ArticleJournal of the American Medical Informatics Association : JAMIA2021
Estimating the impact of engagement with digital health interventions on patient outcomes in randomized trials.
Article in Journal of the American Medical Informatics Association : JAMIA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed.
- The Goldilocks Dilemma on Balancing User Response and Reflection in mHealth Interventions: Observational Study.JMIR mHealth and uHealth · 2024Trial
- Mining Association Rules From a Multimodal Dataset of a Digital Therapeutics Application for Sleep Improvement Through a Healthy Lifestyle: Quantitative Study.JMIR formative research · 2026Article
- The use of telemedicine in palliative care in low- and middle-income countries: A scoping review.Palliative medicine · 2026Article
- Community Participatory Co-Design and Development of a Digital Diabetes Prevention Education Program for Hispanic Families With Obesity: Mixed Methods Study.JMIR formative research · 2026Article
- Maternal mHealth usability strengthened by trust, governance, and navigation.Frontiers in digital health · 2026Article
- Behavioral engagement patterns and psychosocial outcomes in web-based interpretation bias training for anxiety.PLOS digital health · 2025Article
- The preferences of breast cancer patients regarding a digital social care platform.BMC women's health · 2025Article
- Using the Healthy Native Youth Implementation Toolbox to Provide Web-Based Adolescent Health Promotion Decision Support to American Indian and Alaska Native Communities: Implementation Study.JMIR formative research · 2025Article
- Incident prescriptions for common cardiovascular medications: comparison of recent versus pre-2020 medication adherence and discontinuation in three universal health care systems.BMC cardiovascular disorders · 2025Article
- Impact of digital health interventions on glycemic control and weight management.NPJ digital medicine · 2025Article
- Achieving clinically meaningful outcomes in digital health: a six-step, cyclical precision engagement framework (ENGAGE).Frontiers in digital health · 2025Article
- Short-Term Impact of Digital Mental Health Interventions on Psychological Well-Being and Blood Sugar Control in Type 2 Diabetes Patients in Riyadh.Healthcare (Basel, Switzerland) · 2024Article
- Lessons Learned From Developing Dashboards to Support Decision-Making for Community Opioid Response by Community Stakeholders: Mixed Methods and Multisite Study.JMIR human factors · 2024Article
- User Engagement in an Online Digital Health Intervention to Promote Problem Solving.Interacting with computers · 2024Article
- How are Machine Learning and Artificial Intelligence Used in Digital Behavior Change Interventions? A Scoping Review.Mayo Clinic proceedings. Digital health · 2024Review
- Mobile health plus community health worker support for weight management among public housing residents (Path to Health): A randomized controlled trial protocol.Contemporary clinical trials · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveGuidance is needed on studying engagement and treatment effects in digital health interventions, including levels required for benefit. We evaluated multiple analytic approaches for understanding the association between engagement and clinical outcomes. MATERIALS AND
methodsWe defined engagement as intervention participants' response rate to interactive text messages, and considered moderation, standard regression, mediation, and a modified instrumental variable (IV) analysis to investigate the relationship between engagement and clinical outcomes. We applied each approach to two randomized controlled trials featuring text message content in the intervention: REACH (Rapid Encouragement/Education and Communications for Health), which targeted diabetes, and VERB (Vanderbilt Emergency Room Bundle), which targeted hypertension.
resultsIn REACH, the treatment effect on hemoglobin A1c was estimated to be -0.73% (95% CI: [-1.29, -0.21]; P = 0.008), and in VERB, the treatment effect on systolic blood pressure was estimated to be -10.1 mmHg (95% CI: [-17.7, -2.8]; P = 0.007). Only the IV analyses suggested an effect of engagement on outcomes; the difference in treatment effects between engagers and non-engagers was -0.29% to -0.51% in the REACH study and -1.08 to -3.25 mmHg in the VERB study. DISCUSSION: Standard regression and mediation have less power than a modified IV analysis, but the IV approach requires specification of assumptions. This is the first review of the strengths and limitations of various approaches to evaluating the impact of engagement on outcomes.
conclusionsUnderstanding the role of engagement in digital health interventions can help reveal when and how these interventions achieve desired outcomes.
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Registered trials
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.