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The Role of Engagement in a Tailored Web-Based Smoking Cessation Program: Randomized Controlled Trial
BACKGROUND: Web-based programs for health promotion, disease prevention, and disease management often experience high rates of attrition. There are 3 questions which are particularly relevant to this issue. First, does engagement with program content predict long-term outcomes? Second, which users a...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Gunther Eysenbach
2008
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2630833/ https://www.ncbi.nlm.nih.gov/pubmed/18984557 http://dx.doi.org/10.2196/jmir.1002 |
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author | Strecher, Victor J McClure, Jennifer Alexander, Gwen Chakraborty, Bibhas Nair, Vijay Konkel, Janine Greene, Sarah Couper, Mick Carlier, Carola Wiese, Cheryl Little, Roderick Pomerleau, Cynthia Pomerleau, Ovide |
author_facet | Strecher, Victor J McClure, Jennifer Alexander, Gwen Chakraborty, Bibhas Nair, Vijay Konkel, Janine Greene, Sarah Couper, Mick Carlier, Carola Wiese, Cheryl Little, Roderick Pomerleau, Cynthia Pomerleau, Ovide |
author_sort | Strecher, Victor J |
collection | PubMed |
description | BACKGROUND: Web-based programs for health promotion, disease prevention, and disease management often experience high rates of attrition. There are 3 questions which are particularly relevant to this issue. First, does engagement with program content predict long-term outcomes? Second, which users are most likely to drop out or disengage from the program? Third, do particular intervention strategies enhance engagement? OBJECTIVE: To determine: (1) whether engagement (defined by the number of Web sections opened) in a Web-based smoking cessation intervention predicts 6-month abstinence, (2) whether particular sociodemographic and psychographic groups are more likely to have lower engagement, and (3) whether particular components of a Web-based smoking cessation program influence engagement. METHODS: A randomized trial of 1866 smokers was used to examine the efficacy of 5 different treatment components of a Web-based smoking cessation intervention. The components were: high- versus low-personalized message source, high- versus low-tailored outcome expectation, efficacy expectation, and success story messages. Moreover, the timing of exposure to these sections was manipulated, with participants randomized to either a single unified Web program with all sections available at once, or sequential exposure to each section over a 5-week period of time. Participants from 2 large health plans enrolled to receive the online behavioral smoking cessation program and a free course of nicotine replacement therapy (patch). The program included: an introduction section, a section focusing on outcome expectations, 2 sections focusing on efficacy expectations, and a section with a narrative success story (5 sections altogether, each with multiple screens). Most of the analyses were conducted with a stratification of the 2 exposure types. Measures included: sociodemographic and psychosocial characteristics, Web sections opened, perceived message relevance, and smoking cessation 6-months following quit date. RESULTS: The total number of Web sections opened was related to subsequent smoking cessation. Participants who were younger, were male, or had less formal education were more likely to disengage from the Web-based cessation program, particularly when the program sections were delivered sequentially over time. More personalized source and high-depth tailored self-efficacy components were related to a greater number of Web sections opened. A path analysis model suggested that the impact of high-depth message tailoring on engagement in the sequentially delivered Web program was mediated by perceived message relevance. CONCLUSIONS: Results of this study suggest that one of the mechanisms underlying the impact of Web-based smoking cessation interventions is engagement with the program. The source of the message, the degree of message tailoring, and the timing of exposure appear to influence Web-based program engagement. |
format | Text |
id | pubmed-2630833 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | Gunther Eysenbach |
record_format | MEDLINE/PubMed |
spelling | pubmed-26308332009-02-02 The Role of Engagement in a Tailored Web-Based Smoking Cessation Program: Randomized Controlled Trial Strecher, Victor J McClure, Jennifer Alexander, Gwen Chakraborty, Bibhas Nair, Vijay Konkel, Janine Greene, Sarah Couper, Mick Carlier, Carola Wiese, Cheryl Little, Roderick Pomerleau, Cynthia Pomerleau, Ovide J Med Internet Res Original Paper BACKGROUND: Web-based programs for health promotion, disease prevention, and disease management often experience high rates of attrition. There are 3 questions which are particularly relevant to this issue. First, does engagement with program content predict long-term outcomes? Second, which users are most likely to drop out or disengage from the program? Third, do particular intervention strategies enhance engagement? OBJECTIVE: To determine: (1) whether engagement (defined by the number of Web sections opened) in a Web-based smoking cessation intervention predicts 6-month abstinence, (2) whether particular sociodemographic and psychographic groups are more likely to have lower engagement, and (3) whether particular components of a Web-based smoking cessation program influence engagement. METHODS: A randomized trial of 1866 smokers was used to examine the efficacy of 5 different treatment components of a Web-based smoking cessation intervention. The components were: high- versus low-personalized message source, high- versus low-tailored outcome expectation, efficacy expectation, and success story messages. Moreover, the timing of exposure to these sections was manipulated, with participants randomized to either a single unified Web program with all sections available at once, or sequential exposure to each section over a 5-week period of time. Participants from 2 large health plans enrolled to receive the online behavioral smoking cessation program and a free course of nicotine replacement therapy (patch). The program included: an introduction section, a section focusing on outcome expectations, 2 sections focusing on efficacy expectations, and a section with a narrative success story (5 sections altogether, each with multiple screens). Most of the analyses were conducted with a stratification of the 2 exposure types. Measures included: sociodemographic and psychosocial characteristics, Web sections opened, perceived message relevance, and smoking cessation 6-months following quit date. RESULTS: The total number of Web sections opened was related to subsequent smoking cessation. Participants who were younger, were male, or had less formal education were more likely to disengage from the Web-based cessation program, particularly when the program sections were delivered sequentially over time. More personalized source and high-depth tailored self-efficacy components were related to a greater number of Web sections opened. A path analysis model suggested that the impact of high-depth message tailoring on engagement in the sequentially delivered Web program was mediated by perceived message relevance. CONCLUSIONS: Results of this study suggest that one of the mechanisms underlying the impact of Web-based smoking cessation interventions is engagement with the program. The source of the message, the degree of message tailoring, and the timing of exposure appear to influence Web-based program engagement. Gunther Eysenbach 2008-11-04 /pmc/articles/PMC2630833/ /pubmed/18984557 http://dx.doi.org/10.2196/jmir.1002 Text en © Victor Strecher, Jennifer McClure, Gwen Alexander, Bibhas Chakraborty, Vijay Nair, Janine Konkel, Sarah Greene, Mick Couper, Carola Carlier, Cheryl Wiese, Roderick Little, Cynthia Pomerleau, Ovide Pomerleau. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.11.2008. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Strecher, Victor J McClure, Jennifer Alexander, Gwen Chakraborty, Bibhas Nair, Vijay Konkel, Janine Greene, Sarah Couper, Mick Carlier, Carola Wiese, Cheryl Little, Roderick Pomerleau, Cynthia Pomerleau, Ovide The Role of Engagement in a Tailored Web-Based Smoking Cessation Program: Randomized Controlled Trial |
title | The Role of Engagement in a Tailored Web-Based Smoking Cessation Program: Randomized Controlled Trial |
title_full | The Role of Engagement in a Tailored Web-Based Smoking Cessation Program: Randomized Controlled Trial |
title_fullStr | The Role of Engagement in a Tailored Web-Based Smoking Cessation Program: Randomized Controlled Trial |
title_full_unstemmed | The Role of Engagement in a Tailored Web-Based Smoking Cessation Program: Randomized Controlled Trial |
title_short | The Role of Engagement in a Tailored Web-Based Smoking Cessation Program: Randomized Controlled Trial |
title_sort | role of engagement in a tailored web-based smoking cessation program: randomized controlled trial |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2630833/ https://www.ncbi.nlm.nih.gov/pubmed/18984557 http://dx.doi.org/10.2196/jmir.1002 |
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