Defining and Measuring Engagement With Digital Behavior Change Interventions: Application to the Skata Mobile Application for Family Planning in Indonesia

digital health;mHealth;SBCC;behavior change;health communication;family planning;contraception;engagement;decision support;Social & Behavioral Sciences

Rajan, RadhaLabrique, Alain ;

Johns Hopkins University

关键词: digital health;    mHealth;    SBCC;    behavior change;    health communication;    family planning;    contraception;    engagement;    decision support;    Social & Behavioral Sciences;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/59982/RAJAN-DISSERTATION-2018.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Background: There is growing excitement about the potential of digital behavior change interventions (DBCIs) in low and middle-income countries. However, there is limited research on how to define and measure factors that facilitate and inhibit continued participation or ;;engagement” in DBCIs.Parent Study: The dissertation was situated in the MyChoice program, which addresses family planning (FP) demand, supply and service delivery issues. The Skata application (app) and website are a portion of the digital strategy for generating FP demand in Indonesia.Methods & Results: This study begins with a concept explication of engagement with DBCIs. The concept consists of three dimensions (cognitive, emotional and behavioral engagement) and four phases describing behavioral engagement over time. An Extended Engagement Index (EEI) is proposed to align with the concept of engagement with DBCIs. Applying the EEI to Skata mobile application and website usage data, we find high internal consistency of the scale (Chronbach’s Alpha = .8630) and good criterion validity in comparing EEI to a more traditional engagement measure, specifically length of DBCI use. Five factors representing motivations for Skata use are identified, four of which describe seeking and scanning motivations that significantly predict higher engagement with Skata. Comparing these motivations and experiences of Skata engagement qualitatively, we find scanners tend to access a broad variety of features while seekers making planning and contraceptive decisions tend to use a narrow set of features repeatedly before disengagement. For many Skata users, interpersonal communication represents an important step in the conceptual framework connecting engagement in a health topic with engagement in a related DBCI, and mediating the path to behavior change.Significance: The field of digital health is growing rapidly, but standardized metrics have not been widely adopted and thus engagement with DBCIs is still understudied. This research fills significant gaps in the literature to develop a framework for DBCI outcome evaluation.