O'Brien Heather L, Chen Annie T, Kaneshiro Jasmine, Zaslavsky Oleg
School of Information, University of British Columbia, 1961 East Mall, Vancouver, BC, Canada V6T 1Z1.
Department of Biomedical Informatics and Medical Education, University of Washington School of Medicine, 850 Republican St., Box 358047, Seattle, WA 98195, USA.
Interact Comput. 2024 Sep;36(5):355-369. doi: 10.1093/iwc/iwae030. Epub 2024 Jul 22.
Digital health interventions (DHIs) can facilitate positive health outcomes. User engagement (UE) plays an important role in DHI efficacy. Yet, DHIs vary in functionality, design and intended outcomes, underscoring the importance of incremental, user-centred design to understand engagement in specific settings. This study explores the relationship between user engagement and DHI implementation in three design iterations, or rounds, of a unique, multi-week asynchronous intervention that leverages online discussion and problem-solving therapy (PST). The intervention seeks to engage older adults to improve problem solving skills relating to the intervention focus, health aging (two rounds) and Lewy Body Dementias (LBD) caregiving (one round). The PST component drew upon personas, a common user-centered design method, in a novel way. Exit interviews were conducted at the end of each round to understand participants' experiences. Using thematic analysis, we identified factors that contributed to social engagement ('engaging with others') and learning engagement ('engaging with content') with the DHI. The findings demonstrate how iterative changes in the design and delivery of a DHI can contribute to user engagement, increasing the likelihood of knowledge acquisition and developing problem-solving skills as part of health self-management.
数字健康干预措施（DHIs）有助于实现积极的健康成果。用户参与度（UE）在数字健康干预效果中起着重要作用。然而，数字健康干预措施在功能、设计和预期成果方面存在差异，这凸显了以用户为中心的渐进式设计对于理解特定环境中参与度的重要性。本研究通过一个独特的、为期数周的异步干预的三个设计迭代或轮次，探讨了用户参与度与数字健康干预实施之间的关系，该干预利用在线讨论和问题解决疗法（PST）。该干预旨在促使老年人提高与干预重点相关的问题解决技能，即健康老龄化（两轮）和路易体痴呆症（LBD）护理（一轮）。问题解决疗法部分以一种新颖的方式运用了人物角色这一常见的以用户为中心的设计方法。在每一轮结束时进行了退出访谈，以了解参与者的体验。通过主题分析，我们确定了有助于数字健康干预社会参与度（“与他人互动”）和学习参与度（“与内容互动”）的因素。研究结果表明，数字健康干预在设计和实施过程中的迭代变化如何有助于提高用户参与度，增加知识获取的可能性，并培养作为健康自我管理一部分的问题解决技能。
