Understanding Health Behavior Technology Engagement: Pathway to Measuring Digital Behavior Change Interventions
Bibliographic record
Abstract
Researchers and practitioners of digital behavior change interventions (DBCI) use varying and, often, incongruent definitions of the term "engagement," thus leading to a lack of precision in DBCI measurement and evaluation. The objective of this paper is to propose discrete definitions for various types of user engagement and to explain why precision in the measurement of these engagement types is integral to ensuring the intervention is effective for health behavior modulation. Additionally, this paper presents a framework and practical steps for how engagement can be measured in practice and used to inform DBCI design and evaluation. The key purpose of a DBCI is to influence change in a target health behavior of a user, which may ultimately improve a health outcome. Using available literature and practice-based knowledge of DBCI, the framework conceptualizes two primary categories of engagement that must be measured in DBCI. The categories are health behavior engagement, referred to as "Big E," and DBCI engagement, referred to as "Little e." DBCI engagement is further bifurcated into two subclasses: (1) user interactions with features of the intervention designed to encourage frequency of use (ie, simple login, games, and social interactions) and make the user experience appealing, and (2) user interactions with behavior change intervention components (ie, behavior change techniques), which influence determinants of health behavior and subsequently influence health behavior. Achievement of Big E in an intervention delivered via digital means is contingent upon Little e. If users do not interact with DBCI features and enjoy the user experience, exposure to behavior change intervention components will be limited and less likely to influence the behavioral determinants that lead to health behavior engagement (Big E). Big E is also dependent upon the quality and relevance of the behavior change intervention components within the solution. Therefore, the combination of user interactions and behavior change intervention components creates Little e, which is, in turn, designed to improve Big E. The proposed framework includes a model to support measurement of DBCI that describes categories of engagement and details how features of Little e produce Big E. This framework can be applied to DBCI to support various health behaviors and outcomes and can be utilized to identify gaps in intervention efficacy and effectiveness.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.078 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.010 | 0.012 |
| Open science | 0.002 | 0.009 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".