Engagement and Retention: Measuring Breadth and Depth of Participant Use of an Online Intervention

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ID: 112179
2010
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Abstract
Background: The Internet provides us with tools (user metrics or paradata) to evaluate how users interact with online interventions. Analysis of these paradata can lead to design improvements. Objective: The objective was to explore the qualities of online participant engagement in an online intervention. We analyzed the paradata in a randomized controlled trial of alternative versions of an online intervention designed to promote consumption of fruit and vegetables. Methods: Volunteers were randomized to 1 of 3 study arms involving several online sessions. We created 2 indirect measures of breadth and depth to measure different dimensions and dynamics of program engagement based on factor analysis of paradata measures of Web pages visited and time spent online with the intervention materials. Multiple regression was used to assess influence of engagement on retention and change in dietary intake. Results: Baseline surveys were completed by 2513 enrolled participants. Of these, 86.3% (n = 2168) completed the follow-up surveys at 3 months, 79.6% (n = 2027) at 6 months, and 79.4% (n = 1995) at 12 months. The 2 tailored intervention arms exhibited significantly more engagement than the untailored arm (P < .01). Breadth and depth measures of engagement were significantly associated with completion of follow-up surveys (odds ratios [OR] = 4.11 and 2.12, respectively, both P values < .001). The breadth measure of engagement was also significantly positively associated with a key study outcome, the mean increase in fruit and vegetable consumption (P < .001). Conclusions: By exploring participants’ exposures to online interventions, paradata are valuable in explaining the effects of tailoring in increasing participant engagement in the intervention. Controlling for intervention arm, greater engagement is also associated with retention of participants and positive change in a key outcome of the intervention, dietary change. This paper demonstrates the utility of paradata capture and analysis for evaluating online health interventions. Trial Registration: NCT00169312; http://clinicaltrials.gov/ct2/show/NCT00169312 (Archived by WebCite at http://www.webcitation.org/5u8sSr0Ty) [J Med Internet Res 2010;12(4):e52]
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johnson2010journalengagement Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Christine Cole Johnson;
Journal Journal of medical Internet research
Year 2010
DOI
doi:10.2196/jmir.1430
URL
http://www.jmir.org/2010/4/e52/
Keywords
medical Internet research medicine journal ehealth JMIR open access publishing medical research medical informaticsmethodological studies;internet;process metrics;tailored intervention; psychology National Center for Biotechnology Information NCBI NLM MEDLINE therapy fruit humans pubmed abstract nih national institutes of health national library of medicine research support adult female male N.I.H. Extramural middle aged young adult Surveys and Questionnaires Randomized Controlled Trial feeding behavior Health Promotion / methods* self care / methods computer-assisted / methods counseling / methods* internet / statistics & numerical data* pmid:21087922 pmc3056524 doi:10.2196/jmir.1430 mick p couper gwen l alexander christine cole johnson community participation / statistics & numerical data* guideline adherence / statistics & numerical data* retention vegetables

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