Antecedents and consequences of different indicators of engagement with a digital intervention for tobacco cessation.

Abstract

Mobile apps are commonly used to deliver digital interventions, typically through prompts that encourage engagement with intervention contents. However, engagement with these interventions remains suboptimal. A recent organizing framework conceptualizes digital interventions as a sequence of stimuli/tasks, underscoring the importance of measuring engagement with each stimulus/task separately. We applied this framework to a tobacco cessation intervention study that used an app to deliver prompts for practicing self-regulatory strategies. We found that engagement with certain stimuli/tasks (e.g., messages describing a low-effort strategy) declined over time, whereas engagement with others (e.g., messages recommending a more effortful strategy) remained stable. Initiating a brief in-app survey prior to prompting increased the likelihood of engaging with the intervention prompt, but not with subsequent messages or recommended strategies. These findings support conceptualizing engagement as a dynamic, multistage process and offer practical insights for optimizing engagement with digital interventions.