Conceptualising engagement with digital behaviour change interventions: a systematic review using principles from critical interpretive synthesis

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

“Engagement” with digital behaviour change interventions (DBCIs) is considered important for their effectiveness. Evaluating engagement is therefore a priority; however, a shared understanding of how to usefully conceptualise engagement is lacking. This review aimed to synthesise literature on engagement to identify key conceptualisations and to develop an integrative conceptual framework involving potential direct and indirect influences on engagement and relationships between engagement and intervention effectiveness. Four electronic databases (Ovid MEDLINE, PsycINFO, ISI Web of Knowledge, ScienceDirect) were searched in November 2015. We identified 117 articles that met the inclusion criteria: studies employing experimental or non-experimental designs with adult participants explicitly or implicitly referring to engagement with DBCIs, digital games or technology. Data were synthesised using principles from critical interpretive synthesis. Engagement with DBCIs is conceptualised in terms of both experiential and behavioural aspects. A conceptual framework is proposed in which engagement with a DBCI is influenced by the DBCI itself (content and delivery), the context (the setting in which the DBCI is used and the population using it) and the behaviour that the DBCI is targeting. The context and “mechanisms of action” may moderate the influence of the DBCI on engagement. Engagement, in turn, moderates the influence of the DBCI on those mechanisms of action. In the research literature, engagement with DBCIs has been conceptualised in terms of both experience and behaviour and sits within a complex system involving the DBCI, the context of use, the mechanisms of action of the DBCI and the target behaviour.

Electronic supplementary material

The online version of this article (doi:10.1007/s13142-016-0453-1) contains supplementary material, which is available to authorized users.

Related collections

Most cited references 100

Record: found
Abstract: found
Article: found

Is Open Access

Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions

Saskia M Kelders, Robin N Kok, Hans Ossebaard … (2013)

Background Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology is often seen as a black-box, a mere tool that has no effect or value and serves only as a vehicle to deliver intervention content. In this paper we examine technology from a holistic perspective. We see it as a vital and inseparable aspect of web-based interventions to help explain and understand adherence. Objective This study aims to review the literature on web-based health interventions to investigate whether intervention characteristics and persuasive design affect adherence to a web-based intervention. Methods We conducted a systematic review of studies into web-based health interventions. Per intervention, intervention characteristics, persuasive technology elements and adherence were coded. We performed a multiple regression analysis to investigate whether these variables could predict adherence. Results We included 101 articles on 83 interventions. The typical web-based intervention is meant to be used once a week, is modular in set-up, is updated once a week, lasts for 10 weeks, includes interaction with the system and a counselor and peers on the web, includes some persuasive technology elements, and about 50% of the participants adhere to the intervention. Regarding persuasive technology, we see that primary task support elements are most commonly employed (mean 2.9 out of a possible 7.0). Dialogue support and social support are less commonly employed (mean 1.5 and 1.2 out of a possible 7.0, respectively). When comparing the interventions of the different health care areas, we find significant differences in intended usage (p = .004), setup (p < .001), updates (p < .001), frequency of interaction with a counselor (p < .001), the system (p = .003) and peers (p = .017), duration (F = 6.068, p = .004), adherence (F = 4.833, p = .010) and the number of primary task support elements (F = 5.631, p = .005). Our final regression model explained 55% of the variance in adherence. In this model, a RCT study as opposed to an observational study, increased interaction with a counselor, more frequent intended usage, more frequent updates and more extensive employment of dialogue support significantly predicted better adherence. Conclusions Using intervention characteristics and persuasive technology elements, a substantial amount of variance in adherence can be explained. Although there are differences between health care areas on intervention characteristics, health care area per se does not predict adherence. Rather, the differences in technology and interaction predict adherence. The results of this study can be used to make an informed decision about how to design a web-based intervention to which patients are more likely to adhere.

0 comments Cited 579 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

Ecological Momentary Assessment (Ema) in Behavioral Medicine

Saul Shiffman, Arthur Stone (1994)

0 comments Cited 297 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

Why do people play on-line games? An extended TAM with social influences and flow experience

Chin-Lung Hsu, Hsi-Peng Lu (2004)

0 comments Cited 264 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Olga Perski:

ORCID: http://orcid.org/0000-0003-3285-3174

+442076791891 , olga.perski.14@ucl.ac.uk

Journal

Journal ID (nlm-ta): Transl Behav Med

Journal ID (iso-abbrev): Transl Behav Med

Title: Translational Behavioral Medicine

Publisher: Springer US (New York )

ISSN (Print): 1869-6716

ISSN (Electronic): 1613-9860

Publication date (Electronic): 13 December 2016

Publication date PMC-release: 13 December 2016

Publication date (Print): June 2017

Volume: 7

Issue: 2

Pages: 254-267

Affiliations

[1 ]ISNI 0000000121901201, GRID grid.83440.3b, Department of Clinical, Educational and Health Psychology, , University College London, ; 1-19 Torrington Place, London, WC1E 6BT UK

[2 ]ISNI 0000000121901201, GRID grid.83440.3b, UCL Interaction Centre, , University College London, ; 66-72 Gower Street, London, WC1E 6EA UK

[3 ]ISNI 0000000121901201, GRID grid.83440.3b, Cancer Research UK, Health Behaviour Research Centre, Department of Epidemiology and Public Health, , University College London, ; 1-19 Torrington Place, London, WC1E 6BT UK

Author information

Olga Perski http://orcid.org/0000-0003-3285-3174

Article

Publisher ID: 453

DOI: 10.1007/s13142-016-0453-1

PMC ID: 5526809

PubMed ID: 27966189

SO-VID: 9b839385-8215-426d-8c34-df1fe7126641

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100000355, Bupa Foundation;

Custom metadata

ScienceOpen disciplines: Neurology

Keywords: engagement,digital,behaviour change interventions,ehealth,mhealth,conceptual framework,systematic review

Data availability:

ScienceOpen disciplines: Neurology

Keywords: engagement, digital, behaviour change interventions, ehealth, mhealth, conceptual framework, systematic review

Conceptualising engagement with digital behaviour change interventions: a systematic review using principles from critical interpretive synthesis

Read this article at

Abstract

Electronic supplementary material

Related collections

UCL: UN SDG 03 Good Health and Well-Being

Most cited references 100

Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions

Ecological Momentary Assessment (Ema) in Behavioral Medicine

Why do people play on-line games? An extended TAM with social influences and flow experience

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 154

Cited by 419

Most referenced authors 1,750