Examining Participation in Mobile Health Interventions: A Study in Disadvantaged UK Areas
Understanding the dynamics of participation in health interventions is crucial, especially among populations at increased risk for conditions like dementia. This article explores the response to an invitation to participate in a mixed mobile health intervention among adults living in disadvantaged areas within the UK. By analyzing recruitment data from a randomized controlled trial, we aim to shed light on the various factors influencing participation.
Design: A Secondary Analysis Approach
This study utilized a secondary analysis of recruitment data from a randomized controlled trial. The focus was on a primary care population from deprived areas in the UK, particularly targeting individuals in middle to late life, who are at an increased risk of developing dementia due to their risk profile.
Intervention Methodology
The intervention involved an invitation by letter from the family doctor, followed by an SMS reminder via telephone. This dual approach aimed to maximize engagement and response rates among the participants.
Main Outcome Measures
The study aimed to assess the following outcomes:
(1) The response rate to the invitation.
(2) The relationship between the response and factors such as GP practice size, area-level deprivation, and COVID-19 restrictions.
(3) Reasons for non-participation.
Univariate linear regression analyses were conducted to evaluate the association between practice size and area deprivation, measured by the multiple deprivation index, with positive response rates per general practice. Additionally, the impact of COVID-19 isolation policies on response rates was visually assessed by comparing different restriction phases.
Key Findings
Of the 13,814 participants invited, 12,816 (93%) did not respond. Among the 998 (7%) who responded, 690 (69%) expressed willingness to participate, indicating a positive response, while 308 (31%) declined. From those who declined, 209 provided reasons for their non-participation. A significant barrier was identified as the need to use a smartphone, cited by 40% of these respondents. Furthermore, 33% mentioned they lacked a smartphone or internet access, and 7% were unable or unwilling to participate. Notably, there was no observed connection between response rate and COVID-19 public life restrictions.
Conclusions and Implications
The findings reveal that in deprived areas, most individuals invited through their GP practice for a dementia prevention trial did not respond. The requirement for smartphone use emerged as a significant barrier. These results underscore the necessity for substantial efforts to reduce participation bias, enhance the generalizability of study outcomes, and address health disparities in preventative interventions.
For further details, you can access the full study Here.
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