Usage and appreciation of a Web-Based Computer-Tailored Diet and Physical Activity Intervention based on the Self-Determination Theory: Evaluation of process and predictors (Preprint)
BACKGROUND eHealth seems to be a promising tool for promoting lifestyle behaviors, such as a healthy diet and physical activity (PA). However, making people use interventions is a crucial and challenging problem in eHealth. More insight into usage patterns and predicting factors is needed to improve future interventions. OBJECTIVE This paper describes the (predictors of) usage and appreciation of a web-based computer-tailored dietary and PA promotion intervention “MyLifestyleCoach” based on Self-Determination theory. Firstly, we depicted the participants’ flow in the intervention, identifying moments when people are likely to discontinue their use. Secondly, it was investigated whether demographic, motivational, and program-related characteristics predict usage of several intervention elements. Thirdly, appreciation scores of the intervention and the characteristics associated with these scores were reported. METHODS Data from online self-report questionnaires and objectively assessed usage data of several intervention parts were analyzed from participants randomized to the intervention condition. Multiple stepwise (logistic) regression analyses were conducted to examine the predictors of the intervention’s usage and evaluation scores. RESULTS Our findings indicate a low full completion rate for the intervention who chose and completed respectively the diet module (49/146, 33.6%), the PA module (2/12, 16.7%) and both modules (58/273, 21.2%). Several points in the intervention were identified where participants were likely to stop using the intervention. Autonomous and intrinsic motivation towards diet was related to the completion of initial sessions of the intervention (i.e., the opening session in which participants could choose which module to follow and the first session of the diet module). In contrast, controlled motivation was linked to the completion of both modules (initial and follow-up sessions). The appreciation scores were somewhat positive. Appreciation was predicted by several motivational constructs (e.g., amotivation), basic psychological needs (e.g., competence), and program-related features (e.g., the number of sessions completed). CONCLUSIONS To conclude, this study adds meaningful information on the use and appreciation of a Web-based computer-tailored dietary and PA intervention “MyLifestyleCoach”. Results indicate that different types of motivation are at play at different moments where people are likely to stop using the intervention. The intervention was appreciated fairly well, and several motivational constructs and fulfillment of the basic psychological needs were associated with appreciation. Practical implications of these findings have been provided. CLINICALTRIAL Netherlands Trial Register NL7333; https://www.trialregister.nl/trial/7333