title: Patterns of User Engagement with Mobile- and Web-Delivered Self-Care Interventions for Adults with T2DM: A Review of the Literature.
abstract: Technology-delivered interventions can improve the health behaviors and clinical outcomes of persons with diabetes, but only if end users engage with these interventions. To summarize the current knowledge on engagement with technology-based interventions, we conducted a review of recent mobile- and web-delivered intervention studies for adults with type 2 diabetes published from 2011 to 2015. Among 163 identified studies, 24 studies satisfied our inclusion criteria. There was substantial variation in how intervention engagement was reported across studies. Engagement rates were lower among interventions with a longer duration, and engagement decreased over time. In several studies, older age and lower health literacy were associated with less engagement, and more engagement was associated with intervention improvement in at least one outcome, including glycemic control. Future technology-based intervention studies should report on engagement, examine and report on associations between user characteristics and engagement, and aim to standardize how this is reported, particularly in longer trials.
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.|Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Lyndsay A
authors.initials: LA
authors.lastname: Nelson
authors.affiliation: School of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Taylor D
authors.initials: TD
authors.lastname: Coston
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.|Division of Preventative Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Cherrington
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. chandra.osborn@vanderbilt.edu.|Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA. chandra.osborn@vanderbilt.edu.|Center for Diabetes Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA. chandra.osborn@vanderbilt.edu.|Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA. chandra.osborn@vanderbilt.edu.
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D040421:Cell Phone; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D015438:Health Behavior; D006801:Humans; D020407:Internet; D012648:Self Care; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose
keywords: Diabetes; Engagement; Internet; Intervention; Mobile; Review; Technology