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Although dropout and nonusage attrition have been described in relation to commercially available websites, few studies describe similar patterns in freely accessible interventions, especially in regard to physical activity.
#Virtual cb funk windows 8 trial#
This is supported by studies that find a higher percentage of intervention completers and higher website usage for trial users compared to “real-life” users of the same website. Further, people could be more committed to the study because of the formal structure of the trial or active recruitment, which leads to lower attrition. In efficacy trials, participants usually have gone through a rigorous screening process to determine eligibility and therefore include a selected group of participants that is likely more motivated to use the intervention compared to those not undergoing this screening. Findings of nonusage rates from controlled settings may not translate to real-life settings.
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However, to evaluate the real public health impact of an intervention there is a need to examine effectiveness and reach of the target population after implementation to real-life settings. Thus far, research on attrition has been done primarily in the context of controlled trials. Įysenbach calls for a science of attrition to systematically examine attrition rates, engagement measures, and associated variables. For Web-based physical activity interventions, reported dropout attrition rates vary between 0% and 62%. In addition to nonusage attrition, Web-based interventions studies suffer also from high dropout attrition (ie, participants are lost to follow-up). This is important because the level of exposure to intervention content has been linked to intervention effectiveness. For example, in a Web-based weight loss study, only 64% of the intervention group actually used the intervention at least once. This makes it difficult to measure intervention effects because participants receive different doses of the intervention content. Most often, website log-ins, a frequently used indicator of engagement and intervention exposure, decrease rapidly over time. Web-based intervention studies typically suffer from high nonusage attrition (ie, not all participants use or keep using the intervention as intended by the developers). However, maintaining interest of the participants in the intervention over time has been reported as a main challenge of Internet-delivered interventions. The Internet is a promising tool to deliver complex, individualized, and tailored interventions while reaching a large part of the population at lower cost than face-to-face interventions. Previous research has shown that Web-based behavior change interventions can be effective in increasing physical activity. Insufficient physical activity has been identified as the fourth-leading risk factor for global mortality.