J. Med. Internet Res. - Periodic email prompts to re-use an internet-delivered computer-tailored lifestyle program: influence of prompt content and timing.


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CKGROUND: Adherence to Internet-delivered lifestyle interventions using multiple tailoring is suboptimal. Therefore, it is essential to invest in proactive strategies, such as periodic email prompts, to boost re-use of the intervention.OBJECTIVE: This study investigated the influence of content and timing of a single email prompt on re-use of an Internet-delivered computer-tailored (CT) lifestyle program.METHODS: A sample of municipality employees was invited to participate in the program. All participants who decided to use the program received an email prompting them to revisit the program. A 2?3 (content ? timing) design was used to test manipulations of prompt content and timing. Depending on the study group participants were randomly assigned to, they received either a prompt containing standard content (an invitation to revisit the program), or standard content plus a preview of new content placed on the program website. Participants received this prompt after 2, 4, or 6 weeks. In addition to these 6 experimental conditions, a control condition was included consisting of participants who did not receive an additional email prompt. Clicks on the uniform resource locator (URL) provided in the prompt and log-ins to the CT program were objectively monitored. Logistic regression analyses were conducted to determine whether prompt content and/or prompt timing predicted clicking on the URL and logging in to the CT program.RESULTS: Of all program users (N=240), 206 participants received a subsequent email prompting them to revisit the program. A total of 53 participants (25.7%) who received a prompt reacted to this prompt by clicking on the URL, and 25 participants (12.1%) actually logged in to the program. There was a main effect of prompt timing; participants receiving an email prompt 2 weeks after their first visit clicked on the URL significantly more often compared with participants that received the prompt after 4 weeks (odds ratio [OR] 3.069, 95% CI 1.392-6.765, P=.005) and after 6 weeks (OR 4.471, 95% CI 1.909-10.471, P=.001). Furthermore, participants who received an email prompt 2 weeks after their first visit logged in to the program significantly more often compared to participants receiving the prompt after 6 weeks (OR 16.356, 95% CI 2.071-129.196, P=.008). A trend was observed with regard to prompt content. Participants receiving a prompt with additional content were more likely to log in to the program compared to participants who received a standard prompt. However, this result was not statistically significant (OR 2.286, 95% CI 0.892-5.856, P=.09).CONCLUSIONS: The key findings suggest that boosting revisits to a CT program benefits most from relatively short prompt timing. Furthermore, a preview of new website content may be added to a standard prompt to further increase its effectiveness in persuading people to log in to the program.

Resumo Limpo

ckground adher internetdeliv lifestyl intervent use multipl tailor suboptim therefor essenti invest proactiv strategi period email prompt boost reus interventionobject studi investig influenc content time singl email prompt reus internetdeliv computertailor ct lifestyl programmethod sampl municip employe invit particip program particip decid use program receiv email prompt revisit program content time design use test manipul prompt content time depend studi group particip random assign receiv either prompt contain standard content invit revisit program standard content plus preview new content place program websit particip receiv prompt week addit experiment condit control condit includ consist particip receiv addit email prompt click uniform resourc locat url provid prompt login ct program object monitor logist regress analys conduct determin whether prompt content andor prompt time predict click url log ct programresult program user n particip receiv subsequ email prompt revisit program total particip receiv prompt react prompt click url particip actual log program main effect prompt time particip receiv email prompt week first visit click url signific often compar particip receiv prompt week odd ratio ci p week ci p furthermor particip receiv email prompt week first visit log program signific often compar particip receiv prompt week ci p trend observ regard prompt content particip receiv prompt addit content like log program compar particip receiv standard prompt howev result statist signific ci pconclus key find suggest boost revisit ct program benefit relat short prompt time furthermor preview new websit content may ad standard prompt increas effect persuad peopl log program

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