Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.
College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.
BMC Public Health. 2024 Oct 3;24(1):2697. doi: 10.1186/s12889-024-20124-5.
Digital, or eHealth, interventions are highly promising approaches to help adolescents improve their health behaviours and reduce their risk of chronic disease. However, they often have low uptake and retention. There is also a paucity of high-quality research into the predictors of eHealth engagement, and a lack of studies that have systematically evaluated existing engagement strategies in adolescent populations. This paper describes the protocol for a randomised controlled trial which primarily aims to assess the effectiveness of different strategies in increasing engagement with a healthy lifestyles app, Health4Life. Associations between the engagement strategies and improvements in adolescent health behaviours (healthy eating, physical activity, sleep, recreational screen time, smoking, alcohol use) will also be examined, along with potential predictors of adolescents' intentions to use health apps and their use of the Health4Life app.
The current study will aim to recruit 336 adolescent and parent/guardian dyads (total sample N = 672) primarily through Australia wide online advertising. All adolescent participants will have access to the Health4Life app (a multiple health behaviour change, self-monitoring mobile app). The trial will employ a 2 factorial design, where participants will be randomly allocated to receive 1 of 16 different combinations of the four engagement strategies to be evaluated: text messages, access to a health coach, access to additional gamified app content, and provision of parent/guardian information resources. Adolescents and parents/guardians will both complete consent processes, baseline assessments, and a follow-up assessment after 3 months. All participants will also be invited to complete a qualitative interview shortly after follow-up. The primary outcome, app engagement, will be assessed via an App Engagement Index (Ei) using data collected in the Health4Life app and the Mobile App Rating Scale - User version.
This research will contribute significantly to building our understanding of the types of strategies that are most effective in increasing adolescents' engagement with health apps and which factors may predict adolescents' use of health apps.
The trial is registered at the Australian New Zealand Clinical Trials Registry (ACTRN12623000399695). Date registered: 19/04/2023.
数字或电子健康干预措施是帮助青少年改善健康行为和降低慢性病风险的极具前景的方法。然而，它们的参与度和保留率往往较低。此外，关于电子健康参与的预测因素的高质量研究也很少，而且缺乏系统评估青少年人群中现有参与策略的研究。本文介绍了一项随机对照试验的方案，该试验主要旨在评估不同策略在增加对健康生活方式应用程序“Health4Life”的参与度方面的有效性。还将检查参与策略与青少年健康行为（健康饮食、身体活动、睡眠、娱乐屏幕时间、吸烟、饮酒）的改善之间的关联，以及青少年使用健康应用程序的意愿和使用 Health4Life 应用程序的潜在预测因素。
本研究将主要通过澳大利亚范围内的在线广告招募 336 对青少年和家长/监护人（总样本 N=672）。所有青少年参与者都将可以访问 Health4Life 应用程序（一种多健康行为改变、自我监测的移动应用程序）。该试验将采用 2 因素设计，参与者将被随机分配接受 16 种不同组合的 4 种参与策略之一进行评估：短信、访问健康教练、访问额外的游戏化应用程序内容以及提供家长/监护人信息资源。青少年和家长/监护人都将完成同意过程、基线评估和 3 个月后的随访评估。所有参与者还将在随访后不久受邀完成定性访谈。主要结局指标，即应用程序参与度，将通过使用 Health4Life 应用程序和移动应用程序评级量表-用户版本收集的数据来评估应用程序参与指数（Ei）。
这项研究将大大有助于我们了解最有效的增加青少年对健康应用程序参与度的策略类型，以及哪些因素可能预测青少年使用健康应用程序。
该试验在澳大利亚新西兰临床试验注册中心（ACTRN12623000399695）注册。注册日期：2023 年 4 月 19 日。
