J. Med. Internet Res. - Do email and mobile phone prompts stimulate primary school children to reuse an Internet-delivered smoking prevention intervention?


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CKGROUND: Improving the use (eg, initial visit and revisits) of Internet-delivered interventions to promote healthy lifestyles such as non-smoking is one of the largest challenges in the field of eHealth. Prompts have shown to be effective in stimulating reuse of Internet-delivered interventions among adults and adolescents. However, evidence concerning effectiveness of prompts to promote reuse of a website among children is still scarce.OBJECTIVE: The aim of this study is to investigate (1) whether prompts are effective in promoting reuse of an intervention website containing information on smoking prevention for children, (2) whether the content of the prompt is associated with its effect in terms of reuse, and (3) whether there are differences between children who do or do not respond to prompts.METHODS: The sample of this cluster-randomized study consisted of 1124 children (aged 10-11 years) from 108 Dutch primary schools, who were assigned to the experimental group of an Internet-delivered smoking prevention intervention study. All participants completed a Web-based questionnaire on factors related to (non-)smoking. Schools were randomized to a no-prompt group (n=50) or a prompt group (n=58). All children could revisit the intervention website, but only the children in the prompt group received email and SMS prompts to revisit the website. Those prompt messages functioned as a teaser to stimulate reuse of the intervention website. Reuse of the website was objectively tracked by means of a server registration system. Repeated measures analysis of variance and linear regression analysis were performed to assess the effects of prompts on website reuse and to identify individual characteristics of participants who reuse the intervention website.RESULTS: Children in the prompt group reused the intervention website significantly more often compared to children in the no-prompt group (B=1.56, P<.001). Prompts announcing new animated videos (F1,1122=9.33, P=.002) and games about (non-)smoking on the website (F1,1122=8.28, P=.004) resulted in most reuse of the website. Within the prompt group, children with a low socioeconomic status (SES) reused the intervention website more often (B=2.19, P<.001) than children of high SES (B=0.93, P=.005).CONCLUSIONS: Prompts can stimulate children to reuse an intervention website aimed at smoking prevention. Prompts showed, furthermore, to stimulate children of a low SES slightly more to reuse an intervention website, which is often a difficult target group in terms of stimulating participation. However, the number of revisits was quite low, which requires further study into how prompts can be optimized in terms of content and frequency to improve the number of revisits.TRIAL REGISTRATION: Netherlands Trial Register Number: NTR3116; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3116 (Archived by WebCite at http://www.webcitation.org/6O0wQYuPI).

Resumo Limpo

ckground improv use eg initi visit revisit internetdeliv intervent promot healthi lifestyl nonsmok one largest challeng field ehealth prompt shown effect stimul reus internetdeliv intervent among adult adolesc howev evid concern effect prompt promot reus websit among children still scarceobject aim studi investig whether prompt effect promot reus intervent websit contain inform smoke prevent children whether content prompt associ effect term reus whether differ children respond promptsmethod sampl clusterrandom studi consist children age year dutch primari school assign experiment group internetdeliv smoke prevent intervent studi particip complet webbas questionnair factor relat nonsmok school random noprompt group n prompt group n children revisit intervent websit children prompt group receiv email sms prompt revisit websit prompt messag function teaser stimul reus intervent websit reus websit object track mean server registr system repeat measur analysi varianc linear regress analysi perform assess effect prompt websit reus identifi individu characterist particip reus intervent websiteresult children prompt group reus intervent websit signific often compar children noprompt group b p prompt announc new anim video f p game nonsmok websit f p result reus websit within prompt group children low socioeconom status ses reus intervent websit often b p children high ses b pconclus prompt can stimul children reus intervent websit aim smoke prevent prompt show furthermor stimul children low ses slight reus intervent websit often difficult target group term stimul particip howev number revisit quit low requir studi prompt can optim term content frequenc improv number revisitstri registr netherland trial regist number ntr httpwwwtrialregisternltrialregadminrctviewasptc archiv webcit httpwwwwebcitationorgowqyupi

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