JMIR Publications

ABSTRACT

Background:

Research about the engagement of adolescents with mobile health (mHealth) interventions is scarce, while it is generally assumed that the engagement affects the intervention efficacy.

Objective:

The mHealth intervention #LIFEGOALS was used to investigate (a) how adolescents engage with a mobile health promotion intervention, (b) which engagement styles can be identified and how these differ according to personal characteristics, and (c) which style of engagement predicts behavior change. #LIFEGOALS includes self-regulation techniques, a support chatbot, narrative videos, and gamification, brought together in an app coupled to an activity tracker.

Methods:

Logged usage data and self-reports of experience with #LIFEGOALS were collected from 184 adolescents (mean age 13.50, SD 0.97) over a 12-week intervention period. These data were used to describe behavioral and experiential engagement with the intervention components over time. Engagement styles were identified using exploratory cluster analysis on the frequency of usage of the components, and were characterized by multinomial logistic regression on baseline sociodemographic variables, mental health, and behavioral determinants. Linear regression was used to analyze the effect of engagement style on health behavior change (i.e., physical activity, sedentary time, sleep regularity, sleep quality and frequency of taking breakfast).

Results:

Eighty-six percent (159/184) of the participants installed the app and were included in the analyses. Average time in the app was 26 minutes (SD 26.00) over 12 weeks, but the extent of usage substantially decreased after week one. The use of the self-regulation techniques and gamification component were strongly interrelated (0.65

Conclusions:

Engagement styles were identified differing in the frequency of use and the components being used. The results support the relevance of tailoring mHealth to individual, interpersonal and contextual characteristics. The overall low engagement with the intervention may have limited the detection of differences in health effects between engagement styles. Clinical Trial: ClinicalTrials.gov [NCT04719858], registered on 22/01/2021.