could be addressed by means of a psycho-educational approach? How important is it to provide additional just-in-time therapy and how can this be achieved? How can digital technologies be used to prevent ego depletion? How can ePsychology interventions support the making of implementation intentions and coping planning? How can digital technologies help detecting and preventing lapses and relapse? Of course, many other questions could be asked, but these are among those we address herein.


Cutting edge psychology.

It is self evident that ePsychology should utilize insights from cutting edge psychology in order to maximize effect. However, many would say, and we tend to agree, that it is of equal importance to acknowledge that in order to be effective, ePsychology interventions must be able to reach the audience and hold the interest of the user over time. No doubt, the fact that the intervention is judged by the user to be effective in helping her to achieve her ultimate goals, may contribute considerably to this end. Nevertheless, we also need to capitalize on insights about how user interface and information technology influence upon both initial and continued use, and hence ultimate effect. Because we restrict ourselves to talk about the area of psychological change, more specifically to behaviour change and well-being, a focus will be on such questions as: How do you best establish a ‘therapeutic alliance’ by means of digital technology? How do you maximize adherence to digital interventions (i.e., stickiness)? What characterizes successful information systems (ISs) in this area? How do different information architectures influence user perceptions? How can we enhance (perceived) individualization and personalization? How important is interactivity, and how can it be increased?


Use of positive psychology.

A possible disadvantage with digital interventions may be high attrition rates. We have suggested including positive psychology components in digital interventions to lower attrition rates, because this will probably make the intervention feel more self-relevant, and the user will also experience more positive emotions during the change attempt. The user is also more prone to relapse when experiencing negative affect. Thus, including components that help the user effectively regulate emotions is likely to prevent relapse. Moreover, it is likely that interventions that manage to instill positive affect will increase the success rate of the change attempt, as well as increasing well-being during and after the change process.


A new generation of programs.

Our hope is that the growing knowledge in the area of ePsychology results in a new generation of programs for behavioural change with higher efficacy than traditional programs. Hence, we have tried to summarize and synthesize our proposals addressing how strategies and knowledge from the health behaviour change literature can be utilized in digital intervention programs in the scientific article “ePsychology: Designing Theory Based Health Promotion Interventions”.