Exploring the Role of Biological Feedback as a Behavior Change Technique through Continuous Glucose Monitoring

Abstract

Many behavior change interventions rely on “one-size-fits-all” approaches, to which some, but not all, respond favorably. Recent advances in wearable biosensing technologies have supported the shift from standardized to personalized interventions, providing individuals the ability to view the direct impact of their behaviors on their biological data. Nevertheless, the implementation of biological feedback as a behavior change technique has not been comprehensively explored. A scoping review of 767 randomized controlled trials was conducted to map the domains of research that have used biological feedback as a behavior change technique and describe how biological feedback is implemented within behavior change interventions. Subsequently, an in-depth scoping review of a specific mode of biological feedback—continuous glucose monitoring (CGM)—was performed to characterize patient populations, behaviors, health-related outcomes, and intervention protocols in trials that used CGM to target behavior change. Findings from these reviews were utilized to inform a multi-method clinical trial to assess the feasibility of adding a brief CGM intervention to the Arizona Cooperative Extension National Diabetes Prevention Program. Quantitative and qualitative findings demonstrated that the brief CGM intervention was both feasible to deliver within the context of the Extension Diabetes Prevention Program and acceptable to study participants. Findings will be used to inform a future randomized controlled trial to test the efficacy of a brief CGM intervention added to the National Diabetes Prevention Program.