Cited by 209Behavioral Health and InterventionsHealth Policy Implementation ScienceBehavioral and Psychological Studies

Agile science: creating useful products for behavior change in the real world

Open access
Hekler, Eric B., Klasnja, Predrag, Riley, William T., Buman, Matthew P., Huberty, Jennifer, Rivera, Daniel E., Martin, Cesar A.·2016·Translational Behavioral Medicine

Abstract

Evidence-based practice is important for behavioral interventions but there is debate on how best to support real-world behavior change. The purpose of this paper is to define products and a preliminary process for efficiently and adaptively creating and curating a knowledge base for behavior change for real-world implementation. We look to evidence-based practice suggestions and draw parallels to software development. We argue to target three products: (1) the smallest, meaningful, self-contained, and repurposable behavior change modules of an intervention; (2) "computational models" that define the interaction between modules, individuals, and context; and (3) "personalization" algorithms, which are decision rules for intervention adaptation. The "agile science" process includes a generation phase whereby contender operational definitions and constructs of the three products are created and assessed for feasibility and an evaluation phase, whereby effect size estimates/casual inferences are created. The process emphasizes early-and-often sharing. If correct, agile science could enable a more robust knowledge base for behavior change.

AI snapshot

Written from the paper’s full text.

TL;DR

The paper proposes “agile science” as a process and three product types—behavior change modules, computational behavioral models, and personalization algorithms—for creating and curating real-world behavior change interventions. It argues for early-and-often sharing of operations, constructs, and failed tests, drawing parallels to agile software development and optimization methods, but presents a first-draft conceptual process rather than empirical validation.

Key findings

  • Defines three target products: behavior change modules (smallest, meaningful, self-contained, repurposable; structured as inputs, processes, outputs), computational behavioral models (mathematically specified theories including dynamics and threshold conditions), and personalization algorithms (decision rules for selecting interventions for a person/unit at a time and context).
  • Argues that sharing operations and constructs early and often—prior to effect size estimation—could reduce “reinventing the wheel,” facilitate specialization, and enable more robust tests of external validity across populations, treatments, outcomes, and settings.
  • Outlines agile science process v0.1 with two iterative phases: a generate phase (formative work, simulation studies, prototype testing; feasibility criteria from Bowen et al.) and an evaluate phase (effect size estimates/causal inferences using optimization methods such as MOST, SMART, and micro-randomized trials).
  • Describes ongoing complementary physical activity projects as a case study: developing “ambitious but doable” step goals, context-relevant cues and daily planning modules, and a Paco-based system for rapid creation and sharing of behavior change modules.

Methods

  • Conceptual/position paper; no empirical sample, primary data, or original quantitative results are reported.
  • Draws on evidence-based practice literature, optimization methods (MOST, SMART, micro-randomized trials), and analogies to agile software development, open-source software, APIs, and lean start-up methods.
  • Proposes a first-draft agile science process (v0.1) and illustrates it with ongoing, descriptive case-study projects focused on physical activity.

Limitations

  • The paper states that future work is needed on the generate phase, resource-efficient experimental designs and statistics, cognitive biases (e.g., sunk cost), and academic incentives for early-and-often sharing; curation strategies are not fully articulated.
  • The paper labels the process as first draft (v0.1) and generate-phase products as “contender” rather than evidence-based; no empirical validation of the agile science process is reported.
  • Evident from the text: the case study is ongoing and descriptive, and the paper provides no original effect sizes or formal evaluation of the proposed products/process.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1007/s13142-016-0395-7

Cites

62 of 62 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 61 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    MOST establishes a process for continuous optimization of behavior change interventions by iteratively evaluating the efficacy of intervention components.

    “MOST establishes a process for continuous optimization of behavior change interventions by iteratively evaluating the efficacy of intervention components.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [14] Collins LM, Baker TB, Mermelstein RJ, et al. The multiphase optimization strategy for engineering effective tobacco use interventions. Ann Behav Med. 2011; 41: 208–226. source

      Not checked in the free run.

  • Premisecitation

    Individual and contextual differences can moderate when a behavioral intervention will produce its targeted effect.

    “As implied by behavioral ecological models (e.g., [8]), individual and contextual differences (e.g., when, where, for whom, in what state of the person) can moderate when a behavioral intervention will produce its targeted effect [9].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Rothman AJ. Exploring connections between moderators and mediators: commentary on subgroup analyses in intervention research. Prev Sci. 2013; 14: 189–192. source

      Not checked in the free run.

  • Premisecitation

    Behavior change interventions have multiple criteria for success for real-world use, including being effective, usable, desirable to the target group, and safe.

    “To complicate things further, behavior change interventions have multiple criteria for success for real-world use such as being effective, usable, desirable to the target group, and safe [5, 10].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [5] Craig P, Dieppe P, Macintyre S, et al. Developing and evaluating complex interventions: the new medical research council guidance. Int J Nurs Stud. 2013; 50: 587–592. source

      Not checked in the free run.

    • cites [10] Bowen DJ, Kreuter M, Spring B, et al. How we design feasibility studies. Am J Prev Med. 2009; 36: 452–457. source

      Not checked in the free run.

  • Premisecitation

    Factorial or fractional factorial design provides a resource-efficient way of examining main effects of each intervention component and interaction effects among components.

    “For example, the factorial/fractional factorial design provides a resource-efficient way of examining main effects of each intervention component within an intervention and the interaction effects among components [15].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] Collins LM, Murphy SA, Strecher V. The multiphase optimization strategy (MOST) and the sequential multiple assignment randomized trial (SMART): new methods for more potent eHealth interventions. Am J Prev Med. 2007; 32: S112–S118. source

      Not checked in the free run.

  • Premisecitation

    When developing interventions delivered via digital technologies, the technologies often mutate at a faster rate than the scientific process.

    “Further, when developing interventions delivered via digital technologies, there is an added issue that the technologies are often mutating at a faster rate than the scientific process [3].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] Riley WT, Glasgow RE, Etheredge L, Abernethy AP. Rapid, responsive, relevant (R3) research: a call for a rapid learning health research enterprise. Clin Translat Med. 2013; 2: 1–6. source

      Not checked in the free run.

  • Classified as probably not a substantial claim. 64
  • May combine two claims. 32
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    The team has conducted a series of simulations to explore different ways of defining an "ambitious but doable" goal based on interactions between the variables in the model.

    “For example, in the Fig. 1 dynamical model, the team has conducted a series of simulations to explore different ways of defining an “ambitious but doable” goal based on interactions between the variables in the model.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Findingreasoning

    We are actively working toward testing the assumptions outlined.

    “As our ongoing suite of complementary projects illustrate, we are actively working toward testing the assumptions outlined.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Multiple complementary research projects are underway that each focus on developing a different module for a complex intervention for physical activity.

    “Multiple complementary research projects are underway that each focus on developing a different module for a complex intervention for physical activity.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    A third complementary project is focused on the development of a tool that can support the rapid creation and early-and-often sharing of behavior change modules.

    “A third complementary project is focused on the development of a tool that can support the rapid creation and early-and-often sharing of behavior change modules.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    In partnership with Bob Evans at Google and his open-source Paco system, at the time of writing, we are building a system that allows researchers to rapidly build behavior change modules.

    “In partnership with Bob Evans at Google and his open-source Paco system (www.pacoapp.com), at the time of writing, we are building a system that allows researchers to rapidly build behavior change modules.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Findingreasoning

    Within the ambitious but doable and context cue/implementation intention projects, we previously engaged in formative work, simulation studies, and prototype testing and thus are currently utilizing the operations created previously in the evaluate phase.

    “Within the ambitious but doable and context cue/implementation intention projects, we previously engaged in formative work, simulation studies, and prototype testing and thus are currently utilizing the operations created previously in the evaluate phase.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Evidence-based practices in behavioral interventions require both careful examination of intervention efficacy and the ability of the practice to be translated and disseminated for real-world use.

    “Evidence-based practices not only require careful examination of the efficacy of an intervention but also the ability of the evidence-based practice to be translated and disseminated for real-world use [2].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [2] Rotheram-Borus MJ, Swendeman D, Chorpita BF. Disruptive innovations for designing and diffusing evidence-based interventions. Am Psychol. 2012; 67: 463. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Chorpita et al. argued that the fundamental challenge in behavior change science may be an overemphasis on knowledge proliferation at the cost of knowledge management and suggested focusing more on algorithms to curate knowledge.

    “Indeed, Chorpita et al. [20] have argued that the fundamental challenge in behavior change science may be an overemphasis on knowledge proliferation (i.e., the development of new treatments) at the cost of knowledge management (e.g., developing new ways to design, organize, and share existing resources) and thus suggest focusing more on algorithms to curate knowledge.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Chorpita BF, Rotheram-Borus MJ, Daleiden EL, et al. The old solutions are the new problem how do we better use what we already know about reducing the burden of mental illness? Perspect Psychol Sci. 2011; 6: 493–497. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Sharing early and often reduces independent groups reinventing similar operations and, if information is well-curated and modules are interoperable, could facilitate increased specialization.

    “This reduces independent groups reinventing similar operations and also, if the information is well-curated and modules are interoperable, could facilitate increased specialization.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    Testing of assumptions via MVP modules is achieved via sprints, which involve a rapid cycle of identifying an assumption, building an MVP module to test the assumption, and releasing the module to relevant stakeholders to test the assumption.

    “This testing of assumptions via MVP modules is achieved via “sprints,” which involve a rapid cycle of identifying an assumption, building an MVP module to test the assumption, and then releasing the module to relevant stakeholders to test the assumption [23].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [23] Abrahamsson P, Warsta J, Siponen MT, Ronkainen J. New directions on agile methods: a comparative analysis. Proceedings of the International Conference on Software Engineering, 2003.

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Sharing early and often enables individuals to build on one another's work at the beginning and thus makes it easier for the process to facilitate interoperable and repurposable modules across complex interventions.

    “Put differently, sharing early and often enables individuals to build on one another’s work at the beginning and thus makes it easier for the process to facilitate interoperable and repurposable modules across complex interventions.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Personalization algorithms are a pragmatic target for developing evidence-based recommendations of complex interventions because they establish the evidence base for selecting the right intervention option for a particular person in context.

    “As such, the personalization algorithm is a pragmatic target for developing evidence-based recommendations of complex interventions as the personalization algorithms establish the evidence base for selecting the right intervention option for a particular person in context.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationnone given

    Sharing of operations enables different research groups to use the same operations in different use cases, which enables a more robust testing of external validity.

    “(3) sharing of operations enables different research groups to use the same operations in different use cases, which enables a more robust testing of external validity.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Behavioral theories have classically been how behavioral sciences describe how interventions, individuals, and context interact but are fraught with well-documented problems such as lack of falsification, lack of information about subtle dynamics, and being so abstract that they are difficult to apply in practice.

    “Behavioral theories have classically been how behavioral sciences describe how interventions, individuals, and context interact but these are fraught with well-documented problems such as lack of falsification, lack of information about subtle dynamics, and they are often so abstract that they are difficult to apply in practice [36, 37].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [36] Hekler EB, Klasnja P, Froehlich JE, Buman MP. Mind the theoretical gap: interpreting, using, and developing behavioral theory in HCI research. Proceedings of SIGCHI Conference on Human Factors in Computing Systems (CHI’13). 2013; 3307–3316. source

      Not checked in the free run.

    • cites [37] Riley WT, Rivera DE, Atienza AA, et al. Health behavior models in the age of mobile interventions: are our theories up to the task? Translat Behav Med. 2011; 1: 53–71. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    A plausible reason for the siloing of evidence-based protocols is that operations are shared at the wrong time.

    “A plausible reason for this siloing of evidence-based protocols is simply that we are sharing our operations at the wrong time.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    Evidence-based practices often become their own separate silos of evidence, rendering it very difficult to mix and match modules across evidence-based practices.

    “It has been argued elsewhere that evidence-based practices often become their own separate silos of evidence, rendering it very difficult to mix and match modules across evidence-based practices [2].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [2] Rotheram-Borus MJ, Swendeman D, Chorpita BF. Disruptive innovations for designing and diffusing evidence-based interventions. Am Psychol. 2012; 67: 463. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    Together, the three agile science products each uniquely contribute to supporting evidence-based decision making about which intervention to use for whom and at what time.

    “Together, these three agile science products each uniquely contribute to supporting evidence-based decision making about which intervention to use for whom and at what time.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Striving for small modules enables repurposability.

    “In brief, striving for small modules enables repurposability.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    It is likely that a researcher engages in formative work, simulation studies, and even prototyping testing iteratively and/or simultaneously.

    “It is likely that a researcher engages in formative work, simulation studies, and even prototyping testing iteratively and/or simultaneously.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    MVPs are simplified modules designed to test assumptions about the module with relevant stakeholders.

    “MVPs are the simplified modules that are designed to test assumptions about the module with relevant stakeholders [25].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25] Ries E. The lean startup: how today’s entrepreneurs use continuous innovation to create radically successful businesses. Random House LLC; 2011.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Concrete examples, particularly multiple examples, provide richer information about a construct than a textual definition alone.

    “In terms of construct specification, concrete examples, particularly multiple examples, provide richer information about a construct than a textual definition alone.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Careful delineation of inputs, processes, and outputs makes it easier to draw connections between behavior change modules and thus the architecture on how modules interact.

    “Careful delineation of inputs, processes, and outputs makes it easier to draw connections between behavior change modules and thus the architecture on how modules interact (including modules for measuring attributes of the person/population, setting, or outcome measure but,”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Within software development, the basic structure of modules is that they have specific inputs, a process that utilizes these inputs to transform them, and specific outputs.

    “Within software development, the basic structure of modules is that they have specific inputs, a process that utilizes these inputs to transform them in some way and then this process creates specific outputs [24].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] Garlan D, Shaw M. An introduction to software architecture. Advances in software engineering and knowledge engineering. 1993; 1. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The disruptive innovation process emphasizes providing simpler and less expensive alternatives to current practices that meet the essential need for the majority of users to make them more accessible, scalable, and replicable.

    “The disruptive innovation process emphasizes the focus on providing simpler and less expensive alternatives to current practices that meet the essential need for the majority of users in order to make them more easily accessible, scalable, and replicable [2].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [2] Rotheram-Borus MJ, Swendeman D, Chorpita BF. Disruptive innovations for designing and diffusing evidence-based interventions. Am Psychol. 2012; 67: 463. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    There are three behavior change intervention product types that are particularly important for targeting as conceptual building blocks for personalized complex interventions: behavior change intervention modules, computational models, and personalization algorithms.

    “With the value of sharing operations specified, there are three behavior change intervention product types that we view as particularly important for targeting as they are the conceptual building blocks for personalized complex interventions: behavior change intervention modules, computational models, and personalization algorithms.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The micro-randomized trial is a sequential factorial design for modeling effectiveness of treatment components over time.

    “The micro-randomized trial is a sequential factorial design for modeling effectiveness of treatment components over time.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [16] Klasnja P, Hekler EB, Shiffman S, et al. Micro-randomized trials: an experimental design for developing just-in-time adaptive interventions. Health Psychol. 2016. source

      Not checked in the free run.

    • cites [17] Martin CA, Desphande S, Hekler EB, Rivera DE. A system identification approach for improving behavioral interventions based on social cognitive theory. American Control Conference (ACC). 2015; 5878–5883. doi: 10.1109/ACC.2015.7172261 . source

      Not checked in the free run.

    • cites [18] Martin CA, Rivera DE, Hekler EB. An identification test monitoring procedure for MIMO systems based on statistical uncertainty estimation. IEEE Conference on Decision and Control (CDC); 2015. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Products produced via the generate phase are not evidence-based.

    “By contender, we explicitly acknowledge that the products produced via the generate phase are not evidence-based.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Riley et al. utilized simulation to generate a computational model of social cognitive theory.

    “As discussed earlier, Riley et al. utilized simulation to generate a computational model of social cognitive theory [39].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] Riley WT, Martin CA, Rivera DE, et al. The development of a control systems model of social cognitive theory. Translat Behav Med. 2016.

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Good external validity requires variations in who uses an intervention, how the intervention might be operationalized, the outcomes targeted, and the settings in which the intervention is used.

    “As this example illustrates, good external validity requires variations in who uses an intervention, how the intervention might be operationalized, the outcomes the intervention is being targeted to influence, and the settings in which the intervention is used.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [28] Shadish WR, Cook TD, Campbell DT. Experimental and quasi-experimental designs for generalized causal inference. Wadsworth Cengage learning; 2002.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    Algorithms for supporting decisions about matching interventions and modules with specific individuals in context are a valuable target product and could be useful for curation.

    “(3) algorithms for supporting decisions about matching interventions and modules with specific individuals in context is a second valuable target product and could be useful for curation.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Greater value should be placed on concrete operations, even if they have not been empirically validated.

    “Greater value should be placed on concrete operations, even if they have not been empirically validated because:”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Model predictive control, recommender systems, agent-based modeling, or Bayesian network analysis are plausible personalization algorithm strategies.

    “Model predictive control [40–43], recommender systems [44], agent-based modeling [45], or Bayesian network analysis [46] are all plausible personalization algorithm strategies.”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [40] Dong Y, Rivera DE, Downs DS, et al. Hybrid model predictive control for optimizing gestational weight gain behavioral interventions. American Control Conference (ACC). 2013; 1970–1975. source

      Not checked in the free run.

    • cites [41] Nandola NN, Rivera DE. An improved formulation of hybrid model predictive control with application to production-inventory systems. IEEE Trans Control Syst Technol. 2013; 1: 121–135. source

      Not checked in the free run.

    • cites [42] Deshpande S, Rivera DE, Younger JW, Nandola NN. A control systems engineering approach for adaptive behavioral interventions: illustration with a fibromyalgia intervention. Translat Behav Med. 2014; 4: 275–289. Errratum in 274(273), p439. source

      Not checked in the free run.

    • cites [43] Martin CA, Rivera DE, Hekler EB. A decision framework for an adaptive behavioral intervention for physical activity using hybrid model predictive control. American Control Conference (ACC). 2016. source

      Not checked in the free run.

    • cites [44] Resnick P, Varian HR. Recommender systems. Commun ACM. 1997; 40: 56–58. source

      Not checked in the free run.

    • cites [45] Gilbert N. Agent-based models. Sage; 2008. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisereasoning

    The Dropbox founders tested their assumption about demand for a file-syncing service with a video rather than building the technology, demonstrating a resource-efficient feasibility test.

    “For example, the founders of Dropbox made the assumption that there would be demand for a service that makes it easy to sync and share files. To test this assumption, they could have built the technology but that would have required considerable resources. Instead, they tested their assumption with a video (http://techcrunch.com/2011/10/19/dropbox-minimal-viable-product/). The video was a test on”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    The micro-randomized trial can be used to test proximal main effects of components over time, time-varying moderation, and, with variations in study design based on system identification, the development of idiographic computational models.

    “It can be used to test proximal main effects of components over time, time-varying moderation [16], and with variations in study design based on strategies from system identification, the development of idiographic computational models [17, 18].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [16] Klasnja P, Hekler EB, Shiffman S, et al. Micro-randomized trials: an experimental design for developing just-in-time adaptive interventions. Health Psychol. 2016. source

      Not checked in the free run.

    • cites [17] Martin CA, Desphande S, Hekler EB, Rivera DE. A system identification approach for improving behavioral interventions based on social cognitive theory. American Control Conference (ACC). 2015; 5878–5883. doi: 10.1109/ACC.2015.7172261 . source

      Not checked in the free run.

    • cites [18] Martin CA, Rivera DE, Hekler EB. An identification test monitoring procedure for MIMO systems based on statistical uncertainty estimation. IEEE Conference on Decision and Control (CDC); 2015. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    Within the behavioral sciences, reliable effect size estimates for constructs are more important to support evidence-based decisions.

    “Within the behavioral sciences, reliable effect size estimates for constructs are more important to support evidence-based decisions [1].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] Kelly M, Morgan A, Ellis S, et al. Evidence based public health: a review of the experience of the National Institute of Health and Clinical Excellence (NICE) of developing public health guidance in England. Soc Sci Med. 2010; 71: 1056–1062. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationnone given

    While complex interventions might be desired in practice, modules of complex interventions are plausibly more valuable for science.

    “(2) while complex interventions might be desired in practice, modules of complex interventions are plausibly more valuable for science;”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Formative work methods (human-centered design, community-based participatory research, review of previous knowledge) are critical for a wide range of evidence-based practice recommendations related to the research enterprise.

    “These methods are acknowledged as critical for a wide range of evidence-based practice recommendations related to the research enterprise [5].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Craig P, Dieppe P, Macintyre S, et al. Developing and evaluating complex interventions: the new medical research council guidance. Int J Nurs Stud. 2013; 50: 587–592. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given

    HCI processes conform to the generate phase and behavioral science processes roughly conform to the evaluate phase, with overlap.

    “we see these two as complementary with, roughly, HCI processes conforming to the generate phase and behavioral science processes roughly conforming to the evaluate phase, though obviously there is overlap.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisereasoning

    An advantage of software module structure is that the module is built to be self-contained and thus repurposable for any use case with the requisite inputs and desired output.

    “It is essential to note that while modules are often built initially for a specific use case, an advantage of software module structure is that the module is built to be self-contained and thus repurposable for any use case with the requisite inputs (e.g., personal identification information, permission) and desires the requisite output (e.g., a secure bridge to share data across systems).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    As something is learned with one action, that information is fed into the others until contender operations and constructs emerge that show promise for being useful in the real-world.

    “As something is learned with one action, that information is fed into the others until contender operations and constructs emerge that show promise for being useful in the real-world.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Extreme programming (XP) emphasizes well-specified modules that are shared early-and-often with relevant stakeholders when building complex multi-component systems.

    “For example, extreme programming (XP), which is one agile method [23], emphasizes well-specified modules that are shared early-and-often with relevant stakeholders when building complex multi-component systems.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Abrahamsson P, Warsta J, Siponen MT, Ronkainen J. New directions on agile methods: a comparative analysis. Proceedings of the International Conference on Software Engineering, 2003.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Operations are highly valuable for better specifying constructs.

    “(1) operations are highly valuable for better specifying constructs;”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Modules, computational models, and personalization algorithms provide the evidence-based "building blocks" for generating practice recommendations for combining modules into complex interventions for unique use cases.

    “Modules, computational models, and personalization algorithms provide the evidence-based “building blocks” for generating practice recommendations for combining modules into complex interventions for unique use cases.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationreasoning

    This is easier with software but can be difficult with other modalities.

    “This is easier with software but can be difficult with other modalities.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Early-and-often sharing could very likely improve the scientific community's ability to create efficient accumulation of knowledge about behavior change.

    “That said, it could very likely improve the scientific community’s ability to create efficient accumulation of knowledge about behavior change.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationreasoning

    Sharing contender operations and constructs and also failed tests of these contenders from early work has great value for supporting better construct specification, improved efficiency in the scientific process, supporting earlier tests of feasibility, and could plausibly support better collection of data related to external validity and, by extension, support recommender systems for personal化tion

    “Further, sharing contender operations and constructs and also failed tests of these contenders from early work has great value for supporting better construct specification, improved efficiency in the scientific process, supporting earlier tests of feasibility, and could plausibly support better collection of data related to external validity and, by extension, support recommender systems for”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

    Premisecitation

    Other recommendations suggest a clear distinction between testing feasibility of the operations versus research methods.

    “Other recommendations suggest a clear distinction between testing feasibility of the operations versus research methods [54].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] Arain M, Campbell MJ, Cooper CL, Lancaster GA. What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Med Res Methodol. 2010; 10: 67. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Sequential n-of-1 trials could serve as a more efficient feasibility testing method by allowing for intervention adjustments after each series of trials.

    “For example, sequential n-of-1 trials could serve as a more efficient feasibility testing method by allowing for intervention adjustments after each series of trials [55].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [55] Dallery J, Raiff BR. Optimizing behavioral health interventions with single-case designs: from development to dissemination. Translat Behav Med. 2014; 4: 1–14. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    We see at least three use cases for RCTs of complex interventions: quality assurance, A/B style test, and trials of principles.

    “We see at least three use cases: (1) quality assurance of a complex intervention that will be released “as is” to a large population; (2) as an “A/B” style test that is often used in the tech industry; and (3) as used in the “trials of principles” [51].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [51] Mohr DC, Schueller SM, Riley WT, et al. Trials of intervention principles: evaluation methods for evolving behavioral intervention technologies. J Med Internet Res. 2015; 17. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Bond et al. conducted a 61 million person A/B-style experiment on Facebook to explore how message framing might influence voting behavior.

    “For example, Bond et al. conducted a 61 million person A/B-style experiment on Facebook to explore how message framing might influence voting behavior [52].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [52] Bond RM, Fariss CJ, Jones JJ, et al. A 61-million-person experiment in social influence and political mobilization. Nature. 2012; 489: 295–298. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    There are important cognitive biases that likely come into play that need to be better acknowledged in the generate phase.

    “With regard to idea generation and vetting, there are important cognitive biases that likely come into play that need to be better acknowledged in the generate phase.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisenone given

    The two versions in A/B testing represent different hypotheses on how the system might function and are often only subtly different.

    “The two versions represent different hypotheses on how the system might function and are often only subtly different.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    It is quite plausible that the current reward system for academics, particularly the currency (i.e., publications and grants), may be resulting in the unintended consequence of incentivizing the creation of only minimally useful products for real-world use.

    “As suggested by Ioannidis, it is quite plausible that the current reward system for academics, particularly the currency (i.e., publications and grants), may be resulting in the unintended consequence of incentivizing the creation of only minimally useful products for real-world use.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [60] Ioannidis JP. How to make more published research true. PLoS Med/ Public Libr Sci. 2014; 11, e1001747.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    Behavior change modules, computational models, and personalization algorithms are the building blocks for creating complex interventions and thus are logical scientific targets.

    “In particular, behavior change modules, computational models, and personalization algorithms are the building blocks for creating complex interventions and thus are logical scientific targets.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A sister project headed by coauthor Klasnja is focused on developing modules that support physical activity maintenance.

    “A sister project headed by coauthor Klasnja, is focused on developing modules that support physical activity maintenance [16].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Klasnja P, Hekler EB, Shiffman S, et al. Micro-randomized trials: an experimental design for developing just-in-time adaptive interventions. Health Psychol. 2016. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Micro-randomization trials are very efficient and thus could also be used after more classic n-of-1 trials have provided enough confidence to warrant investment in the design of one.

    “From a human-participants perspective, micro-randomization trials are very efficient and thus could also be used after more classic n-of-1 trials have provided enough confidence to warrant investment in the design of one [16].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Klasnja P, Hekler EB, Shiffman S, et al. Micro-randomized trials: an experimental design for developing just-in-time adaptive interventions. Health Psychol. 2016. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The four-phase model ignores variations of units, treatments, outcomes, and settings until the end of the process, but it is highly feasible that when, where, for whom, and in what state of the individual can all moderate when an intervention will produce an effect.

    “As such, the four-phase model ignores variations of units, treatments, outcomes, and settings until the end of the process but it is highly feasible that when, where, for whom, and in what state of the individual can all moderate when an intervention will produce an effect [9].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Rothman AJ. Exploring connections between moderators and mediators: commentary on subgroup analyses in intervention research. Prev Sci. 2013; 14: 189–192. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The major limitations are intervention specification to support replication, which is ideal for all sciences and effective curation as already pointed out by others.

    “The major limitations are intervention specification to support replication, which is ideal for all sciences and effective curation as already pointed out by others [20].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Chorpita BF, Rotheram-Borus MJ, Daleiden EL, et al. The old solutions are the new problem how do we better use what we already know about reducing the burden of mental illness? Perspect Psychol Sci. 2011; 6: 493–497. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationnone given

    As with any scientific process, the essential requirement is replication with sound definitions, robust versioning control, and a process of rapidly sharing and curating that information.

    “As with any scientific process, the essential requirement is replication with sound definitions, robust versioning control, and a process of rapidly sharing and curating that information.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The A/B test is more akin to the optimization methods discussed earlier.

    “As such, it is more akin to the optimization methods discussed earlier.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the digital technology industry, there is a common practice of comparing different versions (often two, hence A/B) of a given system.

    “In the digital technology industry, there is a common practice of comparing different versions (often two, hence A/B) of a given system.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] Hekler EB, Klasnja P, Froehlich JE, Buman MP. Mind the theoretical gap: interpreting, using, and developing behavioral theory in HCI research. Proceedings of SIGCHI Conference on Human Factors in Computing Systems (CHI’13). 2013; 3307–3316. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    The trial of principles fits well with agile science within the evaluate phase.

    “As such, it fits well with agile science within the evaluate phase.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationnone given

    RCTs of complex interventions are the most logical method for establishing that a specific complex intervention will work for a specific target population.

    “RCTs of complex interventions are the most logical method for establishing that a specific complex intervention will work for a specific target population.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    The stay the course observation is similar to the sunk cost bias, which suggests an individual will pursue a less desirable option even if a more desirable option becomes available because of the resources already invested.

    “This stay the course observation is similar to the sunk cost bias [59], which is a well-known cognitive bias that suggests an individual will pursue a less desirable option even if a more desirable option becomes available because of the resources already invested.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [59] Arkes HR, Ayton P. The sunk cost and Concorde effects: are humans less rational than lower animals? Psychol Bull. 1999; 125: 591. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    More rapid and parallel development could support both better defining of a construct and minimize the impact of the sunk cost bias, thus further reinforcing the value of early-and-often sharing and developing multiple operations.

    “More rapid and parallel development could support both better defining of a construct and minimize the impact of the sunk cost bias, thus further reinforcing the value of early-and-often sharing and developing multiple operations.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    In behavioral intervention technologies, it is common for software to change over time but the general principle (e.g., using goal setting as a technique) does not.

    “The third use case for RCTs is the trials of principles, which emphasizes that in behavioral intervention technologies, it is common for a software to change over time but the general principle (e.g., using goal setting as a technique) does not.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [51] Mohr DC, Schueller SM, Riley WT, et al. Trials of intervention principles: evaluation methods for evolving behavioral intervention technologies. J Med Internet Res. 2015; 17. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Careful use of priors within studies of novel systems can be used to help mitigate problems with magnitude effect errors and thus could be a more appropriate statistical method for the generate phase.

    “As demonstrated elsewhere, careful use of priors within studies of novel systems can be used to help mitigate problems with magnitude effect errors and thus could be a more appropriate statistical method for the generate phase [47].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [47] Kaye M, Nelson GL, Hekler EB. Researcher-centered design of statistics: why Bayesian statistics better fit the culture and incentives of HCI. Proceedings of SIGCHI Conference on Human Factors in Computing Systems (CHI’16). San Jose, CA: ACM; 2016. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous work suggests early studies often test feasibility of methods (e.g., recruitment, randomization, retention, and assessment), not hypotheses.

    “Previous work suggests early studies often test feasibility of methods (e.g., recruitment, randomization, retention, and assessment), not hypotheses [48].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [48] Leon AC, Davis LL, Kraemer HC. The role and interpretation of pilot studies in clinical research. J Psychiatr Res. 2011; 45: 626–629. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Individuals randomized to work on multiple ideas at once (parallel group) had greater openness to incorporating feedback and also produced better end products compared to the single iterative concept group.

    “Results found that individuals randomized to work on multiple ideas at once (i.e., parallel group) had greater openness to incorporating feedback and also produced better end products compared to the single iterative concept group.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [58] Dow SP, Klemmer SR. The efficacy of prototyping under time constraints. Design Thinking. Springer; 2011:111–128. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Dow and colleagues showed the possibility of developing better results through iteration, and a subsequent study examined the differences between parallel and iterative development versus serial and iterative development.

    “For example, Dow and colleagues showed the possibility of developing better results through iteration [57] and a subsequent study examined the differences between parallel and iterative development versus serial and iterative development [58].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [57] Dow SP, Glassco A, Kass J, et al. Parallel prototyping leads to better design results, more divergence, and increased self-efficacy. Transactions of Computer-Human Interactions (ToCHI). 2010; 17: 18.

      Not checked in the free run.

    • cites [58] Dow SP, Klemmer SR. The efficacy of prototyping under time constraints. Design Thinking. Springer; 2011:111–128. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    It is quite plausible that the same agile science process can work for other intervention modalities (e.g., face-to-face, group) and other types of complex problems (e.g., precision medications, public policy initiatives).

    “We believe it is quite plausible that the same process can work for other intervention modalities (e.g., face-to-face, group) and other types of complex problems (e.g., precision medications, public policy initiatives).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    The A/B test uses the logic of an RCT but is focused on small differences.

    “As this example illustrates, the A/B test uses the logic of an RCT but is focused on small differences.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisereasoning

    The incredible array of software developed modularly (e.g., Apache) provides evidence for the modular approach to behavior change.

    “The incredible array of software developed modularly (e.g., Apache, arguably the foundation of the Internet) provides evidence for this approach, but there are also epistemological reasons.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    Focusing on modules, building in context, and updating fit embraces these variations and can be codified in computational models and personalization algorithms.

    “Focusing on modules, building in context, and updating fit embraces these variations and can be codified in computational models and personalization algorithms.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Premisecitation

    A Bayesian approach might be more appropriate than Fisherian statistics as the Fisher approach is not appropriate with limited data.

    “In terms of statistics, a Bayesian approach might be more appropriate than Fisherian statistics [56] as the Fisher approach is not appropriate with limited data [48].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [56] Dienes Z. Bayesian versus orthodox statistics: which side are you on? Perspect Psychol Sci. 2011; 6: 274–290. source

      Not checked in the free run.

    • cites [48] Leon AC, Davis LL, Kraemer HC. The role and interpretation of pilot studies in clinical research. J Psychiatr Res. 2011; 45: 626–629. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    These research streams were largely the inspiration for v0.1 of the agile science process and thus are informative to help make the potential of agile science more concrete.

    “These research streams were largely the inspiration for v0.1 of the agile science process and thus are informative to help make the potential of agile science more concrete.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisenone given

    In a trial of principles, heterogeneity between conditions is minimized with careful comparator selection and the method does not ignore technology changes.

    “In a trial of principles, heterogeneity between conditions is minimized with careful comparator selection and the method does not ignore technology changes.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Individuals in the single concept group were less open to feedback and instead often "stayed the course."

    “Individuals in the single concept group were less open to feedback and instead often “stayed the course.””
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [58] Dow SP, Klemmer SR. The efficacy of prototyping under time constraints. Design Thinking. Springer; 2011:111–128. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given

    Early-and-often sharing is not well incentivized in the current research enterprise, particularly the products from the generate phase.

    “For example, early-and-often sharing is not well incentivized in the current research enterprise, particularly the products from the generate phase.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    In this paper, we established three products: modules, computational models, and personalization algorithms, as logical targets for supporting more effective and efficient knowledge accumulation for evidence-based practice.

    “In this paper, we established three products: modules, computational models, and personalization algorithms, as logical targets for supporting more effective and efficient knowledge accumulation for evidence-based practice.”
    Quote in the paperNot a substantial claim
80 of 80
  • The paper relies on this without support.

    Many behavior change operations, particularly interventions, are currently treated as the “secret sauce” of research and only shared after years of evaluation.

    “At present, many of our operations, particularly our interventions, are often treated as the “secret sauce” of our research and only shared after years of evaluation.”
  • The paper relies on this without support.

    A single research group often conducts the evaluation of a behavior change intervention.

    “As a single research group often does the evaluation, this results in limited variability related to populations, treatments, outcomes, and settings, thus providing limited data for external validity claims.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Agile science states that eHealth development should be iterative and flexible, with short sprints to allow for constant changes to the process and products.

    “This is in line with agile science, which states that eHealth development should be iterative and flexible, with short sprints to allow for constant changes to the process and products [14,183].”
  • A technology can be designed for multiple target groups and, depending on the individual user goals and the desired outcomes, technology can be used in many different ways in terms of the features that are used, as well as the frequency, time, and place of use.

    “However, a technology can be designed for multiple target groups and, depending on the individual user goals and the desired outcomes, technology can be used in many different ways in terms of the features that are used, as well as the frequency, time, and place of use [13,14].”
  • RCTs cannot provide insight into process outcomes or how use of different components of eHealth technology contributed to healthier living, improved well-being, or daily tasks.

    “Therefore, no insight can be obtained on process outcomes or how the use of the different components of the technology has contributed to healthier living, improved well-being, or a user’s ability to conduct daily tasks [7,9,10].”
  • eHealth research has limited insight into process outcomes or how technology use contributes to healthier living, improved well-being, or daily tasks.

    “In electronic health (eHealth) research, limited insight has been obtained on process outcomes or how the use of technology has contributed to the users’ ability to have a healthier life, improved well-being, or activate new attitudes in their daily tasks.”
  • eHealth technologies often consist of multiple components that may interact in reaching a certain effect and that people can use in many different ways.

    “Furthermore, to conform to the complexity of behavior change, eHealth technologies often consist of multiple components that may interact in reaching a certain effect and that people can use in many different ways in terms of the elements they use as well as the frequency, time, and place of use [7,8].”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Figure 2 caption points to itself instead of Figure 1

    Minor

    The caption describes Figure 2 as a controller that uses the computational model in Figure 2, but the paper identifies Figure 1 as the computational model and Figure 2 as the controller.

  • Figure 1 attribution does not match reference 38

    Minor

    The Figure 1 caption names Martin, Deshpande, Hekler, and Rivera as the authors of reference 38, but reference 38 lists Martin, Rivera, and Riley as its first three authors.

2 of 2

Cites

Flagged first, then by citations

2 of the 64 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Hovell MF, Wahlgren DR, Adams MA. The logical and empirical basis for the behavioral ecological model. In: DiClemente RJ, Crosby RA, Kegler M, eds. Emerging theories and models in health promotion research and practice: Strategies for enhancing public health. San Francisco, CA: Jossey-Bass Publishers; 2009: 415–450.
  2. Rogers Y, Sharp H, Preece J. Interaction design: beyond human-computer interaction. 3rd ed. West Sussex: Wiley; 2012.
  3. National Research Council. Toward precision medicine: building a knowledge network for biomedical research and a new taxonomy of disease. US: National Academies Press; 2011.

Cited by

Sorted by citations

Authors
Hekler, E. B., Klasnja, P., Riley, W. T., Buman, M. P., Huberty, J., Rivera, D. E., & Martin, C. A.
Affiliations
  • Arizona State University (US)
  • University of Michigan (US)
  • National Institutes of Health (US)
Corresponding author
  • Hekler, Eric B.
  • Klasnja, Predrag
  • Riley, William T.
  • Buman, Matthew P.
  • Huberty, Jennifer
  • Rivera, Daniel E.
Venue
Translational Behavioral Medicine
Published
2016-02-26
Volume
6
Issue
2
Pages
317-328
ISSN
  • 1613-9860 (ISSN-L)
  • 1869-6716
OpenAlex
W2293484899
Cited by
208
References
64
Citations by year
2026: 8 · 2025: 13 · 2024: 15 · 2023: 15 · 2022: 24 · 2021: 30 · 2020: 18 · 2019: 28 · 2018: 30 · 2017: 22 · 2016: 3 · 2015: 1
FWCI
42.50
Type
journal article
Language
en
Open access
Locations
  • Translational Behavioral Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • Robert Wood Jonson Foundation (71995)
  • Division of Information and Intelligent Systems (US) (1449751)
  • National Heart, Lung, and Blood Institute (US) (R01HL125440)
Topics
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
Keywords
behaviour change interventions, evidence-based practice, real-world implementation, intervention module, computational model, personalization algorithms, intervention adaptation, knowledge base curation, operational definitions
MeSH terms
Algorithms, Computer Simulation, Humans, Software, Health Behavior, Evidence-Based Medicine, Evidence-Based Practice

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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