Using a qualitative approach to assess motives for non-uptake and disengagement in digital interventions

Abstract

Background: The impact on public health of digital interventions is often limited due to suboptimal levels of uptake and engagement. In order to understand the process of uptake and engagement, it is important to supplement objective analyses of intervention use with qualitative approaches to understand barriers related to intervention uptake and engagement. Methods: A digital intervention promoting mental fitness was proactively offered to participants of a Dutch Health Monitor. A total of 24 semi-structured individual interviews were conducted in order to assess motives for uptake and disengagement. The interview guide was developed using Roger’s Diffusion of Innovation Theory and the Unified Theory of Acceptance and Use of Technology. Data were analysed using thematic analyses methods. Findings: Almost 17000 participants indicated their interest in the intervention, whereas actual uptake was 4378, of which 20% consisted of active users. Participants refraining from intervention uptake, as well as intervention users reported positive expectations regarding the intervention. They expected the intervention to be easy to use, effective and compatible with their daily routine. In addition, non-uptake could largely be explained by the fact that people were not convinced of the personal necessity of the intervention. Finally, the main reason for disengagement was the personal experience of obtaining positive results, which made further engagement redundant in their perception. Discussion: The results of this study give valuable insights in the motives related to uptake and disengagement. Based on these findings strategies can be developed in order to optimize engagement and increase the impact of public health.