Defining Participant Exposure Measures in Web-Based Health Behavior Change Programs

Abstract

BackgroundPublished research on the use of Web-based behavior change programs is growing rapidly. One of the observations characterized as problematic in these studies is that participants often make relatively few website visits and spend only a brief time accessing the program. Properly structured websites permit the unobtrusive measurement of the ways in which participants access (are exposed to) program content. Research on participant exposure to Web-based programs is not merely of interest to technologists, but represents an important opportunity to better understand the broader theme of program engagement and to guide the development of more effective interventions.ObjectivesThe current paper seeks to provide working definitions and describe initial patterns of various measures of participant exposure to ChewFree.com, a large randomized controlled trial of a Web-based program for smokeless tobacco cessation.MethodsWe examined measures of participant exposure to either an Enhanced condition Web-based program (interactive, tailored, and rich-media program) or a Basic condition control website (static, text-based material). Specific measures focused on email prompting, participant visits (number, duration, and pattern of use over time), and Web page viewing (number of views, types of pages viewed, and Web forum postings).ResultsParticipants in the ChewFree.com Enhanced condition made more visits and spent more time accessing their assigned website than did participants assigned to the Basic condition website. In addition, exposure data demonstrated that Basic condition users thoroughly accessed program content, indicating that the condition provided a meaningful, face-valid control to the Enhanced condition.ConclusionsWe recommend that researchers conducting evaluations of Web-based interventions consider the collection and analysis of exposure measures in the broader context of program engagement in order to assess whether participants obtain sufficient exposure to relevant program content.

Randomized controlled trial examining the adjunctive use of nicotine lozenges with MyLastDip: An eHealth smokeless tobacco cessation intervention

“…Logistic regressions were used to evaluate program usage by the measure of tobacco abstinence at the 6-month assessment. Website program engagement was measured using the composite measure defined as the mean of the z score transformations of visits (number) and duration (minutes) (Danaher et al, 2006).…”

Randomized Controlled Trial of MyLastDip: A Web-Based Smokeless Tobacco Cessation Program for Chewers Ages 14-25

“…Because engagement with web interventions influences efficacy (Danaher & Seeley, 2009), we unobtrusively tracked number of Web site visits, time/date descriptors of visits, duration of visits, and specific webpages visited (Danaher, Boles, Akers, Gordon, & Severson, 2006).…”

“…Because the frequency and duration of Web site visits tend to be positively skewed, program engagement was measured using the composite measure defined as the mean of the Z-score transformations of visits (number) and duration (minutes) (Danaher et al, 2006).…”

Content Analysis—A Methodological Primer for Gender Research

“…This is followed by the recording and analysis of the messages that are received-or created-by these users. For example, some studies of online content have focused on what web users actually attend to, unobtrusively recording their web activity (e.g., Danaher et al 2006;Jansen and Spink 2006;Mastro et al 2002). Further, content analyses of video games have adopted the practice of using a set of recorded gaming sessions as the content, rather than a hypothetical population of all potential content for a given game (e.g., Haninger and Thompson 2004;Martins et al 2009;Weber et al 2009).…”