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Engagement and retention: measuring breadth and depth of participant use of an online intervention.

作者信息

Couper Mick P, Alexander Gwen L, Zhang Nanhua, Little Roderick J A, Maddy Noel, Nowak Michael A, McClure Jennifer B, Calvi Josephine J, Rolnick Sharon J, Stopponi Melanie A, Cole Johnson Christine

机构信息

University of Michigan, Survey Research Center, Ann Arbor, 48106, USA.

出版信息

J Med Internet Res. 2010 Nov 18;12(4):e52. doi: 10.2196/jmir.1430.


DOI:10.2196/jmir.1430
PMID:21087922
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3056524/
Abstract

BACKGROUND: The Internet provides us with tools (user metrics or paradata) to evaluate how users interact with online interventions. Analysis of these paradata can lead to design improvements. OBJECTIVE: The objective was to explore the qualities of online participant engagement in an online intervention. We analyzed the paradata in a randomized controlled trial of alternative versions of an online intervention designed to promote consumption of fruit and vegetables. METHODS: Volunteers were randomized to 1 of 3 study arms involving several online sessions. We created 2 indirect measures of breadth and depth to measure different dimensions and dynamics of program engagement based on factor analysis of paradata measures of Web pages visited and time spent online with the intervention materials. Multiple regression was used to assess influence of engagement on retention and change in dietary intake. RESULTS: Baseline surveys were completed by 2513 enrolled participants. Of these, 86.3% (n = 2168) completed the follow-up surveys at 3 months, 79.6% (n = 2027) at 6 months, and 79.4% (n = 1995) at 12 months. The 2 tailored intervention arms exhibited significantly more engagement than the untailored arm (P < .01). Breadth and depth measures of engagement were significantly associated with completion of follow-up surveys (odds ratios [OR] = 4.11 and 2.12, respectively, both P values < .001). The breadth measure of engagement was also significantly positively associated with a key study outcome, the mean increase in fruit and vegetable consumption (P < .001). CONCLUSIONS: By exploring participants' exposures to online interventions, paradata are valuable in explaining the effects of tailoring in increasing participant engagement in the intervention. Controlling for intervention arm, greater engagement is also associated with retention of participants and positive change in a key outcome of the intervention, dietary change. This paper demonstrates the utility of paradata capture and analysis for evaluating online health interventions. TRIAL REGISTRATION: NCT00169312; http://clinicaltrials.gov/ct2/show/NCT00169312 (Archived by WebCite at http://www.webcitation.org/5u8sSr0Ty).

摘要

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本文引用的文献

[1]
Comparison of trial participants and open access users of a web-based physical activity intervention regarding adherence, attrition, and repeated participation.

J Med Internet Res. 2010-2-10

[2]
A randomized clinical trial evaluating online interventions to improve fruit and vegetable consumption.

Am J Public Health. 2009-12-17

[3]
Recruitment to a randomized web-based nutritional intervention trial: characteristics of participants compared to non-participants.

J Med Internet Res. 2009-8-26

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A conceptual framework for understanding and improving adolescents' exposure to Internet-delivered interventions.

Health Promot Int. 2009-9

[5]
Methodological challenges in online trials.

J Med Internet Res. 2009-4-3

[6]
Predictors of adherence by adolescents to a cognitive behavior therapy website in school and community-based settings.

J Med Internet Res. 2009-2-23

[7]
The role of engagement in a tailored web-based smoking cessation program: randomized controlled trial.

J Med Internet Res. 2008-11-4

[8]
Effect of incentives and mailing features on online health program enrollment.

Am J Prev Med. 2008-5

[9]
Tailoring a fruit and vegetable intervention on novel motivational constructs: results of a randomized study.

Ann Behav Med. 2008-4

[10]
Internet methods for delivering behavioral and health-related interventions (eHealth).

Annu Rev Clin Psychol. 2007

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