The DisENGAGE Framework: supporting the examination of disengagement from health-based digital behaviour change interventions

Abstract

Examining engagement with Digital Behaviour Change Interventions (DBCIs) is a crucial aspect of Behaviour Change research, because it helps to explain why an intervention is or is not successful. However, the concept of engagement presents a number of issues for researchers. The lack of consensus surrounding a definition or approach to measurement is problematic, and this further complicates the issue of identifying an engaged user. This thesis presents an alternative, but complementary perspective by focusing on disengagement. Disengagement can be defined as ‘the termination or non-usage of a DBCI’, which can take three forms: behavioural (relating to the behaviour change process), digital (referring to the DBCI), or digital-behavioural (disengagement from both). This thesis will present a framework that will conceptualise and guide the exploration of disengagement. The DisENGAGE Framework evolved from a review of disengagement-related terminology (Chapter 3). This, in part, informed the selection of the Behaviour Change literature, which provided factors relating to behavioural disengagement (Chapter 4). Chapter 5 explores the Human-Computer Interaction (HCI) literature to identify digital disengagement factors. The DisENGAGE Framework has been tested using the PRIMIT, CIRCA, and Getting Active case studies (Chapters 8, 9, and 10). The analysis of the first two case studies highlighted several issues with retrospective analysis (conducting analysis on pre-existing data). The third case study used the DisENGAGE Framework at all stages of the study. This approach ensured that the relevant elements of disengagement data were collected and analysed. This led to the identification of various factors that were likely to lead to future disengagement. Furthermore, this analysis provided actionable recommendations to improve the DBCI and reduce digital-behavioural disengagement. A focus on disengagement provides a new perspective to DBCI research and further progresses the field of health-related behaviour change.

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Identifiers

ORCID for Anna Charlotte Astley Weston: orcid.org/0000-0003-1675-0466

ORCID for Mark Weal: orcid.org/0000-0001-6251-8786

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