Patterns of User Engagement with Mobile- and Web-Delivered Self-Care Interventions for Adults with T2DM: A Review of the Literature

  • Lyndsay A. Nelson
  • Taylor D. Coston
  • Andrea L. Cherrington
  • Chandra Y. OsbornEmail author
Psychosocial Aspects (S Jaser and KK Hood, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Psychosocial Aspects


Technology-delivered interventions can improve the health behaviors and clinical outcomes of persons with diabetes, but only if end users engage with these interventions. To summarize the current knowledge on engagement with technology-based interventions, we conducted a review of recent mobile- and web-delivered intervention studies for adults with type 2 diabetes published from 2011 to 2015. Among 163 identified studies, 24 studies satisfied our inclusion criteria. There was substantial variation in how intervention engagement was reported across studies. Engagement rates were lower among interventions with a longer duration, and engagement decreased over time. In several studies, older age and lower health literacy were associated with less engagement, and more engagement was associated with intervention improvement in at least one outcome, including glycemic control. Future technology-based intervention studies should report on engagement, examine and report on associations between user characteristics and engagement, and aim to standardize how this is reported, particularly in longer trials.


Technology Internet Mobile Intervention Engagement Diabetes Review 



Drs. Nelson and Osborn are supported by NIH/NIDDK R01-DK100694, and Dr. Osborn is also supported by K01-DK087894. Dr. Cherrington is supported by NIH/NIDDK P30-DK07962.

Compliance with Ethical Standards

Conflict of Interest

Lyndsay A. Nelson, Taylor D. Coston, Andrea L. Cherrington, and Chandra Y. Osborn declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Lyndsay A. Nelson
    • 1
    • 2
  • Taylor D. Coston
    • 3
  • Andrea L. Cherrington
    • 4
    • 5
  • Chandra Y. Osborn
    • 1
    • 2
    • 6
    • 7
    Email author
  1. 1.Department of MedicineVanderbilt University Medical CenterNashvilleUSA
  2. 2.Center for Health Behavior and Health EducationVanderbilt University Medical CenterNashvilleUSA
  3. 3.School of MedicineVanderbilt University Medical CenterNashvilleUSA
  4. 4.Department of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  5. 5.Division of Preventative MedicineUniversity of Alabama at BirminghamBirminghamUSA
  6. 6.Center for Diabetes Translational ResearchVanderbilt University Medical CenterNashvilleUSA
  7. 7.Department of Biomedical InformaticsVanderbilt University Medical CenterNashvilleUSA

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