Technology and Adherence in Web-based Intervantions for Weight Control: a Systematic Review

While technology based health interventions can be effective, high attrition rates are commonly observed in research and practice and are a major issue in eHealth. Research on adherence has recently gained some scientific attention, but little has been done as to how technology itself engages users. It seems plausible that technology plays a role in persuading people to use an eHealth intervention and keep on using it. The present study seeks to apply the PSD-model with regard to this major issue in eHealth. A comprehensive literature search was conducted using the databases Web of Knowledge, EBSCOHOST, Picarta, Scopus and ScienceDirect. The following characteristics were coded: Health care domain, Study level, Sample size, Intended usage, Usage web-based intervention, Adherence, Predictors of adherence, Intervention, Interaction, Persuasive technology in the intervention. The search yielded 4939 unique titles, of which 460 articles were deemed relevant. After title, abstract and full text screening by two researchers, 109 articles were included. Concluding, we can say that it seems that when designing web-based interventions, most attention is given to support the primary task. Dialogue support and social support appear neglected. Taking into account that more extensive use of persuasive technology seems to be positively related to adherence, more attention should be paid to all forms of support through technology.