JMIR Publications

ABSTRACT

Background:

E- and m-health interventions have gained momentum to change health behaviours such as physical activity (PA) and sedentary behaviour (SB). Although these interventions show promising results in terms of behaviour change, they still suffer from high attrition rates, resulting in a lower potential and reachability. In order to reduce attrition rates in the future, there is a need to investigate the reasons why individuals stop using e- and m-health interventions. Certain demographic variables have already been related to attrition in e- and m-health interventions, however the role of psychosocial determinants of behaviour change as predictors of attrition has not yet been fully explored.

Objective:

The aim of this study was to examine when, which and why users stop using an e- and m-health intervention. In particular, we aimed to investigate whether psychosocial determinants of behaviour change were predictors for attrition.

Methods:

The sample consisted of 473 healthy adults who participated in the e-and m-health intervention ‘MyPlan 2.0’ to promote PA or reduce SB. The intervention was developed using the Health Action Process Approach (HAPA) model, which describes psychosocial determinants that guide individuals in changing their behaviour. If participants stopped with the intervention, a questionnaire with eight question concerning attrition was sent by email. To analyze when users stopped using the intervention, descriptive statistics were used per part of the intervention (including pre- and post-test measurements, and 5 website sessions). To analyze which users stopped using the intervention, demographic variables, behavioural status and HAPA-based psychosocial determinants at pre-test measurement were investigated as potential predictors of attrition using logistic regression models. To analyze why users stopped using the intervention, descriptive statistics of answers to the attrition related questionnaire were used.

Results:

The study demonstrated that 227 of the 473 (47,9%) participants stopped using the intervention, and drop out occurred mainly in the beginning of the intervention. The results seem to indicate that gender and participants’ scores on the psychosocial determinants action planning, coping planning and self-monitoring were predictors of first session, third session and/or whole intervention completion. The most endorsed reasons to stop with the intervention were the time-consuming nature of questionnaires, not having time, dissatisfaction with the content of the intervention, technical problems, already meeting the guidelines for PA/SB, and to a lesser extent the experience of medical/emotional problems.

Conclusions:

This study provides some directions for future studies. To decrease attrition, it will be important to personalise interventions on different levels, questionnaires (either for research purposes or tailoring) should be kept to a minimum especially in the beginning of interventions by for example using objective monitoring devices, and technical aspects of e-and m-health interventions should be thoroughly tested in advance.