JMIR Publications

ABSTRACT

Background:

Digital health interventions, have the potential to improve the physical and psychosocial health of people living with type 2 diabetes. However, research investigating the long-term (≥1 year) retention and engagement of users within these programmes is limited.

Objective:

To evaluate long-term user retention and engagement in a digital-based self-management programme (myDESMOND), using real world data.

Methods:

Anonymised data from all myDESMOND users who registered with the programme on or before 16th November 2020 were included in the analyses. User retention was defined as the period between a user registering onto the myDESMOND programme and their last date of access. The primary engagement outcome was defined as the total number of logins to the programme per user. The associations between retention/engagement and sociodemographic factors (age, sex, ethnicity) were tested using Cox regression models and Wilcoxon rank sum tests.

Results:

A total of 9,522 myDESMOND users were included in this analysis. Of these, 56% remained using myDESMOND for at least a month, and 18% remained on the programme for at least one year. Retention was significantly higher among older users; the adjusted hazard ratio (representing the risk of users leaving the programme within the first year) among users aged ≥50 years, compared to those aged <50 years, was 0.80 (95% Confidence Interval: 0.75-0.85). In total, users logged into myDESMOND 8 (IQR: 4-18) times, however engagement was significantly higher among older users, and users from a White ethnic background.

Conclusions:

Although retention and engagement of users on myDESMOND were found to be high, these findings highlight the need for age- and cultural-specific implementation strategies and content adaptations, in order to improve retention and engagement among all users of self-management programmes. Clinical Trial: n/a