Abstract
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Background
Digital interventions (DIs) provide effective and potentially cost-effective
models for improving health behaviour outcomes as they deliver health
information and services that are widely disseminated, confidential, and can
be tailored to needs of the individual user. DIs have been used successfully
for different health behaviours such as smoking cessation and increasing
physical activity. However, their effectiveness is limited by low usage
rates, with non-engagement a major challenge. Engagement can potentially be
optimised through the use of context-specific prompts such as emails and text
messages. Aim To inform, develop and assess the potential of using email and
text message as prompts to optimise users' engagement with a DI called
HeLP-Diabetes (Healthy Living for People with Diabetes). Context
HeLP-Diabetes is a DI targeting self-management for people living with Type 2
diabetes. It aims to provide its users with the tools and support to improve
and maintain their health and well-being. Methods The following series of
studies with their corresponding objectives were conducted: • A systematic
review and meta-analyses to determine the range and effectiveness of
technology based engagement prompts, and to identify characteristics of
prompts to test in subsequent studies. • Developing, piloting and testing
prompts, within the context of HeLP-Diabetes using the Medical Research
Council guidance for complex intervention, to identify the methodological and
practical challenges of developing engagement prompts and integrating them
with HeLP-Diabetes. • A mixed method study to identify the characteristics of
prompts, specifically the content and delivery mode, that have the potential
to promote engagement with HeLP-Diabetes. The mixed method study used
quantitative data from HeLP-Diabetes usage data, and qualitative data from
think aloud interviews exploring prompt content with a selected group of
users. • Two consecutive randomised controlled trials comparing different
prompt content and delivery modes in order to assess the potential impact of
prompts on engagement with HeLP-Diabetes and to test the procedures of the
pilot trial to identify any potential challenges for future trials.
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