Mobile and tablet apps, ubiquitous and pervasive computing, wearable computing and domotics for health.

Didactic approaches to Relationships and Sex Education (RSE) have been shown to yield limited outcomes when compared to approaches that stimulate peer discussion and debate. Creating effective interventions, which stimulate peer involvement, remains a demanding task and finding a solution that is not only engaging but also pedagogically sound is vital. A case thus exists for exploring how game technology might facilitate more feasible solutions. This paper presents the development approach of a digital game: PR:EPARe (Positive Relationships: Eliminating Coercion and Pressure in Adolescent Relationships), designed by a cross-disciplinary team of UK researchers from Coventry University's Studies in Adolescent Sexual Health (SASH) research group and the Serious Games Institute (SGI). Psychological targets for game content were identified through Intervention Mapping (IM) and the game design process was based on the Four-Dimensional Framework of Learning (4DF) emphasizing the context of deployment, learner profiling and the pedagogical perspective that influence the mode of representation of the learning content. Early efficacy testing of the game solution was validated through a cluster-randomized controlled trial in local schools (n = 505) indicated some positive outcomes in favour of the game-based approach, based on self-reported measures of psycho-social preparedness for avoiding coercion (F [3, 501] = 15.306, p < .001, ηp2 = 0.084). Analysis of observation data suggests that blending this interactive game-based approach with traditional classroom delivery encouraged the teachers and students to engage in communal discussions and debriefing during and after game play. Together, the results demonstrated real benefits for pedagogy-driven game-based approaches to support the delivery of RSE within a classroom setting

Smoking in pregnancy remains a global public health issue due to foetal health risks and potential maternal complications. The aims of this systematic review and meta-analysis were to explore: (1) whether digital interventions for pregnancy smoking cessation are effective, (2) the impact of intervention platform on smoking cessation, (3) the associations between specific Behaviour Change Techniques (BCTs) delivered within interventions and smoking cessation and (4) the association between the total number of BCTs delivered and smoking cessation. Systematic searches of 9 databases resulted in the inclusion of 12 published articles (n = 2970). The primary meta-analysis produced a sample-weighted odds ratio (OR) of 1.44 (95% CI 1.04–2.00, p = .03) in favour of digital interventions compared with comparison groups. Computer-based (OR = 3.06, 95% CI 1.28–7.33) and text-message interventions (OR = 1.59, 95% CI 1.07–2.38) were the most effective digital platform. Moderator analyses revealed seven BCTs associated with smoking cessation: information about antecedents; action planning; problem solving; goal setting (behaviour); review behaviour goals; social support (unspecified); and pros and cons. A meta-regression suggested that interventions using larger numbers of BCTs produced the greatest effects. This paper highlights the potential for digital interventions to improve rates of smoking cessation in pregnancy.

Smokers who attend NHS Stop Smoking Services (SSS) are four times more likely to stop smoking; however, uptake has been in decline. We report the development of an intervention designed to increase uptake of SSS, from a more motivated self-selected sample of smokers. In Phase 1 we collected data to explore the barriers and facilitators to people using SSS. In Phase 2, data from extant literature and Phase 1 were subject to behavioural analysis, as outlined by the Behaviour Change Wheel (BCW) framework. Relevant Behaviour Change Techniques (BCTs) were identified in order to address these, informing the content of the StopApp intervention. In Phase 3 we assessed the acceptability of the StopApp. Smokers and ex-smokers identified a number of barriers to attending SSS, including a lack of knowledge about what happens at SSS (Capability); the belief that SSS is not easy to access (Opportunity); that there would be ’scare tactics’ or ‘nagging’; and not knowing anyone who had been and successfully quit (Motivation). The ‘StopApp’ is in development and will link in with the commissioned SSS booking system. Examples of the content and functionality of the app are outlined. The next phase will involve a full trial to test effectiveness.

Self-efficacy is an important determinant of health behaviour. Digital interventions are a potentially acceptable and cost-effective way of delivering programmes of health behaviour change at scale. Whether behaviour change interventions work to increase self-efficacy in this context is unknown. This systematic review and meta-analysis sought to identify whether automated digital interventions are associated with positive changes in self-efficacy amongst non-clinical populations for five major health behaviours, and which BCTs are associated with that change. A systematic literature search identified 20 studies (n = 5624) that assessed changes in self-efficacy and were included in a random effects meta-analysis. Interventions targeted: healthy eating (k = 4), physical activity (k = 9), sexual behaviour (k = 3), and smoking (k = 4). No interventions targeting alcohol use were identified. Overall, interventions had a small, positive effect on self-efficacy ( $\overline{g}$ 0.190, CI [0.078; 0.303]). The effect of interventions on self-efficacy did not differ as a function of health behaviour type (Q-between = 7.3704 p = 0.061, df = 3). Inclusion of the BCT ‘information about social and environmental consequences’ had a small, negative effect on self-efficacy ( $\mathrm{\Delta }\overline{g}$= -0.297, Q = 7.072, p = 0.008). Whilst this review indicates that digital interventions can be used to change self-efficacy, which techniques work best in this context is not clear.