What is it about?

How someone engages with a health behavior change intervention can have a great impact on the actual effect of such an intervention. Previous literature highlights that not the volume but the quality of engagement is key in terms of making behavior change happen. In this paper the authors provide an overview of how engagement in digital behavior change interventions can be measured. The literature was searched to find measures which were then described and evaluated in terms of the merits and drawbacks. Overall, engagement can be measured in various ways ranging from qualitative interviews and observations, surveys, usage data, to using instruments measuring psychological and/or physiological responses to content. Examples for each different method are provided in the paper.

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Why is it important?

This work is important because it provides the reader with a practical list of ways engagement in digital behavior change interventions can be measured. This was previously not existent. Measuring engagement is important as it is proposed to directly impact intervention effects. In addition, high drop out in digital behavior change interventions is often observed; this might be partially attributed to poor engagement. The authors anticipate that others can simply use this list as guide to identify measures they could use in their own studies.


This piece of work highlights the different ways to measure engagement in behavioral health interventions. A key point is that it is not enough to just measure system usage data as engagement is multidimensional.

Dr Andre Matthias Müller
National University of Singapore

Read the Original

This page is a summary of: Measuring engagement in e- & mHealth behaviour change interventions: a methodological overview (Preprint), Journal of Medical Internet Research, November 2017, JMIR Publications Inc.,
DOI: 10.2196/jmir.9397.
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