Application of an Adapted Health Action Process Approach Model to Predict Engagement With a Digital Mental Health...

Area of Science:

• Digital mental health
• Health behavior theory
• User engagement

Background:

• Digital mental health (DMH) tools offer accessible support, but sustained user engagement remains a challenge.
• Limited research exists on factors influencing DMH engagement.
• The Health Action Process Approach (HAPA) is a known theory for health behavior change, but its applicability to DMH engagement is unproven.

Purpose of the Study:

• To investigate if an adapted HAPA model could predict user engagement with DMH tools on a self-guided website.
• To assess the HAPA model's predictive power for both the decision to engage and the extent of engagement with DMH resources.

Main Methods:

• A cross-sectional study surveyed 16,078 website sessions on Mental Health America (MHA) to measure HAPA constructs.
• Structural equation modeling was used to test the adapted HAPA model.
• Engagement was measured by the choice to interact with DMH content and the level of engagement (time and pages visited).

Main Results:

• The adapted HAPA model showed poor fit for predicting engagement, explaining only 0.1% of the variance in choice to engage and 1.4% in the level of engagement.
• While intention and planning were predicted by HAPA constructs, planning did not significantly predict the choice to engage.
• Planning was significantly associated with the level of engagement among those who chose to engage.

Conclusions:

• The HAPA model, in its adapted form, did not adequately predict engagement with DMH via a self-guided website.
• Further investigation into alternative theoretical frameworks and digital design strategies is necessary to enhance DMH tool engagement.