Abstract
BackgroundOnline interventions can be as effective as in-person interventions. However, attrition in online intervention is high and potentially biases the results. More importantly, high attrition rates might reduce the effectiveness of online interventions. Therefore, it is important to discover the extent to which factors affect adherence to online interventions. The setting for this study is the online Friendship Enrichment Program, a loneliness intervention for adults aged 50 years and older.ObjectiveThis study examined the contribution of severity of loneliness, coping preference, activating content, and engagement in attrition within an online intervention.MethodsData were collected from 352 participants in an online loneliness intervention for Dutch people aged 50 years and older. Attrition was defined as not completing all 10 intervention lessons. The number of completed lessons was assessed through the management system of the intervention. We tested 4 hypotheses on attrition by applying survival analysis (Cox regression).ResultsOf the 352 participants who subscribed to the intervention, 46 never started the introduction. The remaining 306 participants were divided into 2 categories: 73 participants who did not start the lessons of the intervention and 233 who started the lessons of the intervention. Results of the survival analysis (n=233) showed that active coping preference (hazard ratio [HR]=0.73), activating content (HR=0.71), and 2 indicators of engagement (HR=0.94 and HR=0.79) lowered attrition. Severity of loneliness was not related to attrition.ConclusionsTo reduce attrition, developers of online (loneliness) interventions may focus on stimulating active behavior within the intervention.
Highlights
During recent years, the number of online interventions has increased rapidly
Severity of loneliness was not related to attrition
Eysenbach [6] points out that online interventions are characterized by high attrition, which is stressed in later studies [7]
Summary
Online interventions offer possibilities for reaching more participants [1], are more cost-effective, and are less prone to stigma than in-person interventions [2]. Online interventions can be as beneficial as in-person interventions [3,4]. They are often self-guided, that is, there is no contact between the participant and a coach or therapist [5]. We examined factors that may be associated with attrition in an http://aging.jmir.org/2019/2/e13638/. Online interventions can be as effective as in-person interventions. High attrition rates might reduce the effectiveness of online interventions. The setting for this study is the online Friendship Enrichment Program, a loneliness intervention for adults aged 50 years and older
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