Crutzen Rik, Cyr Dianne, de Vries Nanne K
Department of Health Promotion, Maastricht University/CAPHRI, Maastricht, Netherlands.
J Med Internet Res. 2012 Mar 9;14(2):e45. doi: 10.2196/jmir.1922.
Internet-delivered interventions can effectively change health risk behaviors and their determinants, but adherence to these interventions once they are accessed is very low. Therefore, it is relevant and necessary to systematically manipulate website characteristics to test their effect on website use. This study focuses on user control as a website characteristic.
To test whether and how user control (the freedom of choice to skip pages) can increase website use and knowledge gained from the website.
Participants older than 18 years were drawn from the Dutch Internet population (in June 2011) and completed a hepatitis knowledge questionnaire. Subsequently, they were randomly assigned to three groups: (1) a tunneled version of the website with less user control; (2) a high user control version of the website where visitors had the freedom of choice to skip pages; and (3) a control group that was not exposed to the website. Participants completed (1) a questionnaire of validated measures regarding user perceptions immediately after exposure to the website (except for the control group), and (2) a hepatitis knowledge questionnaire after one week to test whether participants in the experimental groups only clicked through the website or actually processed and learned its content. Server registrations were used to assess website use. Analyses of covariance (ANCOVA) using all available data were conducted to determine whether user control increases website use. Structural equation models (SEM) using all available data were constructed to test how user control increases website use-a latent variable derived from number of pages visited and time on website.
Of the 1044 persons invited to participate, 668 took part (668/1044, 64.0%). One half of participants (332/668 49.7%) were female and the mean age was 49 years (SD 16). A total of 571 participants completed the one-week follow-up measure regarding hepatitis knowledge (571/668, 85.5%). The findings demonstrate that having less user control (ie, a tunneled version of the website) had a negative effect on users' perception of efficiency (F(1,452) = 97.69, P < .001), but a positive effect on number of pages visited (F(1,452) = 171.49, P < .001), time on the website (F(1,452) = 6.32, P = .01), and knowledge gained from the website (F(1,452) = 134.32, P < .001). The direct effect of having less user control appeared to surpass the effect mediated by efficiency, because website use was higher among participants exposed to the tunneled version of the website in comparison with those having the freedom of choice to skip pages.
The key finding that visitors demonstrated increased website use in the tunneled version of the website indicates that visitors should be carefully guided through the intervention for future intervention websites.
通过互联网提供的干预措施可以有效改变健康风险行为及其决定因素，但这些干预措施一旦被访问，其依从性非常低。因此，系统地操控网站特征以测试其对网站使用的影响是有意义且必要的。本研究聚焦于将用户控制权作为一种网站特征。
测试用户控制权（跳过页面的选择自由）是否以及如何能够增加网站使用量以及从网站获取的知识。
从荷兰互联网用户群体中（2011年6月）招募年龄超过18岁的参与者，并让他们完成一份肝炎知识问卷。随后，他们被随机分为三组：（1）用户控制权较低的网站隧道版；（2）用户控制权较高的网站版本，访客可自由选择跳过页面；（3）未接触该网站的对照组。参与者完成了：（1）在接触网站后（对照组除外）立即填写一份关于用户认知的经过验证的测量问卷；（2）一周后填写一份肝炎知识问卷，以测试实验组的参与者是只是浏览网站还是实际处理并学习了其内容。通过服务器注册来评估网站使用情况。使用所有可用数据进行协方差分析（ANCOVA），以确定用户控制权是否会增加网站使用量。构建使用所有可用数据的结构方程模型（SEM），以测试用户控制权如何增加网站使用量——一个从访问页面数量和在网站上停留时间得出的潜在变量。
在受邀参与的1044人中，668人参与了研究（668/1044，64.0%）。一半的参与者（332/668，49.7%）为女性，平均年龄为49岁（标准差16）。共有571名参与者完成了关于肝炎知识的一周后续测量（571/668，85.5%）。研究结果表明，用户控制权较低（即网站隧道版）对用户的效率感知有负面影响（F(1,452) = 97.69，P < .001），但对访问页面数量有正面影响（F(1,452) = 171.49，P < .001）、在网站上停留的时间（F(1,452) = 6.32，P = .01）以及从网站获取的知识（F(1,452) = 134.32，P < .001）。用户控制权较低的直接影响似乎超过了由效率介导的影响，因为与有自由选择跳过页面的参与者相比，接触网站隧道版的参与者的网站使用量更高。
关键发现是访客在网站隧道版中的网站使用量有所增加，这表明对于未来的干预网站，应仔细引导访客完成干预。
