Personalising digital health interventions applying N-of-1 methods

Last week our CRE Research Fellow Dr Dominika Kwasnicka gave an invited keynote presentation at the Association for Contextual Behavioral Science, Virtual World Conference https://contextualscience.org/2021_virtual_world_conference titled Personalising digital health interventions applying N-of-1 methods.

What are N-of-1 methods? Theories of behaviour change and health behaviour change interventions are usually tested in conventional between-participant designs. However, most of these theories and interventions ultimately focus on within-participant change. This mismatch between the idiographic basis of most theories and intervention causal models and the nomothetic approach of the methodologies typically used to evaluate them is fundamentally problematic. Appreciation of this is fuelling the growing interest in N-of-1/within-participant methods in behavioural medicine, yet there is currently a shortage of opportunities to learn about within-participant approaches.


The talk was divided into four key parts: (I) presentation of N-of-1 method (design overview, theory and basic principles); (II) introduction to observational N-of-1 studies and their practical application; (III) introduction to N-of-1 RCTs and their practical application; and (IV) general elaboration of key priorities (e.g., application, personalising behavioural interventions, data analysis, limitations of the design) and advantages and disadvantages of using this method. One-hour talk was followed by 30 minutes discussion with the audience who were very keen to learn about N-of-1 designs.

Why N-of-1 methods are worth using?

Knowledge of how to employ N-of-1 methods enables researchers to capitalise on the recent technology development to design behavioural studies and interventions which are tailored to each individual. Using unobtrusive data capture such as wearables and smartphone sensors, combined with self-report Ecological Momentary Assessment data, allows us to develop truly personalised treatments. We are therefore at an opportune time to expand our use of within-person designs to better understand health behaviour and to deliver precision behaviour change interventions.

Dr Kwasnicka also participated in the expert panel led by Prof Rhonda Merwin titled Upping Our Game: Research Methods and Strategies for Contextual Behavioral Science Research at the same conference. Dr Kwasnicka is a Research Fellow in Digital Health at the Nossal Institute for Global Health, Melbourne School of Population and Global Health, at the University of Melbourne, funded by the NHMRC Centre for Research Excellence (CRE) in Digital Technology to Transform Chronic Disease Outcomes, Australia. She is a behavioural scientist who has diverse interests in health psychology, digital health and research methods focusing on individuals. She leads Open Digital Health initiative that promotes reusing open digital health solutions across contexts and settings www.opendigitalhealth.org. She is also passionate about science translation and dissemination and is a leader of the Practical Health Psychology blog currently translated to 27 languages

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