Optimising Web-Based Computer-Tailored Physical Activity Interventions for Prostate Cancer Survivors: A Randomised Controlled Trial Examining the Impact of Website Architecture on User Engagement

Abstract

Background: Web-based computer-tailored interventions can assist prostate cancer survivors to become more physically active by providing personally relevant behaviour change support. This study aimed to explore how changing the website architecture (free choice vs. tunnelled) impacted engagement within a physical activity computer-tailored intervention targeting prostate cancer survivors. Methods: On a 2:2:1 ratio, 71 Australian prostate cancer survivors with local or locally advanced disease (mean age: 66.6 years ± 9.66) were randomised into either a free-choice (N = 27), tunnelled (N = 27) or minimal intervention control arm (N =17). The primary outcome was differences in usage of the physical activity self-monitoring and feedback modules between the two intervention arms. Differences in usage of other website components between the two intervention groups were explored as secondary outcomes. Further, secondary outcomes involving comparisons between all study groups (including the control) included usability, personal relevance, and behaviour change. Results: The average number of physical activity self-monitoring and feedback modules accessed was higher in the tunnelled arm (M 2.6 SD 1.3) compared to the free-choice arm (M 1.5 SD 1.4), p = 0.01. However, free-choice participants were significantly more likely to have engaged with the social support (p = 0.008) and habit formation (p = 0.003) ‘once-off’ modules compared to the standard tunnelled arm. There were no other between-group differences found for any other study outcomes. Conclusion: This study indicated that website architecture influences behavioural engagement. Further research is needed to examine the impact of differential usage on mechanisms of action and behaviour change.

Non-Pharmacological Interventions to Improve Chronic Disease Risk Factors and Sleep in Shift Workers: A Systematic Review and Meta-Analysis

“…Importantly, behavioural interventions that tailored the information provided to workers were more likely to result in positive changes. This is consistent with previous studies comparing individualised to non-individualised interventions for health behaviours [ 141 , 142 ]. An example is the study by Van Drongelen et al [ 115 ], in which a control group received general information regarding fatigue and health behaviours, while the intervention group received personalised information.…”

“…Another limitation within the current studies is the relatively limited studies that utilised an individualised design. Personalisation of behavioural interventions [ 141 , 142 ] and controlled light exposure [ 143 ] have been shown to have positive effects for individuals and should be considered for future intervention studies.…”

Acceptability and Preliminary Efficacy of a Web- and Telephone-Based Personalised Exercise Intervention for Individuals with Metastatic Prostate Cancer: The ExerciseGuide Pilot Randomised Controlled Trial

“…Finlay et al compared usability of a computer-tailored website among Australian men with localised prostate cancer set up to deliver modules either in a free choice scenario (similar to ExerciseGuide) or a tunnelled scenario where a new module was unlocked each week. Average usability was higher in the tunnelled intervention 67.4 ± 14.6 compared to the free choice intervention 56.4 ± 12.2 [63,64], but as in the current study the score was marginal. Usability testing and iterative refinement was undertaken with ExerciseGuide in a small lab-based study to enhance usability with some success [17].…”

“…However, given, that usability is likely to affect the uptake and continued use of web-based tools additional strategies should be considered, including implementation of feedback from pilot study participants [ 65 ]. Findings in the Finlay study and qualitative feedback from two ExerciseGuide participants consider that usability may improve if participants are navigated through future interventions [ 64 ]. This may also lead to increased usage of education modules which were not accessed as often as the exercise prescription modules in the current study.…”

Usability, Acceptability, and Safety Analysis of a Computer-Tailored Web-Based Exercise Intervention (ExerciseGuide) for Individuals With Metastatic Prostate Cancer: Multi-Methods Laboratory-Based Study

“…Older adults have been reported to have difficulty filtering out useful information from generalized text because of changes in working memory [ 38 ]. Tailoring information ensures personal relevance, individualized exercise prescription, and limitation of superfluous information [ 39 ]. Notably, additional tailoring occurred after the first iterative cycle, with the aim of increasing the personalization of exercise and reducing the amount of content.…”