Journal
JOURNAL OF MEDICAL INTERNET RESEARCH
Volume 20, Issue 11, Pages -Publisher
JMIR PUBLICATIONS, INC
DOI: 10.2196/jmir.9397
Keywords
telemedicine; internet; health promotion; evaluation studies; treatment adherence and compliance; outcome and process assessment (health care)
Funding
- Freemasons Foundation Centre for Men's Health summer scholarship
- National Health and Medical Research Council (NHMRC) Early Career Research fellowship [1090517]
- Research Foundation-Flanders
- National Heart Foundation of Australia [100427]
- NHMRC Career Development fellowship [1125913]
- Research Foundation Flanders grant [FWO16/PDO/060, 12H6717N]
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Engagement in electronic health (eHealth) and mobile health (mHealth) behavior change interventions is thought to be important for intervention effectiveness, though what constitutes engagement and how it enhances efficacy has been somewhat unclear in the literature. Recently published detailed definitions and conceptual models of engagement have helped to build consensus around a definition of engagement and improve our understanding of how engagement may influence effectiveness. This work has helped to establish a clearer research agenda. However, to test the hypotheses generated by the conceptual modules, we need to know how to measure engagement in a valid and reliable way. The aim of this viewpoint is to provide an overview of engagement measurement options that can be employed in eHealth and mHealth behavior change intervention evaluations, discuss methodological considerations, and provide direction for future research. To identify measures, we used snowball sampling, starting from systematic reviews of engagement research as well as those utilized in studies known to the authors. A wide range of methods to measure engagement were identified, including qualitative measures, self-report questionnaires, ecological momentary assessments, system usage data, sensor data, social media data, and psychophysiological measures. Each measurement method is appraised and examples are provided to illustrate possible use in eHealth and mHealth behavior change research. Recommendations for future research are provided, based on the limitations of current methods and the heavy reliance on system usage data as the sole assessment of engagement. The validation and adoption of a wider range of engagement measurements and their thoughtful application to the study of engagement are encouraged.
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