Analyzing mHealth Engagement: Joint Models for Intensively Collected User Engagement Data
- Resource Type
- article
- Authors
- Scherer, Emily A; Ben-Zeev, Dror; Li, Zhigang; Kane, John M
- Source
- JMIR mHealth and uHealth, Vol 5, Iss 1, p e1 (2017)
- Subject
- Information technology
T58.5-58.64
Public aspects of medicine
RA1-1270
- Language
- English
- ISSN
- 2291-5222
BackgroundEvaluating engagement with an intervention is a key component of understanding its efficacy. With an increasing interest in developing behavioral interventions in the mobile health (mHealth) space, appropriate methods for evaluating engagement in this context are necessary. Data collected to evaluate mHealth interventions are often collected much more frequently than those for clinic-based interventions. Additionally, missing data on engagement is closely linked to level of engagement resulting in the potential for informative missingness. Thus, models that can accommodate intensively collected data and can account for informative missingness are required for unbiased inference when analyzing engagement with an mHealth intervention. ObjectiveThe objectives of this paper are to discuss the utility of the joint modeling approach in the analysis of longitudinal engagement data in mHealth research and to illustrate the application of this approach using data from an mHealth intervention designed to support illness management among people with schizophrenia. MethodsEngagement data from an evaluation of an mHealth intervention designed to support illness management among people with schizophrenia is analyzed. A joint model is applied to the longitudinal engagement outcome and time-to-dropout to allow unbiased inference on the engagement outcome. Results are compared to a naïve model that does not account for the relationship between dropout and engagement. ResultsThe joint model shows a strong relationship between engagement and reduced risk of dropout. Using the mHealth app 1 day more per week was associated with a 23% decreased risk of dropout (P