How Engagement Changes Over Time in a Digital Eating Disorder App: Observational Study
Notice bibliographique
Résumé
Background: Engagement with digital mental health interventions is often measured as a summary-level variable and remains underresearched despite its importance for meaningful symptom change. This study deepens understanding of engagement in a digital eating disorder intervention, recovery record, by measuring engagement with unique components of the app, on 2 different devices (phone and watch), and at a summary level. Objective: This study described and modeled how individuals engaged with the app across a variety of measures of engagement and identified baseline predictors of engagement. Methods: Participants with current binge-eating behavior were recruited as part of the Binge Eating Genetics Initiative study to use a digital eating disorder intervention for 4 weeks. Demographic and severity of illness variables were captured in the baseline survey at enrollment, and engagement data were captured through both an iPhone and Apple Watch version of the intervention. Engagement was characterized by log type (urge, behavior, mood, or meal), device type (logs on phone or watch), and overall usage (total logs) and averaged each week for 4 weeks. Descriptives were tabulated for demographic and engagement variables, and multilevel growth models were conducted for each measure of engagement with baseline characteristics and time as predictors. Results: Participants (N=893) self-reported as primarily White (743/871, 85%), non-Hispanic (801/893, 90%), females (772/893, 87%) with a mean age of 29.6 (SD 7.4) years and mean current BMI of 32.5 (SD 9.8) kg/m2 and used the app for a mean of 24 days. Most logs were captured on phones (217,143/225,927; 96%), and mood logs were the most used app component (174,818/282,136; 62% of logs). All measures of engagement declined over time, as illustrated by the visualizations, but each measure of engagement illustrated unique participant trajectories over time. Time was a significant negative predictor in every multilevel model. Sex and ethnicity were also significant predictors across several measures of engagement, with female and Hispanic participants demonstrating greater engagement than male and non-Hispanic counterparts. Other baseline characteristics (age, current BMI, and binge episodes in the past 28 days) were significant predictors of 1 measure of engagement each. Conclusions: This study highlighted that engagement is far more complex and nuanced than is typically described in research, and that specific components and mode of delivery may have unique engagement profiles and predictors. Future work would benefit from developing early engagement models informed by baseline characteristics to predict intervention outcomes, thereby tailoring digital eating disorder interventions at the individual level.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».