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.
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。