Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 4, 2021
Open Peer Review Period: Jun 3, 2021 - Jul 29, 2021
Date Accepted: Oct 14, 2021
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
NoHoW web-based toolkit with weight and activity tracking for weight-loss maintenance: long-term user experience results from a randomized controlled trial
ABSTRACT
Background:
Digital behavior change interventions (DBCIs) offer a promising channel for providing health promotion services. However, user experience of the technologies largely determines user engagement, which is necessary for their effectiveness.
Objective:
To evaluate user experiences with the NoHoW Toolkit (TK), a DBCI targeting weight loss maintenance (WLM), over a 12-month period using mixed methodology and to identify the main strengths and weaknesses of the TK as well as external factors affecting its adoption. Secondly, the objective was to describe objectively measured usage of the TK and its association with user experience.
Methods:
An 18-month, 2 x 2 factorial randomized controlled trial was delivered, including three intervention arms receiving an 18-week active intervention and a control arm. User experience of the TK was assessed quantitatively through electronic questionnaires after 1, 3, 6 and 12 months of use, including also thematically analyzed open-ended items. Focus group interviews were conducted at month 6 and thematically analyzed to gather deeper insight into user experience. Usage logs of the TK were used to evaluate the number of visits to the TK, the total duration spent in the TK, and intervention completion.
Results:
The level of usability of the TK was rated as satisfactory. User acceptance was rated as modest, declining during the trial in all arms, as did the objectively measured usage of the TK. The most appreciated features were weekly emails, graphs, goal setting, and interactive exercises. Four themes were identified in the qualitative data: 1) engagement with features, 2) usage decline, 3) external factors affecting the user experience, and 4) suggestions for improvements.
Conclusions:
The long-term user experience of the TK highlighted the need to optimize the technical functioning, appearance and content of a DBCI before and during the trial, in a way a commercial app would. The users should be made aware of how they should use the intervention and what the use requires, especially in the case of more intensive intervention content. Clinical Trial: ISRCTN88405328
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