{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:08:46Z","timestamp":1790024926603,"version":"4.0.1"},"reference-count":67,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Digital interventions provide a scalable approach to promote healthy lifestyles, but at-scale evidence of their effects and effect modifiers is limited\u2014even scarcer for habit-based digital interventions, although habits are promising lifestyle intervention targets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We conducted a 1-group pre-post effect and effect modification assessment of a web-based app designed to support the formation of health-promoting lifestyle habits by exploring the relationship between objective app use and subjective changes in behavioral outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Three-month app access was offered to a subsample of the population-based Healthy Finland survey participants aged 20-74 years via SMS text messaging or mail. The app provided personalized behavioral suggestions that translated evidence-based lifestyle guidelines into simple, repeatable actions (\u201chabits\u201d). Users could browse and select these habits, and report and monitor their performances. The assessment used app log data, questionnaires collected through the app at baseline and at 45 and 90 days, and background information obtained from the national population register and the Healthy Finland Survey. Linear mixed effects models explored the (1) associations between app use and changes in self-reported diet quality (Healthy Diet Index), physical activity (metabolic equivalent of task hours per week), and BMI, and (2) modification of these associations by baseline characteristics related to sociodemographics, health, lifestyle, and e-service use. App use measures comprised the percentage of app use days (ie, days with logins\/days of follow-up\u00d7100) and the number of reported habit performances (total, diet-related, physical activity\u2013related, and BMI-related).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 6975 invitees, 1282 (18.4%) accepted the invitation and 382 (5.5%; mean age 51, SD 15 y; women:  %) completed the data collection required for the assessment. Over 90 days, the median percentage of app use days was 5.9% (IQR 3.3%\u201011%), and the total number of reported habit performances was 22 (IQR 3\u201068.5). A higher percentage of use days (by 10 percentage points) was associated with a 3.09 (95% CI 0.79\u20105.39) metabolic equivalent of task hours per week greater increase in physical activity and a 1-unit higher logarithmic number of reported performances with a 0.51 (95% CI 0.07\u20100.95) Healthy Diet Index point greater improvement in diet quality. Other associations between app use and outcomes were nonsignificant. Greater physical activity and a more positive attitude to e-services at baseline appeared to enhance the effect of app use on physical activity (\n                      <jats:italic>P<\/jats:italic>\n                      values &lt;.05). The app received a median acceptability rating of 2.9 (IQR 2.4\u20103.3, scale: 1\u20104) and a median overall score of 7 (IQR 5\u20108, scale: 0\u201010).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An inexpensive, low-intensity digital support for healthy habits could foster small beneficial lifestyle changes, but effects require user engagement and may depend on the individual. The findings warrant confirmation in more robust study designs and call for further research for identifying those most likely to benefit from such digital support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/84076","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T01:25:08Z","timestamp":1783992308000},"page":"e84076-e84076","source":"Crossref","is-referenced-by-count":0,"title":["The Usage Effects, Effect Modifiers, and Experiences of a Web-Based App for Healthy Habit Formation in Adults: Exploratory Analysis of a Quasi-Experimental Real-World Intervention"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8512-6638","authenticated-orcid":false,"given":"Eeva","family":"Rantala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4132-7065","authenticated-orcid":false,"given":"Mikko","family":"Valtanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4681-4486","authenticated-orcid":false,"given":"Adil","family":"Umer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5767-6915","authenticated-orcid":false,"given":"Suvi","family":"Parikka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6241-6859","authenticated-orcid":false,"given":"Jussi","family":"Pihlajam\u00e4ki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9493-0070","authenticated-orcid":false,"given":"Ilona","family":"Ruotsalainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9255-020X","authenticated-orcid":false,"given":"Jaana","family":"Lindstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2024.108174","article-title":"The impact of a lifestyle behaviour change program on healthcare costs: quasi-experimental real-world evidence from an open-access mobile health app in the Netherlands","volume":"189","author":"Agachi","journal-title":"Prev Med"},{"issue":"10","key":"R2","doi-asserted-by":"publisher","first-page":"4522","DOI":"10.1111\/dom.15807","article-title":"Cost-effectiveness analysis of a digital diabetes-prevention programme versus an in-person diabetes-prevention programme in people with prediabetes in the United States","volume":"26","author":"Park","journal-title":"Diabetes Obes Metab"},{"issue":"5","key":"R3","doi-asserted-by":"publisher","DOI":"10.2196\/19688","article-title":"Effectiveness of digital interventions for reducing behavioral risks of cardiovascular disease in nonclinical adult populations: systematic review of reviews","volume":"23","author":"Gold","journal-title":"J Med Internet Res"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-024-01172-y","article-title":"A systematic umbrella review and meta-meta-analysis of eHealth and mHealth interventions for improving lifestyle behaviours","volume":"7","author":"Singh","journal-title":"NPJ Digit Med"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-023-01439-9","article-title":"Digital behaviour change interventions to increase vegetable intake in adults: a systematic review","volume":"20","author":"Livingstone","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"12","key":"R6","doi-asserted-by":"publisher","DOI":"10.2196\/23513","article-title":"The long-term effectiveness of internet-based interventions on multiple health risk behaviors: systematic review and robust variance estimation meta-analysis","volume":"23","author":"Tzelepis","journal-title":"J Med Internet Res"},{"issue":"4","key":"R7","doi-asserted-by":"publisher","DOI":"10.2196\/26699","article-title":"Long-term effectiveness of mHealth physical activity interventions: systematic review and meta-analysis of randomized controlled trials","volume":"23","author":"M\u00f6nninghoff","journal-title":"J Med Internet Res"},{"issue":"5","key":"R8","doi-asserted-by":"publisher","DOI":"10.2196\/15649","article-title":"Effectiveness of eHealth nutritional interventions for middle-aged and older adults: systematic review and meta-analysis","volume":"23","author":"Robert","journal-title":"J Med Internet Res"},{"issue":"4","key":"R9","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1111\/sms.13903","article-title":"Effect of eHealth to increase physical activity in healthy adults over 55 years: a systematic review and meta\u2010analysis","volume":"31","author":"N\u00fa\u00f1ez de Arenas\u2010Arroyo","journal-title":"Scandinavian Med Sci Sports"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.2196\/58174","article-title":"Assessing the effectiveness of eHealth interventions to manage multiple lifestyle risk behaviors among older adults: systematic review and meta-analysis","volume":"26","author":"Shi","journal-title":"J Med Internet Res"},{"key":"R11","doi-asserted-by":"crossref","unstructured":"Orbell S Verplanken B . Changing behavior using habit theory. In: Hagger MS Cameron LD Hamilton K Hankonen N Lintunen T , editors. The Handbook of Behavior Change. 1st ed. Cambridge University Press; 2020:178-192. [doi: 10.1017\/9781108677318.013]","DOI":"10.1017\/9781108677318.013"},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Gardner B Rebar AL Lally P . Habit interventions. In: Hagger MS Cameron LD Hamilton K Hankonen N Lintunen T , editors. The Handbook of Behavior Change. 1st ed. Cambridge University Press; 2020:599-616. [doi: 10.1017\/9781108677318.041]","DOI":"10.1017\/9781108677318.041"},{"key":"R13","doi-asserted-by":"crossref","unstructured":"Gardner B Rebar AL . Habit Formation and Behavior Change. Oxford Research Encyclopedia of Psychology. Oxford University Press; 2019. [doi: 10.1093\/acrefore\/9780190236557.013.129]","DOI":"10.1093\/acrefore\/9780190236557.013.129"},{"issue":"6","key":"R14","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1038\/s44159-024-00305-0","article-title":"Determinants of behaviour and their efficacy as targets of behavioural change interventions","volume":"3","author":"Albarrac\u00edn","journal-title":"Nat Rev Psychol"},{"issue":"4","key":"R15","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1007\/s10865-019-00100-w","article-title":"Efficacy of habit-based weight loss interventions: a systematic review and meta-analysis","volume":"43","author":"Cleo","journal-title":"J Behav Med"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","DOI":"10.1111\/aphw.12605","article-title":"HabitWalk: a micro\u2010randomized trial to understand and promote habit formation in physical activity","volume":"17","author":"Baretta","journal-title":"Applied Psych Health Well"},{"issue":"5","key":"R17","doi-asserted-by":"publisher","DOI":"10.2196\/12326","article-title":"Development of the Top Tips habit-based weight loss app and preliminary indications of its usage, effectiveness, and acceptability: mixed-methods pilot study","volume":"7","author":"Kliemann","journal-title":"JMIR Mhealth Uhealth"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2022.100527","article-title":"Real-world effectiveness of digital and group-based lifestyle interventions as compared with usual care to reduce type 2 diabetes risk - a stop diabetes pragmatic randomised trial","volume":"24","author":"Lakka","journal-title":"Lancet Reg Health Eur"},{"issue":"3","key":"R19","doi-asserted-by":"publisher","DOI":"10.2196\/15219","article-title":"Internet-based lifestyle intervention to prevent type 2 diabetes through healthy habits: design and 6-month usage results of randomized controlled trial","volume":"5","author":"Harjumaa","journal-title":"JMIR Diabetes"},{"issue":"2","key":"R20","doi-asserted-by":"publisher","DOI":"10.2196\/31530","article-title":"Digitally supported lifestyle intervention to prevent type 2 diabetes through healthy habits: secondary analysis of long-term user engagement trajectories in a randomized controlled trial","volume":"24","author":"Lavikainen","journal-title":"J Med Internet Res"},{"issue":"2","key":"R21","doi-asserted-by":"publisher","DOI":"10.2196\/13324","article-title":"Young adults\u2019 engagement with a self-monitoring app for vegetable intake and the impact of social media and gamification: feasibility study","volume":"3","author":"Nour","journal-title":"JMIR Form Res"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.2196\/68982","article-title":"User archetypes of a well-being-promoting mobile app among adults: cross-sectional study and cluster analysis of usage patterns","volume":"13","author":"Rekola","journal-title":"JMIR Mhealth Uhealth"},{"issue":"5","key":"R23","doi-asserted-by":"publisher","DOI":"10.2196\/35371","article-title":"Factors influencing adherence to mHealth apps for prevention or management of noncommunicable diseases: systematic review","volume":"24","author":"Jakob","journal-title":"J Med Internet Res"},{"issue":"5","key":"R24","doi-asserted-by":"publisher","DOI":"10.2196\/17572","article-title":"Influences on the uptake of and engagement with health and well-being smartphone apps: systematic review","volume":"22","author":"Szinay","journal-title":"J Med Internet Res"},{"issue":"3","key":"R25","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13542","article-title":"Is the uptake, engagement, and effectiveness of exclusively mobile interventions for the promotion of weight-related behaviors equal for all? A systematic review","volume":"24","author":"Szinay","journal-title":"Obes Rev"},{"issue":"10","key":"R26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040296","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"4","author":"von Elm","journal-title":"PLoS Med"},{"issue":"10","key":"R27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040297","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration","volume":"4","author":"Vandenbroucke","journal-title":"PLoS Med"},{"issue":"1","key":"R28","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyae166","article-title":"Cohort profile: healthy Finland survey","volume":"54","author":"S\u00e4\u00e4ksj\u00e4rvi","journal-title":"Int J Epidemiol"},{"key":"R29","doi-asserted-by":"crossref","unstructured":"Ruotsalainen I Valtanen M K\u00e4rs\u00e4m\u00e4 R et al. Influencing factors in digital health intervention uptake: the interplay of education, lifestyle, and digital literacy. In: S\u00e4rest\u00f6niemi M Keikhosrokiani P Singh D Harjula E Tiulpin A Jansson M Isomursu M Gils M Saarakkala S Reponen J , editors. Digital Health and Wireless Solutions. Springer Nature Switzerland; 2024:322-332. [doi: 10.1007\/978-3-031-59091-7_21]","DOI":"10.1007\/978-3-031-59091-7_21"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.2196\/63896","article-title":"Unraveling the factors associated with digital health intervention uptake: cross-sectional study","volume":"13","author":"Ruotsalainen","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"R31","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-6574-y","article-title":"Digitally supported program for type 2 diabetes risk identification and risk reduction in real-world setting: protocol for the StopDia model and randomized controlled trial","volume":"19","author":"Pihlajam\u00e4ki","journal-title":"BMC Public Health"},{"key":"R32","doi-asserted-by":"crossref","unstructured":"Fogg BJ Hreha J . Behavior wizard: a method for matching target behaviors with solutions. In: Ploug T Hasle P Oinas-Kukkonen H , editors. Persuasive Technology. Springer; 2010:117-131. [doi: 10.1007\/978-3-642-13226-1_13]","DOI":"10.1007\/978-3-642-13226-1_13"},{"issue":"1","key":"R33","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1177\/237946151600200109","article-title":"Healthy through habit: interventions for initiating & maintaining health behavior change","volume":"2","author":"Wood","journal-title":"Behav Sci Policy"},{"issue":"6","key":"R34","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1002\/ejsp.674","article-title":"How are habits formed: modelling habit formation in the real world","volume":"40","author":"Lally","journal-title":"Euro J Social Psych"},{"key":"R35","doi-asserted-by":"crossref","unstructured":"Ryan RM Deci EL . Basic Psychological Needs in Motivation, Development, and Wellness. The Guilford Press; 2017. ISBN: 978-1-4625-2876-9","DOI":"10.1521\/978.14625\/28806"},{"issue":"1","key":"R36","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1037\/0003-066X.55.1.68","article-title":"Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being","volume":"55","author":"Ryan","journal-title":"Am Psychol"},{"key":"R37","doi-asserted-by":"crossref","unstructured":"Nordic Council of Ministers. Nordic Nutrition Recommendations 2012: Integrating Nutrition and Physical Activity. Nordic Council of Ministers; 2014. [doi: 10.26530\/OAPEN_483279] [Medline: 25246403]","DOI":"10.26530\/OAPEN_483279"},{"key":"R38","unstructured":"The National Nutrition Council of Finland. The Finnish Nutrition Recommendations 2014. The National Nutrition Council of Finland; 2014. ISBN: 978-952-453-801-5"},{"issue":"7","key":"R39","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1249\/MSS.0b013e318213fefb","article-title":"American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise","volume":"43","author":"Garber","journal-title":"Med Sci Sports Exerc"},{"issue":"12","key":"R40","doi-asserted-by":"publisher","first-page":"e147","DOI":"10.2337\/dc10-9990","article-title":"Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement","volume":"33","author":"Colberg","journal-title":"Diabetes Care"},{"issue":"8","key":"R41","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.1249\/mss.0b013e3180616b27","article-title":"Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association","volume":"39","author":"Haskell","journal-title":"Med Sci Sports Exerc"},{"key":"R42","unstructured":"Kyyts\u00f6nen M Aalto AM Vehko T . Social and health care online service use in 2020\u20132021: experiences of the population. Finnish Institute for Health and Welfare (THL); 2021."},{"issue":"6","key":"R43","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1080\/23279095.2021.1970553","article-title":"The Cognitive Function at Work Questionnaire (CFWQ): a new scale for measuring cognitive complaints in occupational population","volume":"30","author":"Heikkinen","journal-title":"Appl Neuropsychol Adult"},{"issue":"2","key":"R44","doi-asserted-by":"publisher","DOI":"10.2196\/23180","article-title":"Associations between digital health intervention engagement, physical activity, and sedentary behavior: systematic review and meta-analysis","volume":"23","author":"Mclaughlin","journal-title":"J Med Internet Res"},{"key":"R45","doi-asserted-by":"crossref","unstructured":"Liedes H Mattila E Honka A et al. Engagement with the bithabit digital lifestyle intervention and changes in type 2 diabetes risk factors: a secondary analysis of a randomized controlled trial (preprint). J Med Internet Res. Preprint posted online on Jun 29, 2023. [doi: 10.2196\/preprints.50361]","DOI":"10.2196\/preprints.50361"},{"issue":"5","key":"R46","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18052362","article-title":"Formation and validation of the Healthy Diet Index (HDI) for evaluation of diet quality in healthcare","volume":"18","author":"Lindstr\u00f6m","journal-title":"Int J Environ Res Public Health"},{"issue":"8","key":"R47","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1002\/clc.4960130809","article-title":"Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity","volume":"13","author":"Jett\u00e9","journal-title":"Clin Cardiol"},{"issue":"7","key":"R48","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0200701","article-title":"Metabolic equivalent of task (METs) thresholds as an indicator of physical activity intensity","volume":"13","author":"Mendes","journal-title":"PLoS One"},{"key":"R49","unstructured":"Weekly physical activity recommendation for 18\u201364-year-olds. UKK Institute. 2019. URL: https:\/\/ukkinstituutti.fi\/en\/products-services\/physical-activity-recommendations\/weekly-physical-activity-recommendation-for-18-64-year-olds\/ [Accessed 17-08-2026]"},{"key":"R50","unstructured":"U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans. 2nd ed. U.S. Department of Health and Human Services; 2018. URL: https:\/\/odphp.health.gov\/our-work\/nutrition-physical-activity\/physical-activity-guidelines\/current-guidelines [Accessed 02-09-2026]"},{"issue":"1","key":"R51","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1038\/oby.2007.504","article-title":"Comparison of self-reported and measured BMI as correlates of disease markers in US adults","volume":"15","author":"McAdams","journal-title":"Obesity (Silver Spring)"},{"issue":"4","key":"R52","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0231229","article-title":"Validation of self-reported height and weight in a large, nationwide cohort of U.S. adults","volume":"15","author":"Hodge","journal-title":"PLoS One"},{"issue":"7","key":"R53","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0279795","article-title":"Self-reported and measured anthropometric variables in association with cardiometabolic markers: a Danish cohort study","volume":"18","author":"Zhang","journal-title":"PLoS ONE"},{"issue":"1","key":"R54","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2031-8","article-title":"Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework","volume":"17","author":"Sekhon","journal-title":"BMC Health Serv Res"},{"issue":"12","key":"R55","first-page":"46","volume":"81","author":"Reichheld","journal-title":"Harv Bus Rev"},{"key":"R56","unstructured":"The r project for statistical computing. R Core Team. 2026. URL: https:\/\/www.R-project.org [Accessed 28-03-2026]"},{"issue":"1","key":"R57","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v067.i01","article-title":"Fitting linear mixed-effects models using lme4","volume":"67","author":"Bates","journal-title":"J Stat Soft"},{"issue":"11","key":"R58","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1037\/hea0000510","article-title":"Effects of circadian cortisol on the development of a health habit","volume":"36","author":"Fournier","journal-title":"Health Psychol"},{"issue":"3","key":"R59","doi-asserted-by":"publisher","first-page":"725","DOI":"10.2337\/diacare.26.3.725","article-title":"The diabetes risk score","volume":"26","author":"Lindstro\u0308m","journal-title":"Diabetes Care"},{"issue":"1","key":"R60","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1136\/qshc.2004.011155","article-title":"Making psychological theory useful for implementing evidence based practice: a consensus approach","volume":"14","author":"Michie","journal-title":"Qual Saf Health Care"},{"key":"R61","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-7-37","article-title":"Validation of the theoretical domains framework for use in behaviour change and implementation research","volume":"7","author":"Cane","journal-title":"Implement Sci"},{"key":"R62","doi-asserted-by":"crossref","unstructured":"Orbell S Zahid H Henderson CJ . Changing behavior using the health belief model and protection motivation theory. In: Hagger MS Cameron LD Hamilton K Hankonen N Lintunen T , editors. The Handbook of Behavior Change. 1st ed. Cambridge University Press; 2020:46-59. [doi: 10.1017\/9781108677318.004]","DOI":"10.1017\/9781108677318.004"},{"key":"R63","doi-asserted-by":"crossref","unstructured":"Schwarzer R Hamilton K . Changing behavior using the health action process approach. In: Hagger MS Cameron LD Hamilton K Hankonen N Lintunen T , editors. The Handbook of Behavior Change. 1st ed. Cambridge University Press; 2020:89-103. [doi: 10.1017\/9781108677318.007]","DOI":"10.1017\/9781108677318.007"},{"key":"R64","doi-asserted-by":"crossref","unstructured":"DiClemente CC Graydon MM . Changing behavior using the transtheoretical model. In: Hagger MS Cameron LD Hamilton K Hankonen N Lintunen T , editors. The Handbook of Behavior Change. 1st ed. Cambridge University Press; 2020:136-149. [doi: 10.1017\/9781108677318.010]","DOI":"10.1017\/9781108677318.010"},{"issue":"1","key":"R65","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/1748-5908-6-42","article-title":"The behaviour change wheel: a new method for characterising and designing behaviour change interventions","volume":"6","author":"Michie","journal-title":"Implementation Sci"},{"issue":"9","key":"R66","doi-asserted-by":"publisher","DOI":"10.3390\/nu13093281","article-title":"Associations between digital health intervention engagement and dietary intake: a systematic review","volume":"13","author":"Delaney","journal-title":"Nutrients"},{"issue":"5","key":"R67","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.amepre.2016.06.015","article-title":"Understanding and promoting effective engagement with digital behavior change interventions","volume":"51","author":"Yardley","journal-title":"Am J Prev Med"}],"container-title":["JMIR mHealth and uHealth"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:42:42Z","timestamp":1790023362000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhealth.jmir.org\/2026\/1\/e84076"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":67,"URL":"https:\/\/doi.org\/10.2196\/84076","relation":{},"ISSN":["2291-5222"],"issn-type":[{"value":"2291-5222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"article-number":"v14i10e84076"}}