Charismatic technology for better online therapy

On 12 October PhD candidate Saskia Kelders defended her dissertation on eHealth interventions: online programs that contribute to good health and a healthier lifestyle. Kelders’ research focuses specifically on therapy adherence in eHealth interventions. Among other things, she investigated the role of persuasive technology: technology that influences participants’ behaviour and attitudes. For example, this might be a reminder sent by SMS text messaging or an e-mail containing feedback. Kelders suggests that participants are less likely to drop out of therapy when persuasive technology is used to promote interaction. She is associated with the University of Twente’s Institute for Innovation and Governance Studies (IGS).

eHealth holds great promise for the future. It is being used more and more in smoking-cessation and weight-loss programmes, for example, and also as a therapeutic measure for psychiatric patients. Kelders: “eHealth can make healthcare cheaper, easier and more effective. Our understanding of how to promote therapy adherence has thus far been lacking. My research shows that a charismatic approach, in other words persuasive technology, can play an important role in getting patients to stick to their therapy regimens.”

Kelder’s dissertation documents her research into various forms of persuasive technology, such as reminders and feedback by e-mail, and a text-message coach. She also investigated whether it matters who the sender is: an actual social worker or a fictitious person generated by a computer program. Surprisingly, this does not seem to play a role at all. In the case of computer-generated communication, it is important that the e-mails or other messages are personalized. This can be achieved by signing the e-mail with a name, for example, or by attaching a photograph. Kelders also concludes that interaction, dialogue and regular information updates help participants experience a greater sense of involvement while promoting therapy adherence. At the same time, the active components of persuasive technology are in a complex relationship with one another and cannot simply be separated.

Kelders does not offer a supreme recipe for success in her dissertation. Kelders: “The most important thing is that the intervention must be appropriate for the target group. The target group has to be identified in advance, and it is also important to consider how interaction between users and technology will be incorporated. I also recommend an extensive evaluation of the intervention beforehand. My research shows that there are no universal personality traits that can predict drop-out in each intervention. It is far more important to match participants to the most effective intervention.”

Kelders conducted her doctoral research at the Center for eHealth Research and Disease Management of the Innovation and Governance Studies (IGS) research institute at the University of Twente. She was supervised by Dr Lisette van Gemert-Pijnen and Prof. Ernst Bohlmeijer. The research was commissioned by the National Institute for Public Health and the Environment (RIVM).