The Effectiveness of Prompts to Promote Engagement With Digital Interventions: A Systematic Review
The Effectiveness of Prompts to Promote Engagement With Digital Interventions: A Systematic Review
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DOI：
10.2196/jmir.4790
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发表时间：
2016-01-01
影响因子：
7.4
通讯作者：
Murray, Elizabeth
中科院分区：
文献类型：
--
作者：
Alkhaldi, Ghadah;Hamilton, Fiona L.;Murray, Elizabeth
背景资料：数字干预措施在改善许多健康结果和健康行为方面是有效的;此外，它们越来越多地用于不同的医疗保健领域，包括长期状况的自我管理，心理健康和健康促进。数字干预的全部潜力因缺乏用户参与而受到阻碍。迫切需要制定有效的战略，促进用户参与数字干预措施。一个潜在的方法是使用基于技术的提醒或prompts.Objective：为了评估基于技术的策略，促进与数字interventions.Methods的参与的有效性：遵循科克伦协作指南的系统评价方法。检索策略在7个电子数据库中执行：科克伦对照试验中心注册库（CENTRAL）、MEDLINE、Embase、Web of Science、教育资源信息中心（ERIC）、PsycINFO和护理和相关健康文献累积索引（CINAHL）。数据库从开始到2013年9月13日进行检索，没有语言或出版物类型限制，使用三个概念：随机对照试验，数字干预和参与。还检索了纳入研究的灰色文献和参考文献列表。标题和摘要由2名作者独立筛选，然后获得潜在合格论文的全文并进行双重筛选。合格论文的数据由一位作者提取，并由另一位作者检查准确性。使用科克伦偏倚风险评估工具评估偏倚。对所有纳入的研究进行叙述性综合，并在适当时使用荟萃分析汇总数据。所有研究结果均按照系统评价和荟萃分析首选报告项目（PRISMA）guidelines.Results进行报告：共纳入14项研究，8774例受试者。在这14项研究中，9项有足够的数据纳入荟萃分析。荟萃分析表明，与没有二分结局策略相比，基于技术的策略可能会促进参与（相对风险[RR] 1.27，95% CI 1.01-1.60，I-2=71%），但由于大多数研究中存在相当大的异质性和样本量较小，因此应谨慎对待该结果。没有研究报告不良或经济后果。只有一个小样本量的研究比较了不同的特点，研究发现，战略促进新的数字干预内容和那些发送给用户后不久，他们开始使用的数字intervention.Conclusions的更有可能从事用户：总体而言，研究报告的边缘积极影响的技术为基础的战略参与相比，没有战略。然而，必须谨慎解释结果。需要进行更多的研究，以复制研究结果，并了解这些战略的哪些特点在促进参与方面是有效的，以及它们的成本效益如何。
Background: Digital interventions have been effective in improving numerous health outcomes and health behaviors; furthermore, they are increasingly being used in different health care areas, including self-management of long-term conditions, mental health, and health promotion. The full potential of digital interventions is hindered by a lack of user engagement. There is an urgent need to develop effective strategies that can promote users' engagement with digital interventions. One potential method is the use of technology-based reminders or prompts.Objective: To evaluate the effectiveness of technology-based strategies for promoting engagement with digital interventions.Methods: Cochrane Collaboration guidelines on systematic review methodology were followed. The search strategy was executed across 7 electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science, the Education Resources Information Center (ERIC), PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Databases were searched from inception to September 13, 2013, with no language or publication type restrictions, using three concepts: randomized controlled trials, digital interventions, and engagement. Gray literature and reference lists of included studies were also searched. Titles and abstracts were independently screened by 2 authors, then the full texts of potentially eligible papers were obtained and double-screened. Data from eligible papers were extracted by one author and checked for accuracy by another author. Bias was assessed using the Cochrane risk of bias assessment tool. Narrative synthesis was performed on all included studies and, where appropriate, data were pooled using meta-analysis. All findings were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: A total of 14 studies were included in the review with 8774 participants. Of the 14 studies, 9 had sufficient data to be included in the meta-analyses. The meta-analyses suggested that technology-based strategies can potentially promote engagement compared to no strategy for dichotomous outcomes (relative risk [RR] 1.27, 95% CI 1.01-1.60, I-2=71%), but due to considerable heterogeneity and the small sample sizes in most studies, this result should be treated with caution. No studies reported adverse or economic outcomes. Only one study with a small sample size compared different characteristics; the study found that strategies promoting new digital intervention content and those sent to users shortly after they started using the digital intervention were more likely to engage users.Conclusions: Overall, studies reported borderline positive effects of technology-based strategies on engagement compared to no strategy. However, the results have to be interpreted with caution. More research is needed to replicate findings and understand which characteristics of the strategies are effective in promoting engagement and how cost-effective they are.