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Engagement and attrition in Internet smoking cessation interventions: Insights from a cross-sectional survey of “one-hit-wonders”

INTRODUCTION: Internet interventions can reach large numbers of individuals. However, low levels of engagement and high rates of follow-up attrition are common, presenting major challenges to evaluation. This study investigated why registrants of an Internet smoking cessation intervention did not re...

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Autores principales: Saul, Jessie E., Amato, Michael S., Cha, Sarah, Graham, Amanda L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096296/
https://www.ncbi.nlm.nih.gov/pubmed/30135803
http://dx.doi.org/10.1016/j.invent.2016.07.001
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author Saul, Jessie E.
Amato, Michael S.
Cha, Sarah
Graham, Amanda L.
author_facet Saul, Jessie E.
Amato, Michael S.
Cha, Sarah
Graham, Amanda L.
author_sort Saul, Jessie E.
collection PubMed
description INTRODUCTION: Internet interventions can reach large numbers of individuals. However, low levels of engagement and high rates of follow-up attrition are common, presenting major challenges to evaluation. This study investigated why registrants of an Internet smoking cessation intervention did not return after joining (“one hit wonders”), and explored the impact of graduated incentives on survey response rates and responder characteristics. METHODS: A sample of “one hit wonders” that registered on a free smoking cessation website between 2014 and 2015 were surveyed. The initial invitation contained no incentive. Subsequent invitations were sent to random subsamples of non-responders from each previous wave offering $25 and $50 respectively. Descriptive statistics characterized respondents on demographic characteristics, reasons for not returning, and length of time since last visit. Differences were investigated with Fisher's Exact tests, Kruskal-Wallis, and logistic regression. RESULTS: Of 8779 users who received the initial invitation, 132 completed the survey (1.5%). Among those subsequently offered a $25 incentive, 127 (3.7%) responded. Among those offered a $50 incentive, 97 responded (5.7%). The most common reasons endorsed for not returning were being unable to quit (51%), not having enough time (33%), having forgotten about the website (28%), and not being ready to quit (21%). Notably, however, 23% reported not returning because they had successfully quit smoking. Paid incentives yielded a higher proportion of individuals who were still smoking than the $0 incentive (72% vs. 61%). Among $0 and $25 responders, likelihood of survey response decreased with time since registration; the $50 incentive removed the negative effect of time-since-registration on probability of response. CONCLUSIONS: One third of participants that had disengaged from an Internet intervention reported abstinence at follow-up, suggesting that low levels of engagement are not synonymous with treatment failure in all cases. Paid incentives above $25 may be needed to elicit survey responses, especially among those with longer intervals of disengagement from an intervention.
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spelling pubmed-60962962018-08-22 Engagement and attrition in Internet smoking cessation interventions: Insights from a cross-sectional survey of “one-hit-wonders” Saul, Jessie E. Amato, Michael S. Cha, Sarah Graham, Amanda L. Internet Interv Full length Article INTRODUCTION: Internet interventions can reach large numbers of individuals. However, low levels of engagement and high rates of follow-up attrition are common, presenting major challenges to evaluation. This study investigated why registrants of an Internet smoking cessation intervention did not return after joining (“one hit wonders”), and explored the impact of graduated incentives on survey response rates and responder characteristics. METHODS: A sample of “one hit wonders” that registered on a free smoking cessation website between 2014 and 2015 were surveyed. The initial invitation contained no incentive. Subsequent invitations were sent to random subsamples of non-responders from each previous wave offering $25 and $50 respectively. Descriptive statistics characterized respondents on demographic characteristics, reasons for not returning, and length of time since last visit. Differences were investigated with Fisher's Exact tests, Kruskal-Wallis, and logistic regression. RESULTS: Of 8779 users who received the initial invitation, 132 completed the survey (1.5%). Among those subsequently offered a $25 incentive, 127 (3.7%) responded. Among those offered a $50 incentive, 97 responded (5.7%). The most common reasons endorsed for not returning were being unable to quit (51%), not having enough time (33%), having forgotten about the website (28%), and not being ready to quit (21%). Notably, however, 23% reported not returning because they had successfully quit smoking. Paid incentives yielded a higher proportion of individuals who were still smoking than the $0 incentive (72% vs. 61%). Among $0 and $25 responders, likelihood of survey response decreased with time since registration; the $50 incentive removed the negative effect of time-since-registration on probability of response. CONCLUSIONS: One third of participants that had disengaged from an Internet intervention reported abstinence at follow-up, suggesting that low levels of engagement are not synonymous with treatment failure in all cases. Paid incentives above $25 may be needed to elicit survey responses, especially among those with longer intervals of disengagement from an intervention. Elsevier 2016-07-07 /pmc/articles/PMC6096296/ /pubmed/30135803 http://dx.doi.org/10.1016/j.invent.2016.07.001 Text en © 2016 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Full length Article
Saul, Jessie E.
Amato, Michael S.
Cha, Sarah
Graham, Amanda L.
Engagement and attrition in Internet smoking cessation interventions: Insights from a cross-sectional survey of “one-hit-wonders”
title Engagement and attrition in Internet smoking cessation interventions: Insights from a cross-sectional survey of “one-hit-wonders”
title_full Engagement and attrition in Internet smoking cessation interventions: Insights from a cross-sectional survey of “one-hit-wonders”
title_fullStr Engagement and attrition in Internet smoking cessation interventions: Insights from a cross-sectional survey of “one-hit-wonders”
title_full_unstemmed Engagement and attrition in Internet smoking cessation interventions: Insights from a cross-sectional survey of “one-hit-wonders”
title_short Engagement and attrition in Internet smoking cessation interventions: Insights from a cross-sectional survey of “one-hit-wonders”
title_sort engagement and attrition in internet smoking cessation interventions: insights from a cross-sectional survey of “one-hit-wonders”
topic Full length Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096296/
https://www.ncbi.nlm.nih.gov/pubmed/30135803
http://dx.doi.org/10.1016/j.invent.2016.07.001
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