Paper Number

ECIS2026-2176

Paper Type

CRP

Abstract

Lifestyle-related diseases remain a pressing public health challenge, and Digital Health Interventions (DHIs) offer scalable strategies to address them. Health Behavior Change Support Systems (HBCSSs) use persuasive design to support sustained behavior change, yet their impact is often limited by uneven engagement and attrition. This study analyzed data from 195 adults with obesity enrolled in a randomized controlled trial of a mobile HBCSS for weight management. Weekly app activity was tracked over 52 weeks and modeled using Latent Class Growth Analysis. Six engagement trajectories were identified: Super Users, Sustained Engagers, Intervention-Bound Engagers, Gradual Disengagers, Inconsistent Engagers, and Early Disengagers. Weight outcomes diverged across classes: Super Users and Sustained Engagers achieved and maintained reductions over 12 months, while disengagement trajectories showed weight regain or net gain. These findings highlight the role of sustained engagement in lasting outcomes and the need for targeted strategies to support at-risk users through adaptive design.

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Jun 14th, 12:00 AM

Engagement Trajectories and Weight Outcomes In A Mobile Health Behavior Change Support System

Lifestyle-related diseases remain a pressing public health challenge, and Digital Health Interventions (DHIs) offer scalable strategies to address them. Health Behavior Change Support Systems (HBCSSs) use persuasive design to support sustained behavior change, yet their impact is often limited by uneven engagement and attrition. This study analyzed data from 195 adults with obesity enrolled in a randomized controlled trial of a mobile HBCSS for weight management. Weekly app activity was tracked over 52 weeks and modeled using Latent Class Growth Analysis. Six engagement trajectories were identified: Super Users, Sustained Engagers, Intervention-Bound Engagers, Gradual Disengagers, Inconsistent Engagers, and Early Disengagers. Weight outcomes diverged across classes: Super Users and Sustained Engagers achieved and maintained reductions over 12 months, while disengagement trajectories showed weight regain or net gain. These findings highlight the role of sustained engagement in lasting outcomes and the need for targeted strategies to support at-risk users through adaptive design.

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