Participation and engagement in online cognitive testing.

Area of Science:

• Cognitive Science
• Digital Health
• Population Health

Background:

• Web-based cognitive testing offers scalable assessments, but its reach to diverse demographics remains uncertain.
• Understanding participation biases is crucial for equitable digital health research.

Purpose of the Study:

• To compare characteristics of participants versus non-participants in a web-based cognitive study (HUNT4-Hjernetrim) from a general population sample (HUNT4).
• To investigate engagement and user experience of participants in the online cognitive assessment.

Main Methods:

• Logistic and linear regressions were used to analyze participation biases, engagement, and user experience.
• Data included socio-demographics, health conditions, cognitive difficulties, and lifestyle factors from the HUNT4 database.
• 13 cognitive tests were administered via the online platform Memoro.

Main Results:

• 9.4% of invited HUNT4 participants (5634 individuals) completed the HUNT4-Hjernetrim study.
• Participants were more likely to be middle-aged, women, highly educated, urban dwellers, and report memory complaints.
• Older adults (80+), individuals with motor/vision impairments, and teenagers with learning disabilities were underrepresented.
• Participants had higher rates of mental health issues and cancer history, but lower rates of cardiovascular disease.
• Average engagement included 42 minutes, 78% task completion, with PCs yielding the most complete data.
• 65% reported positive user experiences, while 14% experienced technical difficulties.

Conclusions:

• Web-based cognitive testing can achieve relatively representative samples, including typically hard-to-reach groups.
• Somatic and mental health conditions influenced participation variably.
• Most participants completed the cognitive tests with generally positive user experiences, indicating feasibility of the approach.