JMIR Publications

ABSTRACT

Background:

eHealth is a promising tool for promoting lifestyle behaviors, such as a healthy diet and physical activity (PA). However, making people use interventions is a crucial and challenging problem in eHealth. More insight into usage patterns and predicting factors is needed to improve future interventions.

Objective:

This paper examines the (predictors of) usage and appreciation of a web-based, computer-tailored dietary and PA promotion intervention, MyLifestyleCoach, which is based on self-determination theory. Firstly, we depict the participants’ flow in the intervention and identify moments when people are likely to discontinue its use. Secondly, we investigate whether demographic, motivational, and program-related characteristics predict the usage of several intervention elements. Lastly, we report the intervention’s appreciation scores and the participant and program characteristics associated with these scores.

Methods:

This study is based on data from online self-report questionnaires. Here, objectively assessed usage data was analyzed from participants randomized to the intervention condition. Multiple stepwise (logistic) regression analyses were conducted to examine the predictors of the intervention’s usage and evaluation scores.

Results:

Our findings indicate a low full completion rate for the intervention among those who chose and completed respectively the diet module (49/146, 33.6%), the PA module (2/12, 16.7%), and both modules (58/273, 21.2%). Several points in the intervention where participants were likely to stop using the intervention were identified. Autonomous and intrinsic motivation towards diet was related to the completion of the initial sessions of the intervention (i.e., the opening session in which participants could choose which module to follow and the first session of the diet module). In contrast, controlled motivation was linked to the completion of both modules (initial and follow-up sessions). The appreciation scores were somewhat positive. Appreciation was predicted by several motivational constructs, such as amotivation and basic psychological needs (e.g., competence) and program-related features (e.g., the number of completed sessions).

Conclusions:

This study adds meaningful information on the use and appreciation of a web-based, computer-tailored dietary and PA intervention, MyLifestyleCoach. Results indicate that different types of motivations, such as extrinsic and intrinsic motivation, are at play at points when people are likely to stop using the intervention. The intervention was appreciated fairly well, and several motivational constructs and fulfillment of the basic psychological needs were associated with appreciation. Practical implications of these findings have been provided. Clinical Trial: Netherlands Trial Register NL7333; https://www.trialregister.nl/trial/7333