Kelders Saskia M, Kip Hanneke, Beerlage-de Jong Nienke, Köhle Nadine
Department of Health, Psychology and Technology, University of Twente, Enschede, The Netherlands.
Optentia Research Unit, North-West University, Vanderbijlpark, South Africa.
Digit Health. 2024 Oct 3;10:20552076241283530. doi: 10.1177/20552076241283530. eCollection 2024 Jan-Dec.
Digital health interventions (DHIs) hold promise for influencing health behaviors positively, but their widespread implementation and effectiveness remain limited. Engagement is crucial for DHI effectiveness, yet its conceptualization is debated. This qualitative study explores engagement from user and professional perspectives.
Twenty self-proclaimed engaged health app users participated in semistructured interviews, and 13 professionals working with DHIs completed an online survey.
Interviews with health app users revealed three key components of their sense of engagement: behavioral, cognitive, and affective. Behavioral engagement includes routine, effortless, and dynamic usage; emphasizing the importance of the quality of fit between user and technology over frequency of use. Cognitive engagement encompasses the technology's utility as a tool for supporting behavior change, providing new insights, and enhancing motivation. Affective engagement involves enjoying progress, deriving pleasure from using the technology, and identifying with the technology. Notably, participants exhibited varying emphasis on these components. Professionals, in a parallel inquiry, agreed on the relevance of behavior, cognition, and affect in defining engagement. In their understanding, behavioral engagement is often associated with adherence and frequency of use, while cognitive engagement emphasizes understanding, motivation, and achieving cognitive outcomes. Affective engagement, although diverse, is recognized as a critical dimension. In addition, it was noticeable that users and professionals perceived microengagement (with the DHI) and macroengagement (with the target behavior) as interconnected.
To conclude, this study contributes a nuanced understanding of the multifaceted nature of engagement, informing future measurement of the concept, DHI design, and implementation strategies for improved user experiences and outcomes.
数字健康干预措施有望对健康行为产生积极影响，但其广泛实施和有效性仍然有限。参与度对于数字健康干预措施的有效性至关重要，但其概念化仍存在争议。本定性研究从用户和专业人员的角度探讨参与度。
20名自称积极参与的健康应用程序用户参与了半结构化访谈，13名从事数字健康干预工作的专业人员完成了在线调查。
对健康应用程序用户的访谈揭示了他们参与感的三个关键组成部分：行为、认知和情感。行为参与包括常规、轻松和动态使用；强调用户与技术之间的适配质量比使用频率更重要。认知参与包括将技术作为支持行为改变、提供新见解和增强动力的工具的效用。情感参与包括享受进步、从使用技术中获得乐趣以及认同该技术。值得注意的是，参与者对这些组成部分的强调各不相同。在一项平行调查中，专业人员认同行为、认知和情感在定义参与度方面的相关性。在他们的理解中，行为参与通常与依从性和使用频率相关，而认知参与强调理解、动机和实现认知成果。情感参与虽然多样，但被认为是一个关键维度。此外，值得注意的是，用户和专业人员将（与数字健康干预措施的）微观参与和（与目标行为的）宏观参与视为相互关联的。
总之，本研究有助于对参与度的多方面性质进行细致入微的理解，为该概念的未来测量、数字健康干预措施的设计以及改善用户体验和结果的实施策略提供信息。
