Baumel Amit, Brandes Or, Brendryen Håvar, Muench Fred, Kane John M, Saar Chen
Department of Community Mental Health, University of Haifa, Haifa, Israel.
Department of Psychology, University of Oslo, Oslo, Norway.
Internet Interv. 2023 Oct 4;34:100680. doi: 10.1016/j.invent.2023.100680. eCollection 2023 Dec.
Understanding how to design engaging unguided digital health interventions is key in our ability to utilize digital tools to improve access to care. Therapeutic persuasiveness (TP) is a design concept that relates to how the digital intervention features as a whole should be designed to encourage users to make positive changes in their lives, while reducing the experienced effort required from them to engage in these activities. In our previous work, we examined the user traffic of publicly available programs, finding programs' TP quality to be a reliable, robust, and stable predictor of real-world usage; however, these findings have not been subject to experimental manipulation in a controlled trial. The current study examined the impact of TP quality in digital parent training programs (DPTs) aimed at treating child's behavior problems. We conducted a pilot randomized controlled trial comparing two interventions that utilize the same evidence-based content of established DPTs, but that differ in terms of the quality of TP (standard: DPT-STD; enhanced: DPT-TP). Altogether, parents from 88 families who have a child with behavior problems were enrolled in the study. Compared to DPT-STD ( = 43), participants allocated to DPT-TP ( = 45) used the program significantly more ( < 0.001; Cohen's = 0.91-2.22). In terms of program completion, 68.9 % of DPT-TP participants completed it compared to 27.9 % of DPT-STD participants. Significant differences between the interventions were also found in reported improvements in child behavior problems favoring DPT-TP ( < 0.05; Cohen's = 0.43-0.54). The results point to the importance of adequate product design and the utilization of conceptual frameworks in order to improve user engagement challenges.
了解如何设计引人入胜的无指导数字健康干预措施是我们利用数字工具改善医疗服务可及性的关键能力。治疗说服力（TP）是一个设计概念，它涉及数字干预整体特征应如何设计，以鼓励用户在生活中做出积极改变，同时减少他们参与这些活动所需的实际努力。在我们之前的工作中，我们研究了公开可用项目的用户流量，发现项目的TP质量是实际使用情况的可靠、稳健且稳定的预测指标；然而，这些发现尚未在对照试验中进行实验性操作验证。本研究考察了数字家长培训项目（DPT）中TP质量对治疗儿童行为问题的影响。我们进行了一项试点随机对照试验，比较了两种干预措施，这两种措施使用相同的基于既定DPT的循证内容，但在TP质量方面有所不同（标准：DPT-STD；增强：DPT-TP）。共有88个有行为问题儿童的家庭的家长参与了该研究。与DPT-STD组（n = 43）相比，分配到DPT-TP组（n = 45）的参与者对该项目的使用显著更多（p < 0.001；科恩d值 = 0.91 - 2.22）。在项目完成率方面，DPT-TP组的参与者中有68.9%完成了项目，而DPT-STD组的参与者中这一比例为27.9%。在报告的儿童行为问题改善方面，也发现了有利于DPT-TP的干预措施之间的显著差异（p < 0.05；科恩d值 = 0.43 - 0.54）。结果表明，充分的产品设计和概念框架的运用对于应对用户参与挑战至关重要。
