Logic Models on Health Information Technology-Related Interventions: A Scoping Review Across Disciplines (Preprint)

Abstract Background Health information technology (HIT) interventions are complex, context-dependent, and often insufficiently theorized, which can hinder their design, implementation, and evaluation. Program theory approaches such as logic models and theory of change (ToC) are well-established in public health and implementation science for articulating causal assumptions. Their use in medical informatics, however, appears inconsistent. A systematic overview of how logic models and ToC have been applied to HIT interventions is therefore needed to support theory-informed development and cumulative learning in the field. Objective We aimed to map how logic models, ToC, and related program theory approaches have been conceptualized, constructed, and applied in HIT-related interventions across disciplines. A secondary objective was to identify implications for medical informatics research and practice. Methods Following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews), searches were conducted in PubMed, Web of Science, Academic Search Elite, APA PsycArticles, and CINAHL. Eligible publications used a logic model, ToC, or related construct within an HIT intervention in any health care or social-care setting. Next, 2 reviewers independently screened records and extracted data on study characteristics, type and purpose of HIT, model structure, theoretical foundations, and reported benefits and challenges. Results A total of 69 publications (2012‐2025) met the criteria. Use of program theory increased markedly after 2020 and spanned medical informatics, public health, health services research, and implementation science. Logic models were most frequently applied to patient-facing and self-management technologies, particularly mobile health, telehealth, and home-based remote monitoring. Most models were used to support HIT development or evaluation. Of the total, 60 (87%) studies provided a logic model visualization, although structures varied considerably. Out of 69, 50 (72%) studies cited guidelines for model development, most commonly UK Medical Research Council guidance, realist evaluation, or the Kellogg Logic Model. Out of 69 studies, 28 (41%) used behavioral or implementation frameworks, such as Capability, Opportunity, Motivation–Behavior model (COM-B), Consolidated Framework for Implementation Research (CFIR), Expert Recommendations for Implementing Change (ERIC), Fit between Individuals, Task, and Technology (FITT), or Non-adoption, Abandonment, and challenges to the Scale-up, Spread, and Sustainability (NASSS) to populate model content. Only 3 (4%) studies reused an existing model. Reported benefits concerned improved theorization, structured evaluation, and stakeholder engagement; challenges included limited empirical evidence, high resource demands, and tensions between specificity and generalizability. Conclusions Program theory approaches are increasingly used to conceptualize and evaluate HIT interventions; yet, their application in medical informatics remains fragmented. More systematic and theory-informed use of logic models could enhance conceptual clarity, methodological rigor, and cumulative learning. Future work should promote model reuse, establish repositories, strengthen reporting standards, and integrate program theory in HIT education and research to support coherent development, evaluation, and scaling of digital health interventions.

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