Conceptualisation, measurement and promotion of engagement with digital behaviour change interventions
I first started working on the problem of engagement with digital behaviour change interventions as part of my MSc project (2014-2015). Here, I explored users’ real-world engagement with a novel smoking cessation app, BupaQuit.
My PhD thesis (2015-2018) comprised 6 studies and aimed to gain a better understanding of how to define, measure and promote engagement with digital interventions in general, and with apps for smoking cessation and alcohol reduction in particular. As part of this work, I led an interdisciplinary, systematic review and generated a two-part, integrative definition of digital engagement and a conceptual framework. I used semi-structured interviews and online surveys to develop a self-report measure of digital engagement and evaluated the new measure in two different populations. I also conducted a think aloud and interview study and a focus group study to gain a better understanding of factors that influence engagement with apps for smoking cessation alcohol reduction, in addition to a series of N-of-1 studies, harnessing smartphone-enabled daily ecological momentary assessments, to explore within-person fluctuations in psychological and behavioural variables (e.g. motivation, extent of alcohol consumption) and their associations with users’ app engagement.
During my post-doctoral training, I’ve become increasingly persuaded that emerging technologies (e.g. chatbots, virtual reality) and novel intervention designs (e.g. hybrid human-digital interventions, ‘just-in-time adaptive interventions’) have potential for counteracting the observed ‘engagement crisis’. In collaboration with the architect of the Smoke Free app, I’ve conducted an experimental study with >55,000 smokers to examine the added effect of a supportive chatbot underpinned by artificial intelligence on user engagement and short-term quit success. The results were positive, with the addition of the chatbot more than doubling rates of engagement and increasing self-reported quit success at a 1-month follow-up. I’m currently leading a qualitative process evaluation which forms part of a feasibility study of a hybrid human-digital smoking cessation intervention, integrated in the UK thoracic surgical pathway, and a feasibility study of a brief virtual reality scenario for smokers unmotivated to stop.