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BackgroundEngagement with digital behavior change interventions (DBCIs) is considered a prerequisite for intervention efficacy. However, in many trials on DBCIs, participants use the intervention either only little or not at all. ObjectiveTo analyze engagement with a web-based intervention to reduce harmful drinking, we explored (1) whether engagement with a web-based alcohol intervention is related to drinking outcomes, (2) which user characteristics are associated with measures of engagement, and (3) whether reported outcomes are associated with data captured by voluntary intervention questionnaires. MethodsWe analyzed data of the intervention arm of a randomized controlled trial on a DBCI to reduce risky alcohol consumption. Data were collected at baseline (T0), after 90 days (T1), and at the end of the 180-day usage period (T2). Engagement with the intervention was measured via system usage data as well as self-reported usage. Drinking behavior was measured as average daily alcohol consumption as well as the number of binge drinking days. User characteristics included demographics, baseline drinking behavior, readiness to change, alcohol-related outcome expectancies, and alcohol abstinence self-efficacy. Following a bivariate approach, we performed two-tailed Welch’s t tests and Wilcoxon signed rank/Mann-Whitney U tests or calculated correlation coefficients. ResultsThe data of 306 users were analyzed. Time spent engaging with the intervention as measured by system usage did not match self-reported usage. Higher self-reported usage was associated with higher reductions in average daily alcohol consumption (T1: ρ=0.39, P

Background: The concept of patient-centeredness has gained in importance over recent decades, including its growing importance on a health policy level. However, many different definitions and frameworks exist. This renders both research and implementation into clinical practice difficult. This study aimed at assessing how German researchers conceptualize patientcenteredness, how they translate the German equivalent into English, and what they consider the most important references on the topic. Methods: All researchers within a German research priority program on patient-centeredness were invited to participate in an online survey with open questions. The data regarding the definitions of patient-centeredness were analyzed using the method of conventional content analysis. Descriptive statistics were used to analyze the responses on translations and references. Results: Thirty-eight (28%) of 136 invited researchers participated in the study. The definitions given by the participants could be classified into ten categories: patient as a unique person, involvement in decision-making, patient information, essential characteristics of the physician, biopsychosocial perspective, patient empowerment, individualized services, patient-reported outcomes, involvement in health policy and coordination and teamwork. The results for the translation of the German word "Patientenorientierung" into English indicate that uncertainty regarding the appropriate English terminology exists. All participants provided a different reference on patient-centeredness that was important to them. Conclusion: The results show a certain degree of "shared meaning" regarding the concept of patient-centeredness. However, they also indicate a considerable amount of "surplus meaning", which can be seen as an indicator for the fuzziness of a theoretical concept. All in all, this study has shown that the conceptual ambiguity found in the literature on patient-centeredness is partly reflected in the conceptualizations of German researchers working in that field. This calls for more conceptual work, eg, developing an integrative model on patient-centeredness grounded in the international literature. [ABSTRACT FROM AUTHOR]

Background: Patient-centeredness has gained importance over the last two decades. However, there is an absence of theoretical clarity regarding the term patient-centeredness. This results in inconsistent measurement of patient-centeredness, which leads to difficulties in comparing research results. To overcome these difficulties, the aims of this study are (1) to identify the dimensions of patient-centeredness and include them in an integrative model, (2) to select and assess the most relevant dimensions of the model, (3) to identify and assess measurement instruments and find evidence for the selected dimensions, and (4) to assess the relevance and applicability of the conceptualization and measurement of patient-centeredness in clinical practice and health services research. Methods: This project is divided into four phases. First, a systematic review will be conducted to identify the constructs and dimensions of patient-centeredness. Second, experts (eg, researchers, clinicians, and patient representatives) will assess and prioritize the identified relevant dimensions using a Delphi survey. Third, the selected dimensions will be assessed regarding their operationalization, and the results will be summarized in a systematic review. Evidence of the measures will be assessed in a scoping review. Fourth, an expert workshop will be held. Experts will assess the results of the previous phases regarding the relevance and applicability of the conceptualization and measurement of patient-centeredness. Discussion: This study will provide an integrative model of patient-centeredness based on the current literature. This model can be used to improve upon the comparability of research results. Through a detailed insight into the existence and evidence of measurement dimensions of patient-centeredness, existing gaps in this field will be shown. Finally, the expert assessment will show the relevance and feasibility of the concept and measures in clinical practice and health services research. Therefore, this study will contribute important knowledge to enhance future research on patient-centeredness and establish a foundation for its implementation. [ABSTRACT FROM AUTHOR]