ArticleJMIR mental health2018
Engagement With a Trauma Recovery Internet Intervention Explained With the Health Action Process Approach (HAPA): Longitudinal Study.
Article in JMIR mental health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 33 citations in OpenAlex.
- Personalization Strategies for Increasing Engagement With Digital Mental Health Resources: Sequential Multiple Assignment Randomized Trial.JMIR mental health · 2025Trial
- How to Improve People's Intentions Regarding COVID-19 Vaccination in China: A Randomized Controlled Trial.International journal of behavioral medicine · 2025Trial
- Studying the Digital Intervention Engagement-Mediated Relationship Between Intrapersonal Measures and Pre-Exposure Prophylaxis Adherence in Sexual and Gender Minority Youth: Secondary Analysis of a Randomized Controlled Trial.Journal of medical Internet research · 2025Trial
- The Impact of Video-Based Microinterventions on Attitudes Toward Mental Health and Help Seeking in Youth: Web-Based Randomized Controlled Trial.Journal of medical Internet research · 2024Trial
- Insomnia predicts treatment engagement and symptom change: a secondary analysis of a web-based CBT intervention for veterans with PTSD symptoms and hazardous alcohol use.Translational behavioral medicine · 2022Trial
- Psychosocial Interventions, Recovery, and Mediating Mechanisms in Schizophrenia-Spectrum Disorders: A Systematic Review and Meta-Analysis of Longitudinal Studies.Brain sciences · 2026Review
- Posttraumatic Symptoms as Predictors of Engagement With a Mobile App for Coping After Military Sexual Trauma: Public Usage Data Analysis Study.Journal of medical Internet research · 2026Observational
- User engagement in a digital health intervention designed for young people who have experienced technology-assisted sexual abuse (i-Minds trial).Internet interventions · 2025Article
- Application of a Sociotechnical Framework to Uncover Factors That Influence Effective User Engagement With Digital Mental Health Tools in Clinical Care Contexts: Scoping Review.Journal of medical Internet research · 2025Article
- Application of an Adapted Health Action Process Approach Model to Predict Engagement With a Digital Mental Health Website: Cross-Sectional Study.JMIR human factors · 2024Article
- The Effect of a Digital Mental Health Program on Anxiety and Depression Symptoms: Retrospective Analysis of Clinical Severity.JMIR formative research · 2023Article
- An Integrative Engagement Model of Digital Psychotherapy: Exploratory Focus Group Findings.JMIR formative research · 2023Article
- Measuring Engagement with Mental Health and Behavior Change Interventions: an Integrative Review of Methods and Instruments.International journal of behavioral medicine · 2023Review
- Engagement, Predictors, and Outcomes of a Trauma Recovery Digital Mental Health Intervention: Longitudinal Study.JMIR mental health · 2022Article
- Examining the initial usability, acceptability and feasibility of a digital mental health intervention for college students in India.International journal of psychology : Journal international de psychologie · 2020Article
- The Concept and Components of Engagement in Different Domains Applied to eHealth: A Systematic Scoping Review.Frontiers in psychology · 2020Article
- Assessment of Rwandan diabetic patients' needs and expectations to develop their first diabetes self-management smartphone application (Kir'App).Therapeutic advances in endocrinology and metabolism · 2019Article
- If we build it, will they come? Issues of engagement with digital health interventions for trauma recovery.mHealth · 2018Review
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Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere has been a growing trend in the delivery of mental health treatment via technology (ie, electronic health, eHealth). However, engagement with eHealth interventions is a concern, and theoretically based research in this area is sparse. Factors that influence engagement are poorly understood, especially in trauma survivors with symptoms of posttraumatic stress.
objectiveThe aim of this study was to examine engagement with a trauma recovery eHealth intervention using the Health Action Process Approach theoretical model. Outcome expectancy, perceived need, pretreatment self-efficacy, and trauma symptoms influence the formation of intentions (motivational phase), followed by planning, which mediates the translation of intentions into engagement (volitional phase). We hypothesized the mediational effect of planning would be moderated by level of treatment self-efficacy.
methodsTrauma survivors from around the United States used the eHealth intervention for 2 weeks. We collected baseline demographic, social cognitive predictors, and distress symptoms and measured engagement subjectively and objectively throughout the intervention.
resultsThe motivational phase model explained 48% of the variance, and outcome expectations (beta=.36), perceived need (beta=.32), pretreatment self-efficacy (beta=.13), and trauma symptoms (beta=.21) were significant predictors of intention (N=440). In the volitional phase, results of the moderated mediation model indicated for low levels of treatment self-efficacy, planning mediated the effects of intention on levels of engagement (B=0.89, 95% CI 0.143-2.605; N=115).
conclusionsThough many factors can affect engagement, these results offer a theoretical framework for understanding engagement with an eHealth intervention. This study highlighted the importance of perceived need, outcome expectations, self-efficacy, and baseline distress symptoms in the formation of intentions to use the intervention. For those low in treatment self-efficacy, planning may play an important role in the translation of intentions into engagement. Results of this study may help bring some clarification to the question of what makes eHealth interventions work.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.