Mapping the Process of Engagement With Digital Health Interventions: A Cross-Case Synthesis
Objective: To map the associations between affective, cognitive, and behavioral components of engagement with digital health interventions to provide a framework to improve intervention design, evaluation, and impact. Patients and Methods: An exploratory multiple case study examined 3 studies evalua...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2542454825000360 |
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| author | Madison Milne-Ives, PhD Sophie R. Homer, PhD Jackie Andrade, PhD Edward Meinert, PhD |
| author_facet | Madison Milne-Ives, PhD Sophie R. Homer, PhD Jackie Andrade, PhD Edward Meinert, PhD |
| author_sort | Madison Milne-Ives, PhD |
| collection | DOAJ |
| description | Objective: To map the associations between affective, cognitive, and behavioral components of engagement with digital health interventions to provide a framework to improve intervention design, evaluation, and impact. Patients and Methods: An exploratory multiple case study examined 3 studies evaluating a childhood obesity mobile application (NoObesity, data collection: from September 15, 2020 to June 23, 2021), a mental health conversational agent mobile application (Wysa, data collection: from December 13, 2022 to July 31, 2023), and a telephone-delivered conversational agent postsurgical assessment (Dora R1, data collection: from September 17, 2021 to January 31, 2022). Qualitative data from semi-structured interviews (NoObesity: n=15, Wysa: n=4, and Dora R1: n=20) was analyzed using a codebook thematic analysis approach to generate models mapping engagement. A cross-case analysis compared the 3 models with a hypothesized model. Results: The case studies highlighted close associations between affective, cognitive, and behavioral components throughout the engagement process. Similar patterns of engagement were generated from the case studies, but these patterns differed from the literature-based hypothesized model in the order of influence of cognitive and affective engagement. Conclusion: Understanding how different components of engagement interact is essential for designing interventions that mitigate barriers to engagement and maximize intervention impact. The framework provides a preliminary guide and recommendations for how to support particular components. Future research on the order of cognitive and affective components (or importance thereof) and testing the influence of particular features on engagement components could improve the framework and clinical impact. Trial Registration: clinicaltrials.gov Identifier: NoObesity: NCT05261555; Wysa: NCT05533190; Dora R1: NCT05213390 |
| format | Article |
| id | doaj-art-eedb8c8f89d346d78a04bdd02c60cc87 |
| institution | OA Journals |
| issn | 2542-4548 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| spelling | doaj-art-eedb8c8f89d346d78a04bdd02c60cc872025-08-20T02:08:35ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482025-06-019310062510.1016/j.mayocpiqo.2025.100625Mapping the Process of Engagement With Digital Health Interventions: A Cross-Case SynthesisMadison Milne-Ives, PhD0Sophie R. Homer, PhD1Jackie Andrade, PhD2Edward Meinert, PhD3Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, United Kingdom; Faculty of Health, Centre for Health Technology, University of Plymouth, United KingdomFaculty of Health, School of Psychology, University of Plymouth, United KingdomFaculty of Health, School of Psychology, University of Plymouth, United KingdomFaculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, United Kingdom; Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom; Correspondence: Address to Edward Meinert, PhD, DEPTH AI Lab, Campus for Ageing and Vitality, Newcastle University, Westgate Road, Newcastle-upon-Tyne, UK, NE4 6BE.Objective: To map the associations between affective, cognitive, and behavioral components of engagement with digital health interventions to provide a framework to improve intervention design, evaluation, and impact. Patients and Methods: An exploratory multiple case study examined 3 studies evaluating a childhood obesity mobile application (NoObesity, data collection: from September 15, 2020 to June 23, 2021), a mental health conversational agent mobile application (Wysa, data collection: from December 13, 2022 to July 31, 2023), and a telephone-delivered conversational agent postsurgical assessment (Dora R1, data collection: from September 17, 2021 to January 31, 2022). Qualitative data from semi-structured interviews (NoObesity: n=15, Wysa: n=4, and Dora R1: n=20) was analyzed using a codebook thematic analysis approach to generate models mapping engagement. A cross-case analysis compared the 3 models with a hypothesized model. Results: The case studies highlighted close associations between affective, cognitive, and behavioral components throughout the engagement process. Similar patterns of engagement were generated from the case studies, but these patterns differed from the literature-based hypothesized model in the order of influence of cognitive and affective engagement. Conclusion: Understanding how different components of engagement interact is essential for designing interventions that mitigate barriers to engagement and maximize intervention impact. The framework provides a preliminary guide and recommendations for how to support particular components. Future research on the order of cognitive and affective components (or importance thereof) and testing the influence of particular features on engagement components could improve the framework and clinical impact. Trial Registration: clinicaltrials.gov Identifier: NoObesity: NCT05261555; Wysa: NCT05533190; Dora R1: NCT05213390http://www.sciencedirect.com/science/article/pii/S2542454825000360 |
| spellingShingle | Madison Milne-Ives, PhD Sophie R. Homer, PhD Jackie Andrade, PhD Edward Meinert, PhD Mapping the Process of Engagement With Digital Health Interventions: A Cross-Case Synthesis Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| title | Mapping the Process of Engagement With Digital Health Interventions: A Cross-Case Synthesis |
| title_full | Mapping the Process of Engagement With Digital Health Interventions: A Cross-Case Synthesis |
| title_fullStr | Mapping the Process of Engagement With Digital Health Interventions: A Cross-Case Synthesis |
| title_full_unstemmed | Mapping the Process of Engagement With Digital Health Interventions: A Cross-Case Synthesis |
| title_short | Mapping the Process of Engagement With Digital Health Interventions: A Cross-Case Synthesis |
| title_sort | mapping the process of engagement with digital health interventions a cross case synthesis |
| url | http://www.sciencedirect.com/science/article/pii/S2542454825000360 |
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