Abstract
BackgroundA critical issue in understanding the benefits of Web-based interventions is the lack of information on the sustainability of those benefits. Sustainability in studies is often determined using group-level analyses that might obscure our understanding of who actually sustains change. Person-centric methods might provide a deeper knowledge of whether benefits are sustained and who tends to sustain those benefits.ObjectiveThe aim of this study was to conduct a person-centric analysis of longitudinal outcomes, examining well-being in participants over the first 3 months following a Web-based happiness intervention. We predicted we would find distinct trajectories in people’s pattern of response over time. We also sought to identify what aspects of the intervention and the individual predicted an individual’s well-being trajectory.MethodsData were gathered from 2 large studies of Web-based happiness interventions: one in which participants were randomly assigned to 1 of 14 possible 1-week activities (N=912) and another wherein participants were randomly assigned to complete 0, 2, 4, or 6 weeks of activities (N=1318). We performed a variation of K-means cluster analysis on trajectories of life satisfaction (LS) and affect balance (AB). After clusters were identified, we used exploratory analyses of variance and logistic regression models to analyze groups and compare predictors of group membership.ResultsCluster analysis produced similar cluster solutions for each sample. In both cases, participant trajectories in LS and AB fell into 1 of 4 distinct groups. These groups were as follows: those with high and static levels of happiness (n=118, or 42.8%, in Sample 1; n=306, or 52.8%, in Sample 2), those who experienced a lasting improvement (n=74, or 26.8% in Sample 1; n=104, or 18.0%, in Sample 2), those who experienced a temporary improvement but returned to baseline (n=37, or 13.4%, in Sample 1; n=82, or 14.2%, in Sample 2), and those with other trajectories (n=47, or 17.0%, in Sample 1; n=87, or 15.0% in Sample 2). The prevalence of depression symptoms predicted membership in 1 of the latter 3 groups. Higher usage and greater adherence predicted sustained rather than temporary benefits.ConclusionsWe revealed a few common patterns of change among those completing Web-based happiness interventions. A noteworthy finding was that many individuals began quite happy and maintained those levels. We failed to identify evidence that the benefit of any particular activity or group of activities was more sustainable than any others. We did find, however, that the distressed portion of participants was more likely to achieve a lasting benefit if they continued to practice, and adhere to, their assigned Web-based happiness intervention.
Highlights
BackgroundThere is a wide variety of electronic health and mobile health interventions available to anyone who is interested in Web-based mental health care or self-improvement and has access to the internet or a mobile network
The remaining 7 studies included in the review, provide initial evidence that the increases to happiness following an online positive psychological interventions (OPPIs) can be partially sustained for 6 weeks [7], 3 months [8], and 6 months [9,10] after the completion of the intervention and that a remediation of depression symptoms can be observed 3 months [11] and 6 months [9,10,12,13] after exposure to an OPPI
In terms of each of our specific research questions, respectively: 1. For the distressed portion of participants, our cluster analysis of trajectories revealed that a lasting benefit following the OPPI might be just as likely as a temporary benefit; both experiences were commonly reported by participants
Summary
BackgroundThere is a wide variety of electronic health (eHealth) and mobile health (mHealth) interventions available to anyone who is interested in Web-based mental health care or self-improvement and has access to the internet or a mobile network. Lack a specific focus and instead attempt to build general wellness or happiness. These interventions have been called elsewhere online positive psychological interventions (OPPIs) [4]. The efficacy of many of these Web-based interventions, including OPPIs, has been demonstrated in the peer-reviewed academic literature, little information is available on the sustainability of the benefits that people see when they use these interventions. A critical issue in understanding the benefits of Web-based interventions is the lack of information on the sustainability of those benefits. Person-centric methods might provide a deeper knowledge of whether benefits are sustained and who tends to sustain those benefits
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