%0 Journal Article
%@ 2368-7959
%I JMIR Publications
%V 9
%N 8
%P e33545
%T Operationalizing Engagement With an Interpretation Bias Smartphone App Intervention: Case Series
%A Ramadurai,Ramya
%A Beckham,Erin
%A McHugh,R Kathryn
%A Björgvinsson,Thröstur
%A Beard,Courtney
%+ Department of Psychology, American University, 4400 Massachusetts Avenue NW, Washington, DC, 20016, United States, 1 202 885 8000, rr4748a@student.american.edu
%K engagement
%K mental health apps
%K cognitive bias modification
%K human support
%K mobile health
%K mHealth
%K mobile phone
%D 2022
%7 17.8.2022
%9 Original Paper
%J JMIR Ment Health
%G English
%X Background: Engagement with mental health smartphone apps is an understudied but critical construct to understand in the pursuit of improved efficacy. Objective: This study aimed to examine engagement as a multidimensional construct for a novel app called HabitWorks. HabitWorks delivers a personalized interpretation bias intervention and includes various strategies to enhance engagement such as human support, personalization, and self-monitoring. Methods: We examined app use in a pilot study (n=31) and identified 5 patterns of behavioral engagement: consistently low, drop-off, adherent, high diary, and superuser. Results: We present a series of cases (5/31, 16%) from this trial to illustrate the patterns of behavioral engagement and cognitive and affective engagement for each case. With rich participant-level data, we emphasize the diverse engagement patterns and the necessity of studying engagement as a heterogeneous and multifaceted construct. Conclusions: Our thorough idiographic exploration of engagement with HabitWorks provides an example of how to operationalize engagement for other mental health apps. 
%M 35976196
%R 10.2196/33545
%U https://mental.jmir.org/2022/8/e33545
%U https://doi.org/10.2196/33545
%U http://www.ncbi.nlm.nih.gov/pubmed/35976196