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Just-in-Time Adaptive Interventions (JITAIs) in Mobile Health: Key Components and Design Principles for Ongoing Health Behavior Support

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

The just-in-time adaptive intervention (JITAI) is an intervention design aiming to provide the right type/amount of support, at the right time, by adapting to an individual’s changing internal and contextual state. The availability of increasingly powerful mobile and sensing technologies underpins the use of JITAIs to support health behavior, as in such a setting an individual’s state can change rapidly, unexpectedly, and in his/her natural environment.

Purpose

Despite the increasing use and appeal of JITAIs, a major gap exists between the growing technological capabilities for delivering JITAIs and research on the development and evaluation of these interventions. Many JITAIs have been developed with minimal use of empirical evidence, theory, or accepted treatment guidelines. Here, we take an essential first step towards bridging this gap.

Methods

Building on health behavior theories and the extant literature on JITAIs, we clarify the scientific motivation for JITAIs, define their fundamental components, and highlight design principles related to these components. Examples of JITAIs from various domains of health behavior research are used for illustration.

Conclusion

As we enter a new era of technological capacity for delivering JITAIs, it is critical that researchers develop sophisticated and nuanced health behavior theories capable of guiding the construction of such interventions. Particular attention has to be given to better understanding the implications of providing timely and ecologically sound support for intervention adherence and retention.

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Acknowledgments

We thank Daniel Almirall, Dror Ben-Zeev, Andrew Isham, and Dave Gustafson for their helpful feedback and advice. This project was supported by awards R01 DA039901, R01 AA022113, R01 HD073975, R21 AA018336, R01 AA023187, R01 HL125440, U54 EB020404, R01 DK108678, R01 DK097364, P50 DA039838, P01 CA180945, R01 DK097364, and R01 AA022931 from the National Institutes of Health, and awards IIS-1452099 and IIS-1545751 from the National Science Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding organizations.

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Authors and Affiliations

  1. Institute for Social Research, University of Michigan, Ann Arbor, MI, USA

    Inbal Nahum-Shani PhD

  2. Division of General Medicine, Department of Internal Medicine and Institute for Social Research, University of Michigan, Ann Arbor, MI, USA

    Shawna N. Smith PhD

  3. Feinberg School of Medicine, Northwestern University, Evanston, IL, USA

    Bonnie J. Spring PhD

  4. The Methodology Center and Department of Human Development & Family Studies, Penn State, State College, PA, USA

    Linda M. Collins PhD

  5. Department of Psychology, University of New Mexico, Albuquerque, NM, USA

    Katie Witkiewitz PhD

  6. Department of Statistics and Department of EECS, University of Michigan, Ann Arbor, MI, USA

    Ambuj Tewari PhD

  7. Department of Statistics, and Institute for Social Research, University of Michigan, Ann Arbor, MI, USA

    Susan A. Murphy PhD

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  1. Inbal Nahum-Shani PhD
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  2. Shawna N. Smith PhD
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  3. Bonnie J. Spring PhD
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  4. Linda M. Collins PhD
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  5. Katie Witkiewitz PhD
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  6. Ambuj Tewari PhD
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  7. Susan A. Murphy PhD
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Correspondence to Inbal Nahum-Shani PhD.

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Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Authors Nahum-Shani, Smith, Spring, Collins, Witkiewitz, Tewari, and Murphy declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Nahum-Shani, I., Smith, S.N., Spring, B.J. et al. Just-in-Time Adaptive Interventions (JITAIs) in Mobile Health: Key Components and Design Principles for Ongoing Health Behavior Support. ann. behav. med. (2016). https://doi.org/10.1007/s12160-016-9830-8

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