scholarly journals To Prompt or Not to Prompt? A Microrandomized Trial of Time-Varying Push Notifications to Increase Proximal Engagement With a Mobile Health App (Preprint)

2018 ◽  
Author(s):  
Niranjan Bidargaddi ◽  
Daniel Almirall ◽  
Susan Murphy ◽  
Inbal Nahum-Shani ◽  
Michael Kovalcik ◽  
...  

BACKGROUND Mobile health (mHealth) apps provide an opportunity for easy, just-in-time access to health promotion and self-management support. However, poor user engagement with these apps remains a significant unresolved challenge. OBJECTIVE This study aimed to assess the effect of sending versus not sending a push notification containing a contextually tailored health message on proximal engagement, measured here as self-monitoring via the app. Secondary aims were to examine whether this effect varies by the number of weeks enrolled in the program or by weekday versus weekend. An exploratory aim was to describe how the effect on proximal engagement differs between weekday versus weekend by the time of day. METHODS The study analyzes the causal effects of push notifications on proximal engagement in 1255 users of a commercial workplace well-being intervention app over 89 days. The app employs a microrandomized trial (MRT) design to send push notifications. At 1 of 6 times per day (8:30 am, 12:30 pm, 5:30 pm, 6:30 pm, 7:30 pm, and 8:30 pm; selected randomly), available users were randomized with equal probability to be sent or not sent a push notification containing a tailored health message. The primary outcome of interest was whether the user self-monitored behaviors and feelings at some time during the next 24 hours via the app. A generalization of log-linear regression analysis, adapted for use with data arising from an MRT, was used to examine the effect of sending a push notification versus not sending a push notification on the probability of engagement over the next 24 hours. RESULTS Users were estimated to be 3.9% more likely to engage with the app in the next 24 hours when a tailored health message was sent versus when it was not sent (risk ratio 1.039; 95% CI 1.01 to 1.08; P<.05). The effect of sending the message attenuated over the course of the study, but this effect was not statistically significant (P=.84). The effect of sending the message was greater on weekends than on weekdays, but the difference between these effects was not statistically significant (P=.18). When sent a tailored health message on weekends, the users were 8.7% more likely to engage with the app (95% CI 1.01 to 1.17), whereas on weekdays, the users were 2.5% more likely to engage with the app (95% CI 0.98 to 1.07). The effect of sending a tailored health message was greatest at 12:30 pm on weekends, when the users were 11.8% more likely to engage (90% CI 1.02 to 1.13). CONCLUSIONS Sending a push notification containing a tailored health message was associated with greater engagement in an mHealth app. Results suggested that users are more likely to engage with the app within 24 hours when push notifications are sent at mid-day on weekends.

2018 ◽  
Author(s):  
Megan M MacPherson ◽  
Kohle J Merry ◽  
Sean R Locke ◽  
Mary E Jung

BACKGROUND A number of mobile health (mHealth) apps exist that focus specifically on promoting exercise behavior. To increase user engagement, prompts, such as text messages, emails, or push notifications, are often used. To date, little research has been done to understand whether, and for how long, these prompts influence exercise behavior. OBJECTIVE This study aimed to assess the impact of prompts on mHealth self-monitoring and self-reported exercise in the days following a prompt and whether these effects differ based on exercise modality. METHODS Of the possible 99 adults at risk for developing type II diabetes who participated in a diabetes prevention program, 69 were included in this secondary analysis. Participants were randomly assigned to 1 of the following 2 exercise conditions: high-intensity interval training or moderate-intensity continuous training. In the year following a brief, community-based diabetes prevention program involving counseling and supervised exercise sessions, all participants self-monitored their daily exercise behaviors on an mHealth app in which they were sent personalized prompts at varying frequencies. mHealth self-monitoring and self-reported exercise data from the app were averaged over 1, 3, 5, and 7 days preceding and following a prompt and subsequently compared using t tests. RESULTS In the year following the diabetes prevention program, self-monitoring (t68=6.82; P<.001; d=0.46) and self-reported exercise (t68=2.16; P=.03; d=0.38) significantly increased in the 3 days following a prompt compared with the 3 days preceding. Prompts were most effective in the first half of the year, and there were no differences in self-monitoring or self-reported exercise behaviors between exercise modalities (P values >.05). In the first half of the year, self-monitoring was significant in the 3 days following a prompt (t68=8.61; P<.001; d=0.60), and self-reported exercise was significant in the 3 days (t68=3.7; P<.001; d=0.37), 5 days (t67=2.15; P=.04; d=0.14), and 7 days (t68=2.46; P=.02; d=0.15) following a prompt, whereas no significant changes were found in the second half of the year. CONCLUSIONS This study provides preliminary evidence regarding the potential influence of prompts on mHealth self-monitoring and self-reported exercise and the duration for which prompts may be effective as exercise behavior change tools. Future studies should determine the optimal prompting frequency for influencing self-reported exercise behaviors. Optimizing prompt frequency can potentially reduce intervention costs and promote user engagement. Furthermore, it can encourage consumers to self-monitor using mHealth technology while ensuring prompts are sent when necessary and effective. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR2-10.2196/11226


10.2196/12956 ◽  
2019 ◽  
Vol 7 (9) ◽  
pp. e12956 ◽  
Author(s):  
Megan M MacPherson ◽  
Kohle J Merry ◽  
Sean R Locke ◽  
Mary E Jung

Background A number of mobile health (mHealth) apps exist that focus specifically on promoting exercise behavior. To increase user engagement, prompts, such as text messages, emails, or push notifications, are often used. To date, little research has been done to understand whether, and for how long, these prompts influence exercise behavior. Objective This study aimed to assess the impact of prompts on mHealth self-monitoring and self-reported exercise in the days following a prompt and whether these effects differ based on exercise modality. Methods Of the possible 99 adults at risk for developing type II diabetes who participated in a diabetes prevention program, 69 were included in this secondary analysis. Participants were randomly assigned to 1 of the following 2 exercise conditions: high-intensity interval training or moderate-intensity continuous training. In the year following a brief, community-based diabetes prevention program involving counseling and supervised exercise sessions, all participants self-monitored their daily exercise behaviors on an mHealth app in which they were sent personalized prompts at varying frequencies. mHealth self-monitoring and self-reported exercise data from the app were averaged over 1, 3, 5, and 7 days preceding and following a prompt and subsequently compared using t tests. Results In the year following the diabetes prevention program, self-monitoring (t68=6.82; P<.001; d=0.46) and self-reported exercise (t68=2.16; P=.03; d=0.38) significantly increased in the 3 days following a prompt compared with the 3 days preceding. Prompts were most effective in the first half of the year, and there were no differences in self-monitoring or self-reported exercise behaviors between exercise modalities (P values >.05). In the first half of the year, self-monitoring was significant in the 3 days following a prompt (t68=8.61; P<.001; d=0.60), and self-reported exercise was significant in the 3 days (t68=3.7; P<.001; d=0.37), 5 days (t67=2.15; P=.04; d=0.14), and 7 days (t68=2.46; P=.02; d=0.15) following a prompt, whereas no significant changes were found in the second half of the year. Conclusions This study provides preliminary evidence regarding the potential influence of prompts on mHealth self-monitoring and self-reported exercise and the duration for which prompts may be effective as exercise behavior change tools. Future studies should determine the optimal prompting frequency for influencing self-reported exercise behaviors. Optimizing prompt frequency can potentially reduce intervention costs and promote user engagement. Furthermore, it can encourage consumers to self-monitor using mHealth technology while ensuring prompts are sent when necessary and effective. International Registered Report Identifier (IRRID) DERR2-10.2196/11226


2001 ◽  
Vol 6 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Harald Walach ◽  
Stefan Schmidt ◽  
Yvonne-Michelle Bihr ◽  
Susanne Wiesch

We studied the effect of experimenter expectations and different instructions in a balanced placebo design. 157 subjects were randomized into a 2 × 4 factorial design. Two experimenters were led to expect placebos either to produce physiological effects or not (pro- vs. antiplacebo). All subjects except a control group received a caffeine placebo. They were either made to expect coffee, no coffee, or were in a double-blind condition. Dependent measures were blood pressure, heart rate, well-being, and a cognitive task. There was one main effect on the instruction factor (p = 0.03) with the group “told no caffeine” reporting significantly better well-being. There was one main effect on the experimenter factor with subjects instructed by experimenter “proplacebo” having higher systolic blood pressure (p = 0.008). There was one interaction with subjects instructed by experimenter “proplacebo” to receive coffee doing worse in the cognitive task than the rest. Subjects instructed by experimenter “antiplacebo” were significantly less likely to believe the experimental instruction, and that mostly if they had been instructed to receive coffee. Contrary to the literature we could not show an effect of instruction, but there was an effect of experimenters. It is likely, however, that these experimenter effects were not due to experimental manipulations, but to the difference in personalities.


Author(s):  
Robert Klinck ◽  
Ben Bradshaw ◽  
Ruby Sandy ◽  
Silas Nabinacaboo ◽  
Mannie Mameanskum ◽  
...  

The Naskapi Nation of Kawawachikamach is an Aboriginal community located in northern Quebec near the Labrador Border. Given the region’s rich iron deposits, the Naskapi Nation has considerable experience with major mineral development, first in the 1950s to the 1980s, and again in the past decade as companies implement plans for further extraction. This has raised concerns regarding a range of environmental and socio-economic impacts that may be caused by renewed development. These concerns have led to an interest among the Naskapi to develop a means to track community well-being over time using indicators of their own design. Exemplifying community-engaged research, this paper describes the beginning development of such a tool in fall 2012—the creation of a baseline of community well-being against which mining-induced change can be identified. Its development owes much to the remarkable and sustained contribution of many key members of the Naskapi Nation. If on-going surveying is completed based on the chosen indicators, the Nation will be better positioned to recognize shifts in its well-being and to communicate these shifts to its partners. In addition, long-term monitoring will allow the Naskapi Nation to contribute to more universal understanding of the impacts of mining for Indigenous peoples.


2017 ◽  
Vol 8 (1) ◽  
pp. 10
Author(s):  
Narendra Kumar Singh ◽  
Nishant Goyal

Background: Schizophrenia is associated with a high familial, social and economic burden. Schizophrenia is also associated with a high level of disability which may create impediments on the social and economic areas of the patients as well as on their respective family networks. Families with schizophrenia may encounter problems such as impairment of health and well being of other family members, restriction of social activities of the family members and shrinking of support from the social network. Aims: The present study examined the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. Methods: This was a cross-sectional study examining the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. The sample consisted of 60 (30 male and 30 female) caregivers of the patients with the diagnosis of schizophrenia as per ICD-10-DCR. Results and Conclusion: This study revealed that male caregivers perceived more social support and less burden of care as compared to female caregivers. Key words: Gender, social support, burden


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Brolin Låftman ◽  
Y Bjereld ◽  
B Modin ◽  
P Löfstedt

Abstract Background Students who are subjected to sexual harassment at school report lower psychological well-being than those who are not exposed. Yet, it is possible that the occurrence of sexual harassment in the school class is stressful also for those who are not directly targeted, with potential negative effects on well-being for all students. The aim was to examine whether sexual harassment at the student- and at the class-level was associated with students' psychological complaints. Methods Data from the Swedish Health Behaviour in School-aged Children (HBSC) of 2017/18 was used, with information from students aged 11, 13 and 15 years (n = 3,720 distributed across 209 classes). Psychological complaints were constructed as a summative index of four items capturing how often the student had felt low, felt irritable or bad tempered, felt nervous, or had difficulties to fall asleep, during the past six months (Cronbach's alpha=0.78). Sexual harassment at the student-level was measured by one item concerning bullying at school: “Other students have exposed me to sexual jokes”. Students who reported that this had happened at least “2 or 3 times a month” were classified as exposed to sexual harassment at school. Sexual harassment at the class-level was defined as the school class proportion of students exposed to sexual harassment, reported in per cent. Two-level linear regression analysis was applied. Results Students who had been exposed to sexual harassment had higher levels of psychological complaints (b = 2.74, p &lt; 0.001). The proportion of students in the school class who had been exposed to sexual harassment was also associated with higher levels of psychological complaints, even when adjusting for sexual harassment at the student-level, gender and grade (b = 0.03, p = 0.015). Conclusions Sexual harassment is harmful for those who are exposed, but may also affect other students negatively. Thus, a school climate free from sexual harassment will profit all students. Key messages Using data collected among students aged 11, 13 and 15 years, this study showed that sexual harassment at the student- and class-level was associated with higher levels of psychological complaints. Sexual harassment is harmful for those who are exposed, but may also affect other students negatively. Thus, a school climate free from sexual harassment will profit all students.


2019 ◽  
Vol 29 (12) ◽  
pp. 5049-5060 ◽  
Author(s):  
Kainan S Wang ◽  
Mauricio R Delgado

AbstractThe ability to perceive and exercise control over an outcome is both desirable and beneficial to our well-being. It has been shown that animals and humans alike exhibit behavioral bias towards seeking control and that such bias recruits the ventromedial prefrontal cortex (vmPFC) and striatum. Yet, this bias remains to be quantitatively captured and studied neurally. Here, we employed a behavioral task to measure the preference for control and characterize its neural underpinnings. Participants made a series of binary choices between having control and no-control over a game for monetary reward. The mere presence of the control option evoked activity in the ventral striatum. Importantly, we manipulated the expected value (EV) of each choice pair to extract the pairing where participants were equally likely to choose either option. The difference in EV between the options at this point of equivalence was inferred as the subjective value of control. Strikingly, perceiving control inflated the reward value of the associated option by 30% and this value inflation was tracked by the vmPFC. Altogether, these results capture the subjective value of perceived control inherent in decision making and highlight the role of corticostriatal circuitry in the perception of control.


Urban Studies ◽  
2016 ◽  
Vol 54 (7) ◽  
pp. 1619-1637 ◽  
Author(s):  
Camilla Baba ◽  
Ade Kearns ◽  
Emma McIntosh ◽  
Carol Tannahill ◽  
James Lewsey

Urban regeneration (UR) programmes are recognised as a type of Population Health Intervention (PHI), addressing social and health inequalities. Policy recommends programmes involve communities through engagement and empowerment. Whilst the literature has started to link empowerment with health improvement, this has not been within an UR context. As part of broader research on the economic evaluation of community empowerment activities, this paper examines how health gains can be generated through promoting empowerment as well as identifying whether feelings of empowerment are associated with residents personal characteristics or perceptions of their neighbourhood. Using 2011 Community Health and Wellbeing Survey (GoWell) cross-sectional data, ordinal logistic regression and simple linear regression analysis of 15 Glasgow neighbourhoods undergoing regeneration with 4302 adult householders (≥16 years old) was completed. Analyses identified strong associations ( P≥ 0.05) between empowerment and the mental health subscale of the SF12v2 and with several items of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) scale. Furthermore, residents’ who felt more empowered reported more positive attitudes towards their surroundings and housing providers. This concurs with recent evidence of the importance of residents’ psychological investments in their neighbourhood influencing their sense of place attachment. Such analyses present initial evidence of the value of investing resources within UR programmes to activities geared towards increasing residents’ empowerment as a means of producing those health gains often sought by more costly aspects of the programmes.


2009 ◽  
pp. 90
Author(s):  
Marek Brabec ◽  
John Komlos

We examine spatial convergence in biological well-being in the Habsburg Monarchy, circa 1890-1910, on the basis of evidence of the physical stature of 21-year-old military recruits, disaggregated into 15 Districts. We find that the shorter the population in 1890, the faster its height grew thereafter. Hence, there was convergence in physical stature between the peripheral areas of the monarchy (located in today’s Poland/Ukraine, Romania, and Slovakia) and its core (located in today’s Austria, Czech Republic, and Hungary). The difference in trends between the trend in height in the Polish District of Przemysl and in Vienna was about 0.9 cm per decade, in favor of the former. Convergence among the core Districts themselves was minimal or non-existent, whereas the convergence among the peripheral Districts was more pronounced. Spatial convergence also took place between the peripheral regions and the more developed ones. The pattern is somewhat reminiscent of modern findings on convergence clubs in the global economy.


Sign in / Sign up

Export Citation Format

Share Document