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Published on: August 1, 2019
Patient Engagement and Symptom Outcomes in a Provider-Guided Online Symptom Management Intervention: Mixed Methods
Yan Wang1, Annette DeVito Dabbs2, Teresa Hagan Thomas1
1Department of Health and Community Systems, School of Nursing, University of Pittsburgh, 3500 Victoria Street, Victoria Building, Pittsburgh, PA, 15261, United States, 1 4126261172.
Journal of Medical Internet Research
|July 23, 2026
Summary
Patient education influences engagement in digital health interventions for cancer survivors. Addressing barriers and supporting lower education levels can improve symptom management outcomes.
Area of Science:
- Oncology
- Digital Health
- Patient Engagement
Background:
- Cancer survivors often disengage from digital health interventions (DHIs).
- Predictors of engagement in provider-guided DHIs are not well understood.
- Nurse WRITE is an 8-week nurse-directed DHI for symptom management.
Purpose of the Study:
- To understand engagement phenomena in the Nurse WRITE DHI.
- To identify factors influencing engagement and challenges faced by participants.
- To assess the relationship between engagement and symptom control.
Main Methods:
- Secondary analysis of the Nurse WRITE arm of a symptom management trial.
- Examined data from 68 women with recurrent ovarian cancer.
- Assessed cognitive, socioaffective, and behavioral engagement using message board and website data; content analysis explored challenges.
Main Results:
- Patient education was linked to cognitive, socioaffective, and behavioral engagement indicators.
- Common challenges included worsening health, family life, and technical difficulties.
- Higher engagement correlated with improved symptom control.
Conclusions:
- Educational attainment impacts engagement with DHIs like Nurse WRITE.
- Future DHIs should address engagement barriers and support participants with lower education.
- Multidimensional engagement is crucial for improving outcomes in DHIs.