More than a text message: Dismantling digital triggers to curate behavior change in patient-centered health interventions

Frederick Muench, Amit Baumel

Research output: Contribution to journalReview articlepeer-review


Digital triggers such as text messages, emails, and push alerts are designed to focus an individual on a desired goal by prompting an internal or external reaction at the appropriate time. Triggers therefore have an essential role in engaging individuals with digital interventions delivered outside of traditional health care settings, where other events in daily lives and fluctuating motivation to engage in effortful behavior exist. There is an emerging body of literature examining the use of digital triggers for short-term action and longer-term behavior change. However, little attention has been given to understanding the components of digital triggers. Using tailoring as an overarching framework, we separated digital triggers into 5 primary components: (1) who (sender), (2) how (stimulus type, delivery medium, heterogeneity), (3) when (delivered), (4) how much (frequency, intensity), and (5) what (trigger’s target, trigger’s structure, trigger’s narrative). We highlighted key considerations when tailoring each component and the pitfalls of ignoring common mistakes, such as alert fatigue and habituation. As evidenced throughout the paper, there is a broad literature base from which to draw when tailoring triggers to curate behavior change in health interventions. More research is needed, however, to examine differences in efficacy based on component tailoring, to best use triggers to facilitate behavior change over time, and to keep individuals engaged in physical and mental health behavior change efforts. Dismantling digital triggers into their component parts and reassembling them according to the gestalt of one’s change goals is the first step in this development work.

Original languageEnglish
Article numbere147
JournalJournal of Medical Internet Research
Issue number5
StatePublished - May 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© Frederick Muench, Amit Baumel.


  • Alerts
  • Behavior change
  • Behavioral medicine
  • Digital triggers
  • Engagement
  • Haptic triggers
  • MHealth
  • Marketing
  • Mobile health
  • Push alerts
  • Reminder systems
  • Text messaging

ASJC Scopus subject areas

  • Health Informatics


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