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The Effect of Periodic Email Prompts on Participant Engagement With a Behavior Change mHealth App: Longitudinal Study

BACKGROUND: Following the need for the prevention of noncommunicable diseases, mobile health (mHealth) apps are increasingly used for promoting lifestyle behavior changes. Although mHealth apps have the potential to reach all population segments, providing accessible and personalized services, their...

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Autores principales: Agachi, Elena, Bijmolt, Tammo H A, van Ittersum, Koert, Mierau, Jochen O
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10214118/
https://www.ncbi.nlm.nih.gov/pubmed/37166974
http://dx.doi.org/10.2196/43033
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author Agachi, Elena
Bijmolt, Tammo H A
van Ittersum, Koert
Mierau, Jochen O
author_facet Agachi, Elena
Bijmolt, Tammo H A
van Ittersum, Koert
Mierau, Jochen O
author_sort Agachi, Elena
collection PubMed
description BACKGROUND: Following the need for the prevention of noncommunicable diseases, mobile health (mHealth) apps are increasingly used for promoting lifestyle behavior changes. Although mHealth apps have the potential to reach all population segments, providing accessible and personalized services, their effectiveness is often limited by low participant engagement and high attrition rates. OBJECTIVE: This study concerns a large-scale, open-access mHealth app, based in the Netherlands, focused on improving the lifestyle behaviors of its participants. The study examines whether periodic email prompts increased participant engagement with the mHealth app and how this effect evolved over time. Points gained from the activities in the app were used as an objective measure of participant engagement with the program. The activities considered were physical workouts tracked through the mHealth app and interactions with the web-based coach. METHODS: The data analyzed covered 22,797 unique participants over a period of 78 weeks. A hidden Markov model (HMM) was used for disentangling the overtime effects of periodic email prompts on participant engagement with the mHealth app. The HMM accounted for transitions between latent activity states, which generated the observed measure of points received in a week. RESULTS: The HMM indicated that, on average, 70% (15,958/22,797) of the participants were in the inactivity state, gaining 0 points in total per week; 18% (4103/22,797) of the participants were in the average activity state, gaining 27 points per week; and 12% (2736/22,797) of the participants were in the high activity state, gaining 182 points per week. Receiving and opening a generic email was associated with a 3 percentage point increase in the likelihood of becoming active in that week, compared with the weeks when no email was received. Examining detailed email categories revealed that the participants were more likely to increase their activity level following emails that were in line with the program’s goal, such as emails regarding health campaigns, while being resistant to emails that deviated from the program’s goal, such as emails regarding special deals. CONCLUSIONS: Participant engagement with a behavior change mHealth app can be positively influenced by email prompts, albeit to a limited extent. Given the relatively low costs associated with emails and the high population reach that mHealth apps can achieve, such instruments can be a cost-effective means of increasing participant engagement in the stride toward improving program effectiveness.
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spelling pubmed-102141182023-05-27 The Effect of Periodic Email Prompts on Participant Engagement With a Behavior Change mHealth App: Longitudinal Study Agachi, Elena Bijmolt, Tammo H A van Ittersum, Koert Mierau, Jochen O JMIR Mhealth Uhealth Original Paper BACKGROUND: Following the need for the prevention of noncommunicable diseases, mobile health (mHealth) apps are increasingly used for promoting lifestyle behavior changes. Although mHealth apps have the potential to reach all population segments, providing accessible and personalized services, their effectiveness is often limited by low participant engagement and high attrition rates. OBJECTIVE: This study concerns a large-scale, open-access mHealth app, based in the Netherlands, focused on improving the lifestyle behaviors of its participants. The study examines whether periodic email prompts increased participant engagement with the mHealth app and how this effect evolved over time. Points gained from the activities in the app were used as an objective measure of participant engagement with the program. The activities considered were physical workouts tracked through the mHealth app and interactions with the web-based coach. METHODS: The data analyzed covered 22,797 unique participants over a period of 78 weeks. A hidden Markov model (HMM) was used for disentangling the overtime effects of periodic email prompts on participant engagement with the mHealth app. The HMM accounted for transitions between latent activity states, which generated the observed measure of points received in a week. RESULTS: The HMM indicated that, on average, 70% (15,958/22,797) of the participants were in the inactivity state, gaining 0 points in total per week; 18% (4103/22,797) of the participants were in the average activity state, gaining 27 points per week; and 12% (2736/22,797) of the participants were in the high activity state, gaining 182 points per week. Receiving and opening a generic email was associated with a 3 percentage point increase in the likelihood of becoming active in that week, compared with the weeks when no email was received. Examining detailed email categories revealed that the participants were more likely to increase their activity level following emails that were in line with the program’s goal, such as emails regarding health campaigns, while being resistant to emails that deviated from the program’s goal, such as emails regarding special deals. CONCLUSIONS: Participant engagement with a behavior change mHealth app can be positively influenced by email prompts, albeit to a limited extent. Given the relatively low costs associated with emails and the high population reach that mHealth apps can achieve, such instruments can be a cost-effective means of increasing participant engagement in the stride toward improving program effectiveness. JMIR Publications 2023-05-11 /pmc/articles/PMC10214118/ /pubmed/37166974 http://dx.doi.org/10.2196/43033 Text en ©Elena Agachi, Tammo H A Bijmolt, Koert van Ittersum, Jochen O Mierau. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 11.05.2023. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on https://mhealth.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Agachi, Elena
Bijmolt, Tammo H A
van Ittersum, Koert
Mierau, Jochen O
The Effect of Periodic Email Prompts on Participant Engagement With a Behavior Change mHealth App: Longitudinal Study
title The Effect of Periodic Email Prompts on Participant Engagement With a Behavior Change mHealth App: Longitudinal Study
title_full The Effect of Periodic Email Prompts on Participant Engagement With a Behavior Change mHealth App: Longitudinal Study
title_fullStr The Effect of Periodic Email Prompts on Participant Engagement With a Behavior Change mHealth App: Longitudinal Study
title_full_unstemmed The Effect of Periodic Email Prompts on Participant Engagement With a Behavior Change mHealth App: Longitudinal Study
title_short The Effect of Periodic Email Prompts on Participant Engagement With a Behavior Change mHealth App: Longitudinal Study
title_sort effect of periodic email prompts on participant engagement with a behavior change mhealth app: longitudinal study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10214118/
https://www.ncbi.nlm.nih.gov/pubmed/37166974
http://dx.doi.org/10.2196/43033
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