Evaluating Engagement with Behavior Change Apps for Groups Experiencing Disadvantages

Getachew-Smith, Hannah Badal

doi:https://doi.org/10.21985/n2-4v06-js62

Work

Evaluating Engagement with Behavior Change Apps for Groups Experiencing Disadvantages

Public

Download PDF

Download All Files (.zip)

Digital behavior change interventions (e.g., mHealth, websites, behavior change apps) can be an effective way to engage groups who experience disadvantages in terms of social and economic attainment, with tailored health content and have potential to improve health outcomes and reduce health disparities. Given the importance and pervasiveness of behavior change apps, it is essential to evaluate their effectiveness to determine if they create change in behavior that improves health and well-being. Engagement, or how users interact with behavior change apps, is often used to quantify success. However, evaluating user engagement with behavior change apps is difficult. Within the field of behavioral sciences, little consensus exists on how to conceptualize and measure user engagement with behavior change apps. Effective measures to evaluate engagement are needed. This would allow for a better understanding of effectiveness and inform future interventions. Moreover, there is limited research on engagement with groups experiencing disadvantages.Thus, the purpose of this dissertation was to conduct exploratory research to understand behavioral and psychosocial (e.g., cognitive and affective) engagement with behavior change apps for groups experiencing disadvantages. Using a behavioral scientist lens, I employed a mixed-methods approach to evaluate engagement with an existing intervention, the Centers for Disease Control and Prevention’s (CDC) Milestone Tracker— a mobile app to help families identify developmental delays and disabilities in young children. Using a three article model approach and drawing on models of engagement that center engagement as a multidimensional phenomenon inclusive of behavioral (both engagement with the app and engagement with the health behavior), cognitive, and affective processes, this dissertation consisted of three studies: (1) a systematic review of the literature (N = 21 articles included) to identify existing conceptual definitions, measures, and methods to measure engagement with behavior change apps for groups experiencing disadvantages, (2) baseline and one-month follow-up surveys and app usage data to understand parent and caregiver (N = 72) engagement with the CDC’s Milestone Tracker app, and (3) interviews to explore perceptions of engagement with CDC’s Milestone Tracker app from the perspective of pediatric clinicians at Federally Qualified Health Centers (N = 20). The findings from these three studies fill a gap in the engagement literature specific to behavior change apps for groups experiencing disadvantages. The culmination of this research helps to consolidate our understanding of engagement and can guide future intervention and evaluation design to develop behavior change apps that are engaging for all.

Creator