Translating Strategies for Promoting Engagement in Mobile Health: A Proof-of-Concept Micro-Randomized Trial

Details

• Alternative Title:
  Health Psychol
• Personal Author:
  Nahum-Shani, Inbal ; Rabbi, Mashfiqui ; Yap, Jamie ; Philyaw-Kotov, Meredith L. ; Klasnja, Predrag ; Bonar, Erin E. ; Cunningham, Rebecca M. ; Murphy, Susan A. ; Walton, Maureen A.
• Description:
  Objective:
  
  Mobile technologies allow for accessible and cost-effective health monitoring and intervention delivery. Despite these advantages, mobile health (mHealth) engagement is often insufficient. While monetary incentives may increase engagement, they can backfire, dampening intrinsic motivations and undermining intervention scalability. Theories from psychology and behavioral economics suggest useful non-monetary strategies for promoting engagement; however, examinations of the applicability of these strategies to mHealth engagement are lacking. This proof-of-concept study evaluates the translation of theoretically-grounded engagement strategies into mHealth, by testing their potential utility in promoting daily self-reporting.
  
  Methods:
  
  A micro-randomized trial (MRT) was conducted with adolescents and emerging adults with past-month substance use. Participants were randomized multiple times daily to receive theoretically-grounded strategies, namely reciprocity (the delivery of inspirational quote prior to self-reporting window) and non-monetary reinforcers (e.g., the delivery of meme/gif following self-reporting completion) to improve proximal engagement in daily mHealth self-reporting.
  
  Results:
  
  Daily self-reporting rates (62.3%; n=68) were slightly lower than prior literature, albeit with much lower financial incentives. The utility of specific strategies was found to depend on contextual factors pertaining to the individual’s receptivity and risk for disengagement. For example, the effect of reciprocity significantly varied depending on whether this strategy was employed (vs. not employed) during the weekend. The non-monetary reinforcement strategy resulted in different outcomes when operationalized in various ways.
  
  Conclusions:
  
  While the results support the translation of the reciprocity strategy into this mHealth setting, the translation of non-monetary reinforcement requires further consideration prior to inclusion in a full scale MRT.
  
  
• Subjects:
  Adolescent Adult Humans Motivation Self Report Telemedicine
• Keywords:
  Chlorination Engagement Household Water Treatment Micro-Randomized Trial (MRT) Mobile Health (mHealth) Reciprocity Reinforcement Safe Water Storage [ClinicalTrials.gov: NCT03255317]
• Source:
  Health Psychol. 40(12):974-987
• Pubmed ID:
  34735165
• Pubmed Central ID:
  PMC8738098
• Document Type:
  Journal Article
• Funding:
  R49 CE002099/CE/NCIPC CDC HHSUnited States/ ; Michigan Institute for Data Science/ ; R49CE002099/ACL/ACL HHSUnited States/ ; P50 DA039838/DA/NIDA NIH HHSUnited States/ ; National Institutes of Health; National Institute on Alcohol Abuse and Alcoholism/ ; R01 AA023187/AA/NIAAA NIH HHSUnited States/ ; National Institutes of Health; National Institute on Drug Abuse/ ; U01 CA229437/CA/NCI NIH HHSUnited States/ ; U10 CA180819/CA/NCI NIH HHSUnited States/ ; CC/CDC HHSUnited States/ ; P41 EB028242/EB/NIBIB NIH HHSUnited States/ ; R01 DA039901/DA/NIDA NIH HHSUnited States/
• Volume:
  40
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e6fa6b8c1d22192e2baa631ff8733c176b2832e5c53bf9b4dde0495d0cb9907f
• Download URL:
  https://stacks.cdc.gov/view/cdc/113156/cdc_113156_DS1.pdf
• File Type:
  [PDF - 999.58 KB ]