Associations between behaviour change technique clusters and weight loss outcomes of automated digital interventions: a systematic review and meta-regression

ABSTRACT

Automated digital interventions for weight loss represent a highly scalable and potentially cost-effective approach to treat obesity. However, current understanding of the active components of automated digital interventions is limited, hindering efforts to improve efficacy. Thus, the current systematic review and meta-analysis (preregistration: PROSPERO 2021-CRD42021238878) examined relationships between utilisation of behaviour change techniques (BCTs) and the efficacy of automated digital interventions for producing weight loss. Electronic database searches (December 2020 to March 2021) were used to identify trials of automated digital interventions reporting weight loss as an outcome. BCT clusters were coded using Michie’s 93-item BCT taxonomy. Mixed-effects meta-regression was used to examine moderating effects of BCT clusters and techniques on both within-group and between-group measures of weight change. One hundred and eight conditions across sixty-six trials met inclusion criteria (13,672 participants). Random-effects meta-analysis revealed a small mean post-intervention weight loss of −1.37 kg (95% CI, −1.75 to −1.00) relative to control groups. Interventions utilised a median of five BCT clusters, with goal-setting, feedback and providing instruction on behaviour being most common. Use of Reward and Threat techniques, and specifically social incentive/reward BCTs, was associated with a higher between-group difference in efficacy, although results were not robust to sensitivity analyses.

KEYWORDS:

• Digital interventions
• weight loss
• behaviour change techniques
• Michie taxonomy
• meta-regression
• systematic review

Data availability statement

The dataset used for this meta-analytic review has been made available online and can be accessed at https://doi.org/10.17605/OSF.IO/X8VHW.

Acknowledgements

Evan M. Forman receives royalties from Oxford Press for a published acceptance-based behavioural weight loss treatment manual and workbook and is on the Scientific Advisory board for Tivity Health. Evan M. Forman contributed to study design and manuscript preparation.

Author Contributions

Michael P. Berry initially conceived the project, assumed the lead role manuscript preparation and was involved in article eligibility screening, data extraction and data analysis. Christina Chwyl contributed to study design and participated in eligibility screening, data extraction, interpretation of findings and manuscript preparation. Abigail L. Metzler participated in eligibility screening, data extraction and manuscript revision. Jasmine H. Sun and Hannah Dart participated in data extraction and manuscript revision.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research did not receive any specific funding.