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Bridging the adherence gap in internet interventions: A randomized controlled trial study protocol investigating

Ewelina Smoktunowicz1, Jan Maciejewski1, Magdalena Lesnierowska1

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Enhancing self-efficacy before internet interventions may improve adherence. This study tested a self-efficacy exercise to boost adherence and outcomes in a medical student internet intervention.

Keywords:
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Area of Science:

  • Psychology
  • Digital Health
  • Intervention Science

Background:

  • Low adherence to self-guided internet interventions negatively impacts outcomes.
  • Few adherence predictors are easily modifiable for broad implementation.
  • Context-specific self-efficacy is a potential modifiable factor for improving adherence.

Purpose of the Study:

  • To evaluate the effectiveness of a self-efficacy-enhancing exercise on adherence to an internet intervention.
  • To assess the impact of this exercise on stress reduction and work engagement.
  • To determine if enhanced self-efficacy improves adherence and outcomes in medical students.

Main Methods:

  • A two-phase randomized controlled trial design.
  • Phase 1: Tested a self-efficacy exercise against a waitlist control (N=216 students).
  • Phase 2: Compared the internet intervention with and without the preceding self-efficacy exercise (N=952 medical students), with follow-ups at 6 months and 1 year.

Main Results:

  • Anticipated higher adherence in the experimental group receiving the self-efficacy exercise.
  • Expected greater improvements in secondary outcomes (lower stress, higher work engagement) in the experimental group.
  • The primary outcome is intervention adherence; secondary outcomes include stress and work engagement levels.

Conclusions:

  • Enhancing context-specific self-efficacy may be a simple strategy to improve adherence to internet interventions.
  • This approach could lead to better outcomes for participants in digital health programs.
  • The findings could inform recommendations for pre-intervention strategies to boost engagement.