Translating strategies for promoting engagement in mobile health: A proof-of-concept microrandomized trial.
Open accessAbstract
OBJECTIVE: Mobile technologies allow for accessible and cost-effective health monitoring and intervention delivery. Despite these advantages, mobile health (mHealth) engagement is often insufficient. While monetary incentives may increase engagement, they can backfire, dampening intrinsic motivations and undermining intervention scalability. Theories from psychology and behavioral economics suggest useful nonmonetary strategies for promoting engagement; however, examinations of the applicability of these strategies to mHealth engagement are lacking. This proof-of-concept study evaluates the translation of theoretically-grounded engagement strategies into mHealth, by testing their potential utility in promoting daily self-reporting. METHOD: A microrandomized trial (MRT) was conducted with adolescents and emerging adults with past-month substance use. Participants were randomized multiple times daily to receive theoretically-grounded strategies, namely reciprocity (the delivery of inspirational quote prior to self-reporting window) and nonmonetary reinforcers (e.g., the delivery of meme/gif following self-reporting completion) to improve proximal engagement in daily mHealth self-reporting. RESULTS: = 68) were slightly lower than prior literature, albeit with much lower financial incentives. The utility of specific strategies was found to depend on contextual factors pertaining to the individual's receptivity and risk for disengagement. For example, the effect of reciprocity significantly varied depending on whether this strategy was employed (vs. not employed) during the weekend. The nonmonetary reinforcement strategy resulted in different outcomes when operationalized in various ways. CONCLUSIONS: While the results support the translation of the reciprocity strategy into this mHealth setting, the translation of nonmonetary reinforcement requires further consideration prior to inclusion in a full scale MRT. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Goodday, S. M., Goldenberg, A., Doshi‐Velez, F., & Friend, S. H. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1967226
- Authors
- Nahum-Shani, I., Rabbi, M., Yap, J., Philyaw-Kotov, M. L., Klasnja, P., Bonar, E. E., Cunningham, R. M., Murphy, S. A., & Walton, M. A.
- ORCID
- Venue
- Health Psychology
- Published
- 2021-12
- Volume
- 40
- Issue
- 12
- Pages
- 974-987
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- PMC
- PMC8738098
- OpenAlex
- W3208949549
- Cited by
- 41
- References
- 53
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 8 · 2023: 9 · 2022: 10 · 2021: 1
- FWCI
- 7.87
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Health Psychology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Michigan Institute for Data Science
- Centers for Disease Control and Prevention (R49CE002099, R49-CE-003085)
- National Institutes of Health (P50 DA039838, R01 DA039901; 02R01 DA039901, R01 AA023187)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- reciprocity, substance use, adolescents, emerging adults, motivational strategies, behavioral economics
- MeSH terms
- Adolescent, Adult, Humans, Motivation, Telemedicine, Self Report
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