Just-in-Time Feedback in Diet and Physical Activity Interventions: Systematic Review and Practical Design Framework

Schembre, Susan M; Liao, Yue; Robertson, Michael C; Dunton, Genevieve Fridlund; Kerr, Jacqueline; Haffey, Meghan E; Burnett, Taylor; Basen-Engquist, Karen; Hicklen, Rachel S

doi:10.2196/jmir.8701

Cited by 154Mobile Health and mHealth ApplicationsInnovative Human-Technology InteractionBehavioral Health and Interventions

Just-in-Time Feedback in Diet and Physical Activity Interventions: Systematic Review and Practical Design Framework

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Schembre, Susan M, Liao, Yue, Robertson, Michael C, Dunton, Genevieve Fridlund, Kerr, Jacqueline, Haffey, Meghan E, Burnett, Taylor, Basen-Engquist, Karen +1 more·2018·Journal of Medical Internet Research

DOI 10.2196/jmir.8701PMC PMC5887039

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Abstract

BACKGROUND: The integration of body-worn sensors with mobile devices presents a tremendous opportunity to improve just-in-time behavioral interventions by enhancing bidirectional communication between investigators and their participants. This approach can be used to deliver supportive feedback at critical moments to optimize the attainment of health behavior goals. OBJECTIVE: The goals of this systematic review were to summarize data on the content characteristics of feedback messaging used in diet and physical activity (PA) interventions and to develop a practical framework for designing just-in-time feedback for behavioral interventions. METHODS: Interventions that included just-in-time feedback on PA, sedentary behavior, or dietary intake were eligible for inclusion. Feedback content and efficacy data were synthesized descriptively. RESULTS: The review included 31 studies (15/31, 48%, targeting PA or sedentary behavior only; 13/31, 42%, targeting diet and PA; and 3/31, 10%, targeting diet only). All studies used just-in-time feedback, 30 (97%, 30/31) used personalized feedback, and 24 (78%, 24/31) used goal-oriented feedback, but only 5 (16%, 5/31) used actionable feedback. Of the 9 studies that tested the efficacy of providing feedback to promote behavior change, 4 reported significant improvements in health behavior. In 3 of these 4 studies, feedback was continuously available, goal-oriented, or actionable. CONCLUSIONS: Feedback that was continuously available, personalized, and actionable relative to a known behavioral objective was prominent in intervention studies with significant behavior change outcomes. Future research should determine whether all or some of these characteristics are needed to optimize the effect of feedback in just-in-time interventions.

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A crucial element in fostering effective health behavior change is the provision of just-in-time feedback.
“A crucial element in fostering effective health behavior change is the provision of ‘just-in-time’ feedback [5].”
From Sequential use of continuous glucose monitoring, with or without exercise trackers, significantly improves glycemic control in patients with type 2 diabetes (2025) · cites this paper as [5]

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Embracing the Future of Medical Education With Large Language Model–Based Virtual Patients: Scoping Review
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Ask the Users
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Using Feedback to Improve Accountability in Global Environmental Health and Engineering
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An Ecological Momentary Assessment Study Investigating Self-efficacy and Outcome Expectancy as Mediators of Affective and Physiological Responses and Exercise Among Endometrial Cancer Survivors
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Within-person examination of the exercise intention-behavior gap among women in midlife with elevated cardiovascular disease risk
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Self-efficacy and Physical Activity in Overweight and Obese Adults Participating in a Worksite Weight Loss Intervention: Multistate Modeling of Wearable Device Data
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Daily Level Association of Physical Activity and Performance on Ecological Momentary Cognitive Tests in Free-living Environments: A Mobile Health Observational Study
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Physiotherapy’s Place in a Rapidly Changing World: A Pan-Canadian Perspective of Threats Facing Practice from the Physio Moves Canada Project, Part 2
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Design and Development of a Digital Weight Management Intervention (ToDAy): Qualitative Study
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A Mobile Health Team Challenge to Promote Stepping and Stair Climbing Activities: Exploratory Feasibility Study
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Multi Agent Architecture for Automated Health Coaching
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Ecological Momentary Assessment of Associations Between Social Interactions and Physical Activity Outcomes Among Women in Midlife With CVD Risk Conditions
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Online and Offline Behavior Change Techniques to Promote a Healthy Lifestyle: A Qualitative Study
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From Steps to Context: Optimizing Digital Phenotyping for Physical Activity Monitoring in Older Adults by Integrating Wearable Data and Ecological Momentary Assessment
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Interpretable Conditional Recurrent Neural Network for Weight Change Prediction: Algorithm Development and Validation Study
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Increasing workplace physical activity through motivational and volitional coaching – a randomized controlled trial with truck drivers
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Notice of Removal October 9, 2026: Social Life Simulation for Non-Cognitive Skills Learning
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IoT-Enabled Digital Nudge Architecture for Sustainable Energy Behavior: An SEM-PLS Approach
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Why Machines Matter for Survey and Social Science Researchers
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Exploring the Use of Persuasive System Design Principles to Enhance Medication Incident Reporting and Learning Systems: Scoping Reviews and Persuasive Design Assessment
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Tailoring coaching conversations with virtual health coaches
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Need for Cognition Among Users of Self-Monitoring Systems for Physical Activity: Survey Study
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Feasibility, Acceptability, and Preliminary Outcomes of a Mobile Adaptation of a Relational Savoring Intervention to Prevent Loneliness in College Students: Mixed Methods Pilot Study
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The Role of Self-Regulation in the Effect of Self-Tracking of Physical Activity and Weight on BMI
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Informing the Physical Activity Evaluation Framework: A Scoping Review of Reviews
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A Pragmatic Approach to Translating Low- and Very Low-Carbohydrate Diets Into Clinical Practice for Patients With Obesity and Type 2 Diabetes
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Like Adding a Small Weight to a Scale About to Tip: Personalizing Micro-Financial Incentives for Digital Wellbeing
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Technological enhancements in personalized dietary management for chronic conditions
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Validity of the PortionSize and MyFitnessPal Smartphone Applications for Estimating Dietary Intake: A Randomized Crossover Clinical Trial
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A Scoping Review of Sensor-Based Capture of Eating and Drinking Occasions That Could Be Used for Enhancing Personalized Nutrition Interventions in Real Time
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Authors: Schembre, S. M., Liao, Y., Robertson, M. C., Dunton, G. F., Kerr, J., Haffey, M. E., Burnett, T., Basen-Engquist, K., & Hicklen, R. S.
Affiliations: The University of Texas MD Anderson Cancer Center (US)
University of Southern California (US)
University of California San Diego (US)
The University of Texas Health Science Center at Houston (US)
Sam Houston State University (US)
Corresponding author: Schembre, Susan M
ORCID: Schembre, Susan M
Liao, Yue
Robertson, Michael C
Dunton, Genevieve Fridlund
Kerr, Jacqueline
Haffey, Meghan E
Burnett, Taylor
Basen-Engquist, Karen
Hicklen, Rachel S
Venue: Journal of Medical Internet Research
Publisher: JMIR Publications Inc.
Published: 2018-03-22
Volume: 20
Issue: 3
Pages: e106
ISSN: 1438-8871 (ISSN-L)
DOI: 10.2196/jmir.8701
PMC: PMC5887039
OpenAlex: W2791241701
Cited by: 154
References: 72
Citations by year: 2026: 15 · 2025: 29 · 2024: 14 · 2023: 7 · 2022: 23 · 2021: 26 · 2020: 23 · 2019: 10 · 2018: 5 · 2017: 1
FWCI: 2.91
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Journal of Medical Internet Research (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Funders: Duncan Family Institute for Cancer Prevention and Risk Assessment
Center for Energy Balance in Cancer Prevention and Survivorship
National Institutes of Health
University of Texas MD Anderson Cancer Center (P30-CA-016672)
National Heart, Lung, and Blood Institute (R01HL119255)
National Cancer Institute (R01CA186700, R21CA215415, P30CA016672, R25CA056452)
Topics: Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Physical Sciences › Computer Science › Human-Computer Interaction › Innovative Human-Technology Interaction
Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Keywords: just-in-time feedback, personalized feedback, actionable feedback, dietary intervention, physical activity interventions, sedentary behavior, wearable sensors, mobile health, health behavior change, continuous feedback
MeSH terms: Behavior Therapy, Diet, Feedback, Female, Humans, Male, Health Behavior, Exercise

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Just-in-Time Feedback in Diet and Physical Activity Interventions: Systematic Review and Practical Design Framework

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