TY  - JOUR
AU  - Ramadurai, Ramya
AU  - Beckham, Erin
AU  - McHugh, R Kathryn
AU  - Björgvinsson, Thröstur
AU  - Beard, Courtney
PY  - 2022
DA  - 2022/8/17
TI  - Operationalizing Engagement With an Interpretation Bias Smartphone App Intervention: Case Series
JO  - JMIR Ment Health
SP  - e33545
VL  - 9
IS  - 8
KW  - engagement
KW  - mental health apps
KW  - cognitive bias modification
KW  - human support
KW  - mobile health
KW  - mHealth
KW  - mobile phone
AB  - 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. 
SN  - 2368-7959
UR  - https://mental.jmir.org/2022/8/e33545
UR  - https://doi.org/10.2196/33545
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35976196
DO  - 10.2196/33545
ID  - info:doi/10.2196/33545
ER  -