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Using an analysis of behavior change to inform effective digital intervention design: How did the PRIMIT website change hand hygiene behavior across 8993 users?

Using an analysis of behavior change to inform effective digital intervention design: How did the PRIMIT website change hand hygiene behavior across 8993 users?
Using an analysis of behavior change to inform effective digital intervention design: How did the PRIMIT website change hand hygiene behavior across 8993 users?
Background: In designing digital interventions for healthcare, it is important to understand not just whether interventions work, but also how and for whom - including whether individual intervention components have different effects, whether a certain usage threshold is required to change behavior in each intervention, and whether usage differs across population subgroups.

Purpose: We investigated these questions using data from a large trial of the digital PRIMIT intervention, which aimed to reduce respiratory tract infections (RTIs) by increasing hand hygiene behavior.

Method: Baseline and follow-up questionnaires measured behaviors, intentions and attitudes in hand-hygiene. In conjunction with objective measures of usage of the four PRIMIT sessions, we analysed these observational data to examine mechanisms of behavior change in 8993 intervention users.

Results: We found that the PRIMIT intervention changed behavior, intentions and attitudes, and this change was associated with reduced RTIs. The largest hand hygiene change occurred after the first session, with incrementally smaller changes after each subsequent session, suggesting that engagement with the core behavior change techniques included in the first session was necessary and sufficient for behavior change. The intervention was equally effective for men and women, olderand younger people, and was particularly effective for those with lower levels of education.

Conclusions: Our well-powered analysis has implications for intervention development. We were able to determine a 'minimum threshold' of intervention engagement that is required for hand hygiene change, and we discuss the potential implications this (and other analyses of this type) may have for further intervention development. We also discuss the application of similar analyses to other interventions.
0883-6612
423-431
Ainsworth, Ben
b02d78c3-aa8b-462d-a534-31f1bf164f81
Steele, Mary
dd7833c4-c04c-495c-aa9a-b23e01a89762
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Joseph, Judith
edd7d342-89d2-4344-a7aa-fbcb0b1370ac
Miller, Sascha
65f79a72-063a-4240-9c25-dca6abda1775
Morrison, Leanne
920a4eda-0f9d-4bd9-842d-6873b1afafef
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Ainsworth, Ben
b02d78c3-aa8b-462d-a534-31f1bf164f81
Steele, Mary
dd7833c4-c04c-495c-aa9a-b23e01a89762
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Joseph, Judith
edd7d342-89d2-4344-a7aa-fbcb0b1370ac
Miller, Sascha
65f79a72-063a-4240-9c25-dca6abda1775
Morrison, Leanne
920a4eda-0f9d-4bd9-842d-6873b1afafef
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e

Ainsworth, Ben, Steele, Mary, Stuart, Beth, Joseph, Judith, Miller, Sascha, Morrison, Leanne, Little, Paul and Yardley, Lucy (2017) Using an analysis of behavior change to inform effective digital intervention design: How did the PRIMIT website change hand hygiene behavior across 8993 users? Annals of Behavioral Medicine, 51 (3), 423-431. (doi:10.1007/s12160-016-9866-9).

Record type: Article

Abstract

Background: In designing digital interventions for healthcare, it is important to understand not just whether interventions work, but also how and for whom - including whether individual intervention components have different effects, whether a certain usage threshold is required to change behavior in each intervention, and whether usage differs across population subgroups.

Purpose: We investigated these questions using data from a large trial of the digital PRIMIT intervention, which aimed to reduce respiratory tract infections (RTIs) by increasing hand hygiene behavior.

Method: Baseline and follow-up questionnaires measured behaviors, intentions and attitudes in hand-hygiene. In conjunction with objective measures of usage of the four PRIMIT sessions, we analysed these observational data to examine mechanisms of behavior change in 8993 intervention users.

Results: We found that the PRIMIT intervention changed behavior, intentions and attitudes, and this change was associated with reduced RTIs. The largest hand hygiene change occurred after the first session, with incrementally smaller changes after each subsequent session, suggesting that engagement with the core behavior change techniques included in the first session was necessary and sufficient for behavior change. The intervention was equally effective for men and women, olderand younger people, and was particularly effective for those with lower levels of education.

Conclusions: Our well-powered analysis has implications for intervention development. We were able to determine a 'minimum threshold' of intervention engagement that is required for hand hygiene change, and we discuss the potential implications this (and other analyses of this type) may have for further intervention development. We also discuss the application of similar analyses to other interventions.

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More information

Accepted/In Press date: 20 November 2016
e-pub ahead of print date: 1 December 2016
Published date: June 2017
Organisations: Psychology

Identifiers

Local EPrints ID: 403395
URI: https://eprints.soton.ac.uk/id/eprint/403395
ISSN: 0883-6612
PURE UUID: 4edb2d10-4715-44d8-96d8-2ffb1ced591d
ORCID for Ben Ainsworth: ORCID iD orcid.org/0000-0002-5098-1092
ORCID for Leanne Morrison: ORCID iD orcid.org/0000-0002-9961-551X

Catalogue record

Date deposited: 30 Nov 2016 14:56
Last modified: 06 Jun 2018 12:34

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