title: Engagement with a social networking intervention for cancer-related distress.
abstract: BACKGROUND
  Understanding patterns and predictors of engagement could improve the efficacy of Internet interventions.
  
  
  OBJECTIVE
  The purpose of the study was to characterize engagement in a multi-component Internet intervention for cancer survivors with distress.
  
  
  METHODS
  Data were derived from 296 cancer survivors provided with access to the Internet intervention and included self-report measures and directly-measured engagement with each component of the intervention.
  
  
  RESULTS
  Over 12 weeks, average total engagement was 7.3 h (sd = 11.7), and 42 % of participants spent >3 h on the website. Participants spent more time using social networking components than structured intervention content. Greater early and total engagement was associated with previous chemotherapy, being female, and being recruited via the Internet. Early engagement was associated with greater fatigue and more social constraints.
  
  
  CONCLUSIONS
  For many users, engagement with an Internet intervention was quite high. Reducing attrition and tailoring content to better meet the needs of those who do not engage should be a focus of future efforts.
authors.affiliation: Department of Psychology, Loma Linda University, Loma Linda, CA, USA, jason.owen@va.gov.
authors.forename: Jason E
authors.initials: JE
authors.lastname: Owen
authors.forename: Erin O
authors.initials: EO
authors.lastname: Bantum
authors.forename: Amanda
authors.initials: A
authors.lastname: Gorlick
authors.forename: Annette L
authors.initials: AL
authors.lastname: Stanton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D012648:Self Care; D060756:Social Networking; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome