Foundational knowledge - Behavioral Intervention Technology (BIT) model

1. Introduction

The behavioral intervention technology model consists of a framework for developing implementable interventions, and it is anchored in the contemporary behavioral change models presented in lesson 2 (Mohr et al., 2014). BIT offers the necessary steps of translating the behavior change theories and models into actions that need to be taken when designing and implementing a digital behavior change intervention. The BIT model proposes the “why”, “what”, “how”, and “when” for developing DHIs, which can be observed in the figure below.

BIT model (Mohr et al., 2014)

2. Why

This component of the BIT model discusses the intervention aims, and it can refer to both clinical aims (e.g. reducing weight) or usage aims (e.g. maintaining the engagement with specific components of the intervention – like daily use of the mHealth app). These outcomes are most of the time overlapping; therefore, a usage aim is often reflected in the clinical aim and vice versa (Mohr et al., 2014).

3. What

This component of the BIT model refers to the actual behavioral intervention technologies the intervention offers to prompt behavior change. These can take the form of a data field for logging in the desired behavior (e.g. food consumption, sleep hours, etc.) to act as a behavior change strategy of monitoring (Mohr et al., 2014). Other examples of behavioral intervention strategies are notifications, app reports for users, logs, and visualizations; these elements are delivered separately or embedded together (Mohr et al., 2014).

4. How

This component of the BIT model offers both conceptual and technical strategies for behavioral interventions that help attain the intervention aims (Mohr et al., 2014). The conceptual strategies are based on theories and models of behavior change (presented in lesson 2) and are crucial for behavior change to occur and be maintained. A list of conceptual strategies, developed upon an extensive taxonomy of behavior change strategies (Michie et al., 2013), is offered by the BIT model to attain behavioral change (Mohr et al., 2014). The technical strategies are used to offer the user a good experience with the app in terms of engagement, ability to complete tasks, and app comprehension. These strategies can vary in complexity, media employed, aesthetics, and personalization depending on the needs of the interventions and the characteristics of the users (Mohr et al., 2014).

5. When

This component refers to the workflow of the intervention and defines under what conditions the intervention is delivered. Some common examples of workflow elements are: (1) tunnelling – the use of data to decide which interventions meet the needs and preference of users in a specific time period; (2) frequency – how frequent the intervention is offered; (3) conditions – the use of data to determine when should an intervention be delivered (it can be time-based, task-completion, and event-based); (4) user-defined – offers access to all elements of the intervention from the beginning, allowing the user to set the sequence and timing of the app (Mohr et al., 2014). Usually, workflows integrate a number of these elements to achieve behavior change, depending on the needs of the interventions and the characteristics of the users (Mohr et al., 2014).

6. Summary

The BTI model can be useful for mHealth app developers to decide on the app design and clarify their intentions, aims, and intervention conceptual and technical elements (Mohr et al., 2014). It was successfully used for fitness applications, such as MyFitnessPall (Mohr et al., 2014).