Open research and systematic review on using virtual representations in mHealth application interventions for health-related behaviour change
Lauren Taylor, PhD, and Trainee Health Psychologist has been focusing on using digital images on mobile health applications to promote lifestyle behaviours and evaluating their potential with a multidisciplinary team at the University of Surrey and City University, including Dr Bridget Dibb, Dr Aliya Amirova, Ayan Ahmed, Louisa Zhang and Dr Hannah Randaldi.
Many mobile health application interventions include virtual representations of the self (e.g. avatars) to initiate behaviour change. This systematic review aimed to determine: (i) which virtual representations are effective in mHealth application interventions, and (ii) whether any studies implemented specific mechanisms (psychological causes of change) and behaviour change techniques (BCTs) to influence positive behaviour change.
Our approach and challenges
Following PRISMA guidelines, a narrative systematic review of empirical studies was conducted using ten different databases prior to December 2021. This included any articles published on the topic of virtual representation mHealth app interventions that addressed any health behaviours.
In the beginning stages of this review, LT attended an open research course at the University of Surrey (1) to inform herself about open research, and how she could disseminate the findings to a network of researchers. Throughout the review, a research team was formed to ensure that the findings for this review had multiple inputs from more than one member, and that the contributions were not limited to one researcher alone. All the researchers also registered for an ORCID ID to ensure that my work was accurately identified with each of them.
To promote the collaboration, the data from this review is accessible in an open repository (Github, 2), and therefore publicly available. This is beneficial in demonstrating the integrity of the research by allowing others to verify and validate the study. In addition, if the data is reused by others, this could be used as evidence of impact, and chances of engagement with future research studies. However, there are limited opportunities to promote the benefits of sharing data in repositories for easy access, storage, and preservation.
In addition, this review is beneficial in maintaining scholarly communication within this area of research, in increasing knowledge creation around mHealth and virtual representation research as it includes a pre-registered protocol on PROSPERO (CRD42021231215) and has been published in a peer-reviewed open access journal that has been newly established and follow FAIR principles for sharing data. However, there is a lack of guidance around preferred formats to present research content and data fairly.
Out of 2,579 original hits, five eligible studies (total participants = 509), with low to moderate quality were included. Results showed that customisable virtual representation mHealth interventions were effective in encouraging behaviour change and app adherence. These interventions included mechanisms such as motivation, feedback, self-image, and BCTs such as goal setting, and self-monitoring. The current evidence suggests that virtual representations in mHealth app interventions may positively influence health behaviour change. However, there is limited evidence available to determine whether these influences are the result of the virtual representations themselves or the intervention design.
The main learnings from conducting this review in an open research format was the importance of increasing accessibility and impact of my research using open software tools and establishing a pre-print protocol to speed the delivery of the research topic area. Publishing the article in an open research journal was also beneficial in increasing the recognition for the work and public and scholarly transparency.
For more information, please read the article (this is also available on Surrey Open Access).
(See  for further information of other authors)
Lauren Taylor, Trainee Health Psychologist, Department of Psychology, School of Health Sciences, University of Surrey
- ORCHID: 0000-0002-9985-9768
- Twitter: @laurentaylorHP
- Instagram: @thetraineehealthpsych