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J Med Internet Res. May 2013; 15(5): e96.
Published online May 22, 2013. doi:  10.2196/jmir.2323
PMCID: PMC3668607

Predictors of Participant Retention in a Guided Online Self-Help Program for University Students: Prospective Cohort Study

Monitoring Editor: Gunther Eysenbach
Reviewed by Elizabeth Murray and Kirsikka Kaipainen
Magdalena Wojtowicz, BSc (Hons),corresponding author1 Victor Day, PhD,2 and Patrick J McGrath, OC, PhD, FRSC3,4

Abstract

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 (F 3,62=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 (F 3,61=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.

Keywords: self-help, online treatment, Web-based, retention, dropouts, theory of planned behavior

Articles from Journal of Medical Internet Research are provided here courtesy of Gunther Eysenbach

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