Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions
Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions
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DOI：
10.2196/jmir.7270
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发表时间：
2017-03-01
影响因子：
7.4
通讯作者：
Muench, Fred
中科院分区：
文献类型：
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作者：
Baumel, Amit;Faber, Keren;Muench, Fred
基于标准的评估工具的研究已经证明了独立于实证测试客观评估电子健康干预措施的可行性。然而，目前的工具还没有包括一些与干预结果相关的质量结构，如说服性设计，行为改变或治疗联盟。此外，这些工具的普遍性还没有明确检查。的目的是介绍的发展和进一步分析的Enlight套件的措施，开发，以纳入上述概念和解决的普遍性aspects.MethodsAs第一步，进行了全面系统的审查，以确定相关的质量评级标准符合PRISMA声明。然后将这些标准分类以创建Enlight。第二步是在42个移动的应用程序和42个基于Web的程序（交付媒介）上测试Enlight，这些程序针对与医疗疾病或心理健康（临床目的）相关的可修改行为。评级措施分为两部分：质量评估和核对表。质量评估包括可用性、视觉设计、用户参与、内容、治疗说服力、治疗联盟和一般主观评价。检查表包括可信度，隐私解释，基本安全性和基于证据的程序排名。质量结构表现出良好的评分者间可靠性（组内相关性= 0.77 - 0.98，中位数0.91）和内部一致性（Cronbach α = 0.83 - 0.90，中位数0.88），当分离到交付介质或临床目标时，结果相似。条件概率分析显示，100%在治疗说服力或治疗联盟中获得公平或以上分数（>= 3.0）的程序在用户参与度和内容方面获得相同范围的分数-这种模式并没有出现相反的方向。初步的同时效度分析指出，正相关的综合质量分数与选定的变量。不包括治疗的说服力和治疗联盟的综合评分concretively低于其他综合scores.ConclusionsThis本文提供了实证证据，支持有说服力的设计和治疗联盟的重要性，在一个程序的评价范围内。可靠性指标和初步的并发有效性分析表明，无论交付介质和临床目标的潜在的光线检查电子健康计划。
BackgroundStudies of criteria-based assessment tools have demonstrated the feasibility of objectively evaluating eHealth interventions independent of empirical testing. However, current tools have not included some quality constructs associated with intervention outcome, such as persuasive design, behavior change, or therapeutic alliance. In addition, the generalizability of such tools has not been explicitly examined.ObjectiveThe aim is to introduce the development and further analysis of the Enlight suite of measures, developed to incorporate the aforementioned concepts and address generalizability aspects.MethodsAs a first step, a comprehensive systematic review was performed to identify relevant quality rating criteria in line with the PRISMA statement. These criteria were then categorized to create Enlight. The second step involved testing Enlight on 42 mobile apps and 42 Web-based programs (delivery mediums) targeting modifiable behaviors related to medical illness or mental health (clinical aims).ResultsA total of 476 criteria from 99 identified sources were used to build Enlight. The rating measures were divided into two sections: quality assessments and checklists. Quality assessments included usability, visual design, user engagement, content, therapeutic persuasiveness, therapeutic alliance, and general subjective evaluation. The checklists included credibility, privacy explanation, basic security, and evidence-based program ranking. The quality constructs exhibited excellent interrater reliability (intraclass correlations=.77-.98, median.91) and internal consistency (Cronbach alphas=.83-.90, median.88), with similar results when separated into delivery mediums or clinical aims. Conditional probability analysis revealed that 100% of the programs that received a score of fair or above (>= 3.0) in therapeutic persuasiveness or therapeutic alliance received the same range of scores in user engagement and content-a pattern that did not appear in the opposite direction. Preliminary concurrent validity analysis pointed to positive correlations of combined quality scores with selected variables. The combined score that did not include therapeutic persuasiveness and therapeutic alliance descriptively underperformed the other combined scores.ConclusionsThis paper provides empirical evidence supporting the importance of persuasive design and therapeutic alliance within the context of a program's evaluation. Reliability metrics and preliminary concurrent validity analysis indicate the potential of Enlight in examining eHealth programs regardless of delivery mediums and clinical aims.