PDF(Pubmed)
Abstract：
BACKGROUND: Limited guidance exists for analyzing participant engagement in provider-guided digital health interventions (DHIs). System usage is commonly assessed, with acknowledged limitations in measuring socio-affective and cognitive aspects of engagement. Nurse WRITE, an 8-week web-based nurse-guided DHI for managing symptoms among women with recurrent ovarian cancer, offers an opportunity to develop a framework for assessing multidimensional engagement.
OBJECTIVE: This study aims to develop a conceptual and analytic framework to measure socio-affective, cognitive, and behavioral engagement with provider-guided DHIs. We then illustrate the framework\'s ability to describe and categorize engagement using Nurse WRITE as an example.
METHODS: A sample of 68 participants from Nurse WRITE who posted on the message boards were included. We adapted a prior framework for conceptualizing and operationalizing engagement across 3 dimensions and finalized a set of 6 distinct measures. Using patients\' posts, we created 2 socio-affective engagement measures-total count of socio-affective engagement classes (eg, sharing personal experience) and total word count-and 2 cognitive engagement measures-total count of cognitive engagement classes (eg, asking information-seeking questions) and average question completion percentage. Additionally, we devised behavioral engagement measures using website data-the total count of symptom care plans and plan reviews. k-Means clustering categorized the participants into distinct groups based on levels of engagement across 3 dimensions. Descriptive statistics and narratives were used to describe engagement in 3 dimensions.
RESULTS: On average, participants displayed socio-affective engagement 34.7 times, writing 14,851 words. They showed cognitive engagement 19.4 times, with an average of 78.3% completion of nurses\' inquiries. Participants also submitted an average of 1.6 symptom care plans and 0.7 plan reviews. Participants were clustered into high (n=13), moderate (n=17), and low engagers (n=38) based on the 6 measures. High engagers wrote a median of 36,956 (IQR 26,199-46,265) words. They demonstrated socio-affective engagement approximately 81 times and cognitive engagement around 46 times, approximately 6 times that of the low engagers and twice that of the moderate engagers. High engagers had a median of 91.7% (IQR 82.2%-93.7%) completion of the nurses\' queries, whereas moderate engagers had 86.4% (IQR 80%-96.4%), and low engagers had 68.3% (IQR 60.1%-79.6%). High engagers completed a median of 3 symptom care plans and 2 reviews, while moderate engagers completed 2 plans and 1 review. Low engagers completed a median of 1 plan with no reviews.
CONCLUSIONS: This study developed and reported an engagement framework to guide behavioral intervention scientists in understanding and analyzing participants\' engagement with provider-guided DHIs. Significant variations in engagement levels across 3 dimensions highlight the importance of measuring engagement with provider-guided DHIs in socio-affective, cognitive, and behavioral dimensions. Future studies should validate the framework with other DHIs, explore the influence of patient and provider factors on engagement, and investigate how engagement influences intervention efficacy.
OBJECTIVE: This study aims to develop a conceptual and analytic framework to measure socio-affective, cognitive, and behavioral engagement with provider-guided DHIs. We then illustrate the framework\'s ability to describe and categorize engagement using Nurse WRITE as an example.
METHODS: A sample of 68 participants from Nurse WRITE who posted on the message boards were included. We adapted a prior framework for conceptualizing and operationalizing engagement across 3 dimensions and finalized a set of 6 distinct measures. Using patients\' posts, we created 2 socio-affective engagement measures-total count of socio-affective engagement classes (eg, sharing personal experience) and total word count-and 2 cognitive engagement measures-total count of cognitive engagement classes (eg, asking information-seeking questions) and average question completion percentage. Additionally, we devised behavioral engagement measures using website data-the total count of symptom care plans and plan reviews. k-Means clustering categorized the participants into distinct groups based on levels of engagement across 3 dimensions. Descriptive statistics and narratives were used to describe engagement in 3 dimensions.
RESULTS: On average, participants displayed socio-affective engagement 34.7 times, writing 14,851 words. They showed cognitive engagement 19.4 times, with an average of 78.3% completion of nurses\' inquiries. Participants also submitted an average of 1.6 symptom care plans and 0.7 plan reviews. Participants were clustered into high (n=13), moderate (n=17), and low engagers (n=38) based on the 6 measures. High engagers wrote a median of 36,956 (IQR 26,199-46,265) words. They demonstrated socio-affective engagement approximately 81 times and cognitive engagement around 46 times, approximately 6 times that of the low engagers and twice that of the moderate engagers. High engagers had a median of 91.7% (IQR 82.2%-93.7%) completion of the nurses\' queries, whereas moderate engagers had 86.4% (IQR 80%-96.4%), and low engagers had 68.3% (IQR 60.1%-79.6%). High engagers completed a median of 3 symptom care plans and 2 reviews, while moderate engagers completed 2 plans and 1 review. Low engagers completed a median of 1 plan with no reviews.
CONCLUSIONS: This study developed and reported an engagement framework to guide behavioral intervention scientists in understanding and analyzing participants\' engagement with provider-guided DHIs. Significant variations in engagement levels across 3 dimensions highlight the importance of measuring engagement with provider-guided DHIs in socio-affective, cognitive, and behavioral dimensions. Future studies should validate the framework with other DHIs, explore the influence of patient and provider factors on engagement, and investigate how engagement influences intervention efficacy.
摘要：
背景：在分析参与者参与提供者指导的数字健康干预（DHIs）方面存在有限的指导。通常会评估系统使用情况，在衡量参与的社会情感和认知方面具有公认的局限性。护士写,一个为期8周的基于网络的护士指导的DHI，用于管理复发性卵巢癌女性的症状，提供了一个机会来开发一个评估多层面参与的框架。
目的：本研究旨在开发一个概念和分析框架来衡量社会情感，认知，以及与提供者指导的DHI的行为参与。然后，我们以NurseWRITE为例说明该框架描述和分类参与的能力。
方法：纳入了68名来自护士WRITE的参与者的样本，他们张贴在留言板上。我们调整了一个先前的框架，用于概念化和实施3个维度的参与，并最终确定了一组6种不同的措施。使用病人的帖子，我们创建了2个社会情感参与措施-社会情感参与类的总数(例如，分享个人经验)和总字数-和2个认知参与度量-认知参与类的总数(例如，询问信息寻求问题)和平均问题完成百分比。此外,我们使用网站数据-症状护理计划和计划审查的总数设计了行为参与措施.k-Means聚类根据3个维度的参与程度将参与者分为不同的组。描述性统计和叙述用于描述3个维度的参与。
结果：平均而言，参与者表现出34.7倍的社会情感参与，写作14851字他们表现出19.4倍的认知参与，平均78.3%的护士完成询问。参与者还提交了平均1.6个症状护理计划和0.7个计划审查。参与者聚集到高(n=13)，中等(n=17)，和基于6项措施的低接合(n=38)。较高的英语单词的中位数为36,956（IQR26,199-46,265）。他们表现出社会情感参与约81次，认知参与约46次，大约是低衔接者的6倍，中等衔接者的2倍。高级学生完成护士查询的中位数为91.7％（IQR82.2％-93.7％），而中度学生有86.4%(IQR80%-96.4%)，低入学率为68.3%（IQR60.1%-79.6%）。高级学员完成了3个症状护理计划和2个评论的中位数，而中度运动员完成了2个计划和1个审查。低目标完成了1个计划的中位数，没有评论。
结论：本研究开发并报告了一个参与框架，以指导行为干预科学家理解和分析参与者与提供者指导的DHI的参与。3个维度上的参与度的显著差异突出了衡量与提供者指导的DHI在社会情感中的参与度的重要性，认知，和行为维度。未来的研究应该与其他DHI验证该框架，探索患者和提供者因素对参与度的影响，并调查参与度如何影响干预效果。
目的：本研究旨在开发一个概念和分析框架来衡量社会情感，认知，以及与提供者指导的DHI的行为参与。然后，我们以NurseWRITE为例说明该框架描述和分类参与的能力。
方法：纳入了68名来自护士WRITE的参与者的样本，他们张贴在留言板上。我们调整了一个先前的框架，用于概念化和实施3个维度的参与，并最终确定了一组6种不同的措施。使用病人的帖子，我们创建了2个社会情感参与措施-社会情感参与类的总数(例如，分享个人经验)和总字数-和2个认知参与度量-认知参与类的总数(例如，询问信息寻求问题)和平均问题完成百分比。此外,我们使用网站数据-症状护理计划和计划审查的总数设计了行为参与措施.k-Means聚类根据3个维度的参与程度将参与者分为不同的组。描述性统计和叙述用于描述3个维度的参与。
结果：平均而言，参与者表现出34.7倍的社会情感参与，写作14851字他们表现出19.4倍的认知参与，平均78.3%的护士完成询问。参与者还提交了平均1.6个症状护理计划和0.7个计划审查。参与者聚集到高(n=13)，中等(n=17)，和基于6项措施的低接合(n=38)。较高的英语单词的中位数为36,956（IQR26,199-46,265）。他们表现出社会情感参与约81次，认知参与约46次，大约是低衔接者的6倍，中等衔接者的2倍。高级学生完成护士查询的中位数为91.7％（IQR82.2％-93.7％），而中度学生有86.4%(IQR80%-96.4%)，低入学率为68.3%（IQR60.1%-79.6%）。高级学员完成了3个症状护理计划和2个评论的中位数，而中度运动员完成了2个计划和1个审查。低目标完成了1个计划的中位数，没有评论。
结论：本研究开发并报告了一个参与框架，以指导行为干预科学家理解和分析参与者与提供者指导的DHI的参与。3个维度上的参与度的显著差异突出了衡量与提供者指导的DHI在社会情感中的参与度的重要性，认知，和行为维度。未来的研究应该与其他DHI验证该框架，探索患者和提供者因素对参与度的影响，并调查参与度如何影响干预效果。
