Evidence Levels for Persuasive Software Features in Digital Health Interventions: Insights from a Scoping Review Regarding T2DM

Behavior change support systems, a subtype of persuasive systems, are pivotal in health promotion efforts, focusing on behavior modification, and especially vital in addressing chronic non-communicable diseases, such as Type 2 Diabetes Mellitus (T2DM). This study aimed to construct a logical framework for assessing the levels of evidence associated with Persuasive Systems Design (PSD) features in T2DM applications. Through a scoping review of 24 studies, 17 PSD features were identified and categorized into five levels of evidence (A-E). Self-monitoring, personalization, reduction, reminders, rewards, praise, authority, and expertise were found to possess level A evidence, suggesting a greater level of strength in terms of evidence. Our findings offer valuable insights for developers and users, providing a basis for developing guidelines in the field of persuasive technology. Establishing evidence-based standards is crucial to advancing this area and ensuring the realistic design of persuasive software features in health applications.