Foundational knowledge - Contemporary Behavior Change Theories

3. Internet Intervention Model (RIIM)

Internet Intervention Model (RIIM) suggests that internet-based interventions are effective if they follow the 9 nonlinear steps of the model, namely:

1. User characteristics refer to the patient, consumer, or research participant who bring their own diverse set of variables or characteristics that cannot be manipulated (e.g., age, gender, cognitive traits) and serve as predictor variables in developing an intervention (Ritterband et al., 2009).
2. Environment refers to multiple factors such as family, friends, employer, the community, which can either offer support or put barriers to adopting the behavior; therefore, it needs to be accounted for when developing an intervention (Ritterband et al., 2009).
3. Website refers to the program or application through which treatment is delivered and has eight main areas that need to be taken into account when developing the intervention: appearance, behavioral prescriptions, burdens, content, delivery, message, participation (Ritterband et al., 2009).
4. Website use refers to the actual utilization of the intervention. The other steps of the model highly influence it; therefore, special attention needs to be given to them when developing the intervention (Ritterband et al., 2009).
5. Support refers to how the person’s feels they receive help to make the change. Support usually impacts adherence, ranging from emails and texts to other prompts (Ritterband et al., 2009).
6. Mechanisms of change are the catalysts of transformation and may take the form of knowledge, information, motivation, attitude, beliefs, skill-building, self-efficacy, cognitive restructuring and self-monitoring (Ritterband et al., 2009).
7. Behavior change is the ultimate variable of change, and it is critical to identify  behaviors that are essential to change to reduce associated symptoms and achieve a positive outcome (Ritterband et al., 2009).
8. Symptom improvement is the goal of most interventions, and it refers to improving the wellbeing of the target group (Ritterband et al., 2009).
9. Treatment maintenance refers to including some form of relapse prevention in the intervention to help users maintain treatment gains (Ritterband et al., 2009).

The main idea that the model states is that “the user, influenced by environmental factors, affects website use and adherence, which is influenced by support and website characteristics. Website use leads to behavior change and symptom improvement through various mechanisms of change. The improvements are sustained via treatment maintenance” (Ritterband et al., 2009).

Internet Intervention Model (Ritterband et al., 2009)