Predictors of Participant Retention in a Guided Online Self-Help Program for University Students: Prospective Cohort Study
Open accessAbstract
BACKGROUND: Attrition is a persistent issue in online self-help programs, but limited research is available on reasons for attrition or successful methods for improving participant retention. One potential approach to understanding attrition and retention in such programs is to examine person-related variables (eg, beliefs and attitudes) that influence behavior. Theoretical models, such as the Theory of Planned Behavior, that describe conditions influencing human behavior may provide a useful framework for predicting participant retention in online-based program. OBJECTIVE: We examined predictors of participant retention in a guided online anxiety, depression, and stress self-help program for university students using the theory of planned behavior. We also explored whether age, symptom severity, and type of coaching (ie, email vs phone) affected participant retention. METHODS: 65 university students with mild to moderate depression, anxiety, and stress were enrolled in this prospective cohort study. Participants completed a questionnaire based on the theory of planned behavior prior to commencing the online-based program and the Depression Anxiety and Stress Scale (DASS) during the assessment module of the program. Participant retention was operationalized as the number of program modules completed. RESULTS: Perceived control over completing the online program significantly predicted intention to complete the program (F3,62=6.7; P=.001; adjusted R(2)=.2; standardized beta=.436, P=.001). Age (standardized beta=.319, P=.03) and perceived behavioral control (standardized beta=.295, P=.05) predicted the number of program modules completed (F3,61=3.20, P=.03, adjusted R(2) =.11). Initial level of distress (ie, symptom severity) did not predict participant retention (P=.55). Participants who chose phone-based coaching completed more program modules than participants who chose email-based coaching (Mann-Whitney's U=137; P=.004). CONCLUSIONS: Participants' age, level of perceived behavioral control, and choice of interaction (ie, phone-based or email-based coaching) were found to influence retention in this online-based program.
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Previous efforts to identify nontechnological factors influencing attrition in online interventions have yielded inconclusive results.
“although previous efforts to identify nontechnological factors influencing attrition in online interventions have yielded inconclusive results [71-75].”
From Short-term effectiveness of web-based guided self-help for phobic outpatients: randomized controlled trial. (2014) · cites this paper as [72]
Because there was systematic attrition in this trial, the significant differences between completers and dropouts may provide valuable information to identify focal points for targeted attrition reduction.
“Because there was systematic attrition in this trial, the significant differences between completers and dropouts may provide valuable information to identify focal points for targeted attrition reduction, although previous efforts to identify nontechnological factors influencing attrition in online interventions have yielded inconclusive results [71-75].”
From Short-term effectiveness of web-based guided self-help for phobic outpatients: randomized controlled trial. (2014) · cites this paper as [72]
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- Authors
- Wojtowicz, M., Day, V., & McGrath, P. J.
- Affiliations
- Dalhousie University (CA)
- Corresponding author
- Wojtowicz, Magdalena
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2013-05-22
- Volume
- 15
- Issue
- 5
- Pages
- e96
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC3668607
- OpenAlex
- W1986446865
- Cited by
- 43
- References
- 37
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 5 · 2023: 4 · 2022: 2 · 2021: 4 · 2019: 4 · 2018: 1 · 2017: 4 · 2016: 5 · 2015: 1 · 2014: 6 · 2013: 1
- FWCI
- 6.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- other-oa
- Locations
- Journal of Medical Internet Research (publishedVersion, other-oa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Nova Scotia Health Research Foundation
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- participant retention, attrition, online self-help program, guided self-help, university students, anxiety, depression, stress, theory of planned behavior, perceived behavioral control, perceived control, phone coaching, symptom severity, age
- MeSH terms
- Adolescent, Adult, Animals, Anxiety, Depression, Humans, Prospective Studies, Surveys and Questionnaires, Self-Help Groups, Stress, Psychological, Students, Universities, Internet, Mice, Young Adult
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