Budney Alan J, Marsch Lisa A, Aklin Will M, Borodovsky Jacob T, Brunette Mary F, Campbell Andrew T, Dallery Jesse, Kotz David, Knapp Ashley A, Lord Sarah E, Nunes Edward V, Scherer Emily A, Stanger Catherine, Torrey William C
Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States.
Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States.
JMIR Ment Health. 2020 Feb 26;7(2):e16751. doi: 10.2196/16751.
The health care field has integrated advances into digital technology at an accelerating pace to improve health behavior, health care delivery, and cost-effectiveness of care. The realm of behavioral science has embraced this evolution of digital health, allowing for an exciting roadmap for advancing care by addressing the many challenges to the field via technological innovations. Digital therapeutics offer the potential to extend the reach of effective interventions at reduced cost and patient burden and to increase the potency of existing interventions. Intervention models have included the use of digital tools as supplements to standard care models, as tools that can replace a portion of treatment as usual, or as stand-alone tools accessed outside of care settings or direct to the consumer. To advance the potential public health impact of this promising line of research, multiple areas warrant further development and investigation. The Center for Technology and Behavioral Health (CTBH), a P30 Center of Excellence supported by the National Institute on Drug Abuse at the National Institutes of Health, is an interdisciplinary research center at Dartmouth College focused on the goal of harnessing existing and emerging technologies to effectively develop and deliver evidence-based interventions for substance use and co-occurring disorders. The CTBH launched a series of workshops to encourage and expand multidisciplinary collaborations among Dartmouth scientists and international CTBH affiliates engaged in research related to digital technology and behavioral health (eg, addiction science, behavioral health intervention, technology development, computer science and engineering, digital security, health economics, and implementation science). This paper summarizes a workshop conducted on the Development and Evaluation of Digital Therapeutics for Behavior Change, which addressed (1) principles of behavior change, (2) methods of identifying and testing the underlying mechanisms of behavior change, (3) conceptual frameworks for optimizing applications for mental health and addictive behavior, and (4) the diversity of experimental methods and designs that are essential to the successful development and testing of digital therapeutics. Examples were presented of ongoing CTBH projects focused on identifying and improving the measurement of health behavior change mechanisms and the development and evaluation of digital therapeutics. In summary, the workshop showcased the myriad research targets that will be instrumental in promoting and accelerating progress in the field of digital health and health behavior change and illustrated how the CTBH provides a model of multidisciplinary leadership and collaboration that can facilitate innovative, science-based efforts to address the health behavior challenges afflicting our communities.
医疗保健领域正以越来越快的速度将数字技术的进步融入其中，以改善健康行为、医疗保健服务以及医疗保健的成本效益。行为科学领域已经接受了数字健康的这一演变，通过技术创新应对该领域的诸多挑战，从而为推进医疗保健提供了一条令人兴奋的路线图。数字疗法有可能以降低成本和患者负担的方式扩大有效干预措施的覆盖范围，并提高现有干预措施的效力。干预模式包括将数字工具用作标准护理模式的补充、用作可以替代部分常规治疗的工具，或用作在护理环境之外获取或直接面向消费者的独立工具。为了推进这一有前景的研究领域对公众健康的潜在影响，多个领域值得进一步发展和研究。技术与行为健康中心（CTBH）是美国国立卫生研究院国家药物滥用研究所支持的一个P30卓越中心，是达特茅斯学院的一个跨学科研究中心，其目标是利用现有和新兴技术，有效地开发和提供基于证据的针对物质使用及共病障碍的干预措施。CTBH举办了一系列研讨会，以鼓励和扩大达特茅斯学院的科学家与国际CTBH附属机构之间的多学科合作，这些附属机构从事与数字技术和行为健康相关的研究（例如，成瘾科学、行为健康干预、技术开发、计算机科学与工程、数字安全、健康经济学以及实施科学）。本文总结了一次关于行为改变数字疗法的开发与评估的研讨会，该研讨会讨论了：（1）行为改变的原则；（2）识别和测试行为改变潜在机制的方法；（3）优化心理健康和成瘾行为应用的概念框架；（4）对于数字疗法的成功开发和测试至关重要的实验方法和设计的多样性。文中列举了CTBH正在进行的项目示例，这些项目专注于识别和改进健康行为改变机制的测量，以及数字疗法的开发与评估。总之，该研讨会展示了众多研究目标，这些目标将有助于促进和加速数字健康与健康行为改变领域的进展，并说明了CTBH如何提供一个多学科领导与合作的模式，以推动基于科学的创新努力，应对困扰我们社区的健康行为挑战。
