Trial reportThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2025
An exploratory study to understand how rurality status and demographic characteristics are associated with enrollment, engagement, and retention in a digital health intervention targeting the Appalachian region.
Trial report in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
4 citing papers in PubMed.
- Action Planning for Reducing Sugar-Sweetened Beverage Intake in Appalachian Adults: Longitudinal Process Evaluation of a Digital Behavioral Health Intervention.JMIR mHealth and uHealth · 2026Trial
- A Stepped Care Approach to Promoting Engagement in a Digital Health Intervention: Secondary Analysis of a Randomized Controlled Trial.Journal of medical Internet research · 2026Trial
- An exploratory study to understand how rurality status and demographic characteristics are associated with enrollment, engagement, and retention in a digital health intervention targeting the Appalachian region.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Trial
- Retention and Acceptability of a Linkage-to-Care Intervention Among Patients with Chronic Conditions in Rural South Africa.International journal of environmental research and public health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
purposeDigital health studies exploring group disparities across research phases are limited. As a secondary aim of a larger digital health trial, this study explored how rurality and other sociodemographics were associated with enrollment, retention, and engagement in a randomized controlled sugar-sweetened beverage (SSB) reduction trial.
methodsParticipants from a primarily Appalachian sample were randomized into iSIPsmarter (experimental) or static Patient Education (control) websites. Enrollment, retention (6 months), and iSIPsmarter engagement (completion of metered program Core content and SSB and weight diaries) were collected from July 2021 to August 2023. Regression models assessed subgroup associations using Rural Urban Continuum Codes (RUCC), sex, race, age, income, education, and other sociodemographic predictors.
findingsOf the 509 eligible participants, 249 (49%) enrolled, and 218 (88%) were retained. Participants were predominantly White (89%), college-educated (59%) females (83%) with household incomes <$55,000/year (52%). Rurality varied: RUCC 1-2 (medium-large metro) = 15%, RUCC 3 (small metro) = 45%, and RUCC 4-9 (nonmetro) = 41%. On average, iSIPsmarter participants (n = 127) completed 4.89/6 (SD = 1.69) Cores and 76% (SD = 29%) and 57% (SD = 31%) of SSB and weight diaries. Rurality was a nonsignificant predictor, but higher education and health literacy increased enrollment likelihood by 37% (95% CI = 1.12-1.67) and 23% (95% CI = 1.03-1.47), respectively. Greater education (OR = 1.51, 95% CI = 1.00-2.29), age (OR = 1.04, 95% CI = 1.01-1.07), and income (OR = 1.13, 95% CI = 1.00-1.28) significantly predicted retention. Older age significantly (P<.05) predicted the completion of Cores and diaries.
conclusionsResults suggested rurality was not significantly associated with enrollment, retention, or engagement, though this conclusion warrants caution. Future digital health studies targeting similar populations should consider additional sociodemographic differences.
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