Assessing User Engagement of an mHealth Intervention: Development and Implementation of the Growing Healthy App Engagement Index

BackgroundChildhood obesity is an ongoing problem in developed countries that needs targeted prevention in the youngest age groups. Children in socioeconomically disadvantaged families are most at risk. Mobile health (mHealth) interventions offer a potential route to target these families because of...

Full description

Bibliographic Details
Main Authors: Taki, Sarah, Lymer, Sharyn, Russell, Catherine Georgina, Campbell, Karen, Laws, Rachel, Ong, Kok-Leong, Elliott, Rosalind, Denney-Wilson, Elizabeth
Format: Article
Language:English
Published: JMIR Publications 2017-06-01
Series:JMIR mHealth and uHealth
Online Access:http://mhealth.jmir.org/2017/6/e89/
_version_ 1818902085330010112
author Taki, Sarah
Lymer, Sharyn
Russell, Catherine Georgina
Campbell, Karen
Laws, Rachel
Ong, Kok-Leong
Elliott, Rosalind
Denney-Wilson, Elizabeth
author_facet Taki, Sarah
Lymer, Sharyn
Russell, Catherine Georgina
Campbell, Karen
Laws, Rachel
Ong, Kok-Leong
Elliott, Rosalind
Denney-Wilson, Elizabeth
author_sort Taki, Sarah
collection DOAJ
description BackgroundChildhood obesity is an ongoing problem in developed countries that needs targeted prevention in the youngest age groups. Children in socioeconomically disadvantaged families are most at risk. Mobile health (mHealth) interventions offer a potential route to target these families because of its relatively low cost and high reach. The Growing healthy program was developed to provide evidence-based information on infant feeding from birth to 9 months via app or website. Understanding user engagement with these media is vital to developing successful interventions. Engagement is a complex, multifactorial concept that needs to move beyond simple metrics. ObjectiveThe aim of our study was to describe the development of an engagement index (EI) to monitor participant interaction with the Growing healthy app. The index included a number of subindices and cut-points to categorize engagement. MethodsThe Growing program was a feasibility study in which 300 mother-infant dyads were provided with an app which included 3 push notifications that was sent each week. Growing healthy participants completed surveys at 3 time points: baseline (T1) (infant age ≤3 months), infant aged 6 months (T2), and infant aged 9 months (T3). In addition, app usage data were captured from the app. The EI was adapted from the Web Analytics Demystified visitor EI. Our EI included 5 subindices: (1) click depth, (2) loyalty, (3) interaction, (4) recency, and (5) feedback. The overall EI summarized the subindices from date of registration through to 39 weeks (9 months) from the infant’s date of birth. ResultsThe overall EI mean score was 30.0% (SD 11.5%) with a range of 1.8% - 57.6%. The cut-points used for high engagement were scores greater than 37.1% and for poor engagement were scores less than 21.1%. Significant explanatory variables of the EI score included: parity (P=.005), system type including “app only” users or “both” app and email users (P<.001), recruitment method (P=.02), and baby age at recruitment (P=.005). ConclusionsThe EI provided a comprehensive understanding of participant behavior with the app over the 9-month period of the Growing healthy program. The use of the EI in this study demonstrates that rich and useful data can be collected and used to inform assessments of the strengths and weaknesses of the app and in turn inform future interventions.
first_indexed 2024-12-19T20:30:02Z
format Article
id doaj.art-395536d2240f4b4ea5e3f0bf7503d949
institution Directory Open Access Journal
issn 2291-5222
language English
last_indexed 2024-12-19T20:30:02Z
publishDate 2017-06-01
publisher JMIR Publications
record_format Article
series JMIR mHealth and uHealth
spelling doaj.art-395536d2240f4b4ea5e3f0bf7503d9492022-12-21T20:06:44ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222017-06-0156e8910.2196/mhealth.7236Assessing User Engagement of an mHealth Intervention: Development and Implementation of the Growing Healthy App Engagement IndexTaki, SarahLymer, SharynRussell, Catherine GeorginaCampbell, KarenLaws, RachelOng, Kok-LeongElliott, RosalindDenney-Wilson, ElizabethBackgroundChildhood obesity is an ongoing problem in developed countries that needs targeted prevention in the youngest age groups. Children in socioeconomically disadvantaged families are most at risk. Mobile health (mHealth) interventions offer a potential route to target these families because of its relatively low cost and high reach. The Growing healthy program was developed to provide evidence-based information on infant feeding from birth to 9 months via app or website. Understanding user engagement with these media is vital to developing successful interventions. Engagement is a complex, multifactorial concept that needs to move beyond simple metrics. ObjectiveThe aim of our study was to describe the development of an engagement index (EI) to monitor participant interaction with the Growing healthy app. The index included a number of subindices and cut-points to categorize engagement. MethodsThe Growing program was a feasibility study in which 300 mother-infant dyads were provided with an app which included 3 push notifications that was sent each week. Growing healthy participants completed surveys at 3 time points: baseline (T1) (infant age ≤3 months), infant aged 6 months (T2), and infant aged 9 months (T3). In addition, app usage data were captured from the app. The EI was adapted from the Web Analytics Demystified visitor EI. Our EI included 5 subindices: (1) click depth, (2) loyalty, (3) interaction, (4) recency, and (5) feedback. The overall EI summarized the subindices from date of registration through to 39 weeks (9 months) from the infant’s date of birth. ResultsThe overall EI mean score was 30.0% (SD 11.5%) with a range of 1.8% - 57.6%. The cut-points used for high engagement were scores greater than 37.1% and for poor engagement were scores less than 21.1%. Significant explanatory variables of the EI score included: parity (P=.005), system type including “app only” users or “both” app and email users (P<.001), recruitment method (P=.02), and baby age at recruitment (P=.005). ConclusionsThe EI provided a comprehensive understanding of participant behavior with the app over the 9-month period of the Growing healthy program. The use of the EI in this study demonstrates that rich and useful data can be collected and used to inform assessments of the strengths and weaknesses of the app and in turn inform future interventions.http://mhealth.jmir.org/2017/6/e89/
spellingShingle Taki, Sarah
Lymer, Sharyn
Russell, Catherine Georgina
Campbell, Karen
Laws, Rachel
Ong, Kok-Leong
Elliott, Rosalind
Denney-Wilson, Elizabeth
Assessing User Engagement of an mHealth Intervention: Development and Implementation of the Growing Healthy App Engagement Index
JMIR mHealth and uHealth
title Assessing User Engagement of an mHealth Intervention: Development and Implementation of the Growing Healthy App Engagement Index
title_full Assessing User Engagement of an mHealth Intervention: Development and Implementation of the Growing Healthy App Engagement Index
title_fullStr Assessing User Engagement of an mHealth Intervention: Development and Implementation of the Growing Healthy App Engagement Index
title_full_unstemmed Assessing User Engagement of an mHealth Intervention: Development and Implementation of the Growing Healthy App Engagement Index
title_short Assessing User Engagement of an mHealth Intervention: Development and Implementation of the Growing Healthy App Engagement Index
title_sort assessing user engagement of an mhealth intervention development and implementation of the growing healthy app engagement index
url http://mhealth.jmir.org/2017/6/e89/
work_keys_str_mv AT takisarah assessinguserengagementofanmhealthinterventiondevelopmentandimplementationofthegrowinghealthyappengagementindex
AT lymersharyn assessinguserengagementofanmhealthinterventiondevelopmentandimplementationofthegrowinghealthyappengagementindex
AT russellcatherinegeorgina assessinguserengagementofanmhealthinterventiondevelopmentandimplementationofthegrowinghealthyappengagementindex
AT campbellkaren assessinguserengagementofanmhealthinterventiondevelopmentandimplementationofthegrowinghealthyappengagementindex
AT lawsrachel assessinguserengagementofanmhealthinterventiondevelopmentandimplementationofthegrowinghealthyappengagementindex
AT ongkokleong assessinguserengagementofanmhealthinterventiondevelopmentandimplementationofthegrowinghealthyappengagementindex
AT elliottrosalind assessinguserengagementofanmhealthinterventiondevelopmentandimplementationofthegrowinghealthyappengagementindex
AT denneywilsonelizabeth assessinguserengagementofanmhealthinterventiondevelopmentandimplementationofthegrowinghealthyappengagementindex