JMIR Publications

ABSTRACT

Background:

A critical issue in understanding the benefits of online interventions is a lack of information on the sustainability of those benefits. Sustainability in studies is often determined using group-level analyses which might obscure our understanding of who actually sustains change. Person-centric methods might provide a deeper knowledge of whether benefits are sustained and who tend to sustain those benefits.

Objective:

We conducted a person-centric analysis of longitudinal outcomes, examining wellbeing in participants over the first three months following an online happiness intervention. We predicted we would find distinct trajectories in people’s pattern of response over time. We also sought to identify what aspects of the intervention and the individual predicted an individual’s wellbeing trajectory.

Methods:

Data were gathered from two large studies of online happiness interventions: one in which participants were randomly assigned to one of fourteen possible one-week activities (N = 912) and another wherein participants were randomly assigned to complete zero, two, four, or six weeks of activities (N = 1,318). We performed a variation of k-means cluster analysis on trajectories of Life Satisfaction (LS) and Affect Balance (AB). After clusters were identified, we used exploratory ANOVAs and logistic regression models to analyze groups and compare predictors of group membership.

Results:

Cluster analysis produced similar cluster solutions for each sample. In both cases, participant trajectories in LS and AB fell into one of four distinct groups. These groups were: those with high and static levels of happiness (42.8-52.8%), those who experienced a lasting improvement (18.0-26.8%), those who experienced a temporary improvement but returned to baseline (13.4-14.2%), and those with other trajectories (15.0-17.0%). The prevalence of depression symptoms predicted membership in one of the later three groups. Higher usage and greater adherence predicted sustained rather than temporary benefits.

Conclusions:

We revealed a few common patterns of change among those completing online happiness interventions. Noteworthy were that many individuals began quite happy and maintained those levels. We failed to identify evidence that the benefit of any particular activity or group of activities was more sustainable than any others. We did find, however, that the distressed portion of participants were more likely to achieve a lasting benefit if they continued to practice, and adhere to, their assigned online happiness intervention.