Adolescent Engagement With a Multicomponent mHealth Tool: Identifying Usage Patterns, Determinants, and Health Behavior Change in an Intervention Trial
Bibliographic record
Abstract
Background: Research about the engagement of adolescents with mobile health (mHealth) interventions is scarce, while it is generally assumed that the engagement affects the intervention efficacy. Objective: Using an mHealth intervention that targets the general population of adolescents to promote healthy behaviors (physical activity, low sedentary time, adequate sleep, and taking breakfast) and mental health, we aimed to investigate (1) how adolescents engage with the intervention, (2) which engagement styles can be identified and how these differ according to personal characteristics, and (3) which style of engagement predicts behavior change. The intervention used, #LIFEGOALS, includes self-regulation techniques, a support chatbot, narrative videos, and gamification, brought together in an app coupled to an activity tracker. Methods: Logged usage data and self-reports of experience with #LIFEGOALS were collected from 159 adolescents (mean age 13.54, SD 0.95 years) over a 12-week intervention period and used to describe behavioral and experiential engagement with the intervention components over time. Baseline data on sociodemographic variables, mental health, and behavioral determinants were explored as determinants of engagement and were used to characterize engagement styles that were identified through exploratory cluster analysis on the frequency of usage of the components. Linear mixed-effects regression was used to analyze the effect of engagement style on health behavior change. Results: Average time in the app was 26 minutes (SD 26) over the 12-week period, with usage decreasing substantially after the first week. The use of self-regulation techniques and gamification was strongly interrelated (0.65 <r <0.70), whereas use of Fitbit showed weaker correlations with other component usage (0.15 <r <0.31). Exploratory analyses suggest that engagement was influenced by immigration background and by adolescents' attitudes, self-efficacy, and intentions toward healthy living. Younger participants tended to use the Fitbit more frequently. Cluster analysis identified 4 engagement styles: narrative usage (n=19), app usage (n=36), Fitbit usage (n=32), and no usage (n=72), which were associated with differences in age, peer support, and mental health. Engagement style did not affect change in health behavior outcomes from preintervention to postintervention. Conclusions: Different engagement styles were identified based on the frequency and type of components used. Findings support the relevance of tailoring mHealth to individual, interpersonal, and contextual characteristics. The overall low engagement with the intervention may have limited the detection of differences in health effects between engagement styles.
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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 | 0.011 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
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".