Abstract

In electronic health (eHealth) research, limited insight has been obtained on process outcomes or how the use of technology has contributed to the users’ ability to have a healthier life, improved well-being, or activate new attitudes in their daily tasks. As a result, eHealth is often perceived as a black box. To open this black box of eHealth, methodologies must extend beyond the classic effect evaluations. The analyses of log data (anonymous records of real-time actions performed by each user) can provide continuous and objective insights into the actual usage of the technology. However, the possibilities of log data in eHealth research have not been exploited to their fullest extent. The aim of this paper is to describe how log data can be used to improve the evaluation and understand the use of eHealth technology with a broader approach than only descriptive statistics. This paper serves as a starting point for using log data analysis in eHealth research. Here, we describe what log data is and provide an overview of research questions to evaluate the system, the context, the users of a technology, as well as the underpinning theoretical constructs. We also explain the requirements for log data, the starting points for the data preparation, and methods for data collection. Finally, we describe methods for data analysis and draw a conclusion regarding the importance of the results for both scientific and practical applications. The analysis of log data can be of great value for opening the black box of eHealth. A deliberate log data analysis can give new insights into how the usage of the technology contributes to found effects and can thereby help to improve the persuasiveness and effectiveness of eHealth technology and the underpinning behavioral models.

Highlights

  • Many electronic health technologies, such as behavior change technologies, aim to support users in reaching certain health-related behavioral outcomes

  • EHealth research is dominated by a classic conception of medical research where randomized controlled trials (RCTs) are the golden standard for measuring outcomes [6]

  • (eHealth) technology can be characterized by its constant evolution and, apps or interventions often become obsolete by the time the results of the RCT are available

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Summary

Introduction

Many electronic health (eHealth) technologies, such as behavior change technologies, aim to support users in reaching certain health-related behavioral outcomes. While such technologies can be effective [1,2], one of the main problems is that users’ adoption and long-term use remains lower than expected [3,4,5]. (eHealth) technology can be characterized by its constant evolution and, apps or interventions often become obsolete by the time the results of the RCT are available. To conform to the complexity of behavior change, eHealth technologies often consist of multiple components that may interact in reaching a certain effect and that people can use http://www.researchprotocols.org/2017/8/e156/

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