Supportive Accountability: A Model for Providing Human Support to Enhance Adherence to eHealth Interventions

The effectiveness of and adherence to eHealth interventions is enhanced by human support. However, human support has largely not been manualized and has usually not been guided by clear models. The objective of this paper is to develop a clear theoretical model, based on relevant empirical literatur...

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Bibliographic Details
Published in:Journal of medical Internet research Vol. 13; no. 1; p. e30
Main Authors: Mohr, David C, Cuijpers, Pim, Lehman, Kenneth
Format: Journal Article
Language:English
Published: Canada Gunther Eysenbach 10.03.2011
JMIR Publications
Subjects:
Behavior Therapy
Delivery of Health Care - methods
Electronic Mail
Health Services Research - methods
Humans
Internet
Models, Psychological
Motivation
Patient Compliance
Population Surveillance
Psychological Techniques
Social Responsibility
Social Support
Telemedicine - methods
Viewpoint
ISSN:1438-8871, 1438-8871
Online Access:Get full text
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Summary:The effectiveness of and adherence to eHealth interventions is enhanced by human support. However, human support has largely not been manualized and has usually not been guided by clear models. The objective of this paper is to develop a clear theoretical model, based on relevant empirical literature, that can guide research into human support components of eHealth interventions. A review of the literature revealed little relevant information from clinical sciences. Applicable literature was drawn primarily from organizational psychology, motivation theory, and computer-mediated communication (CMC) research. We have developed a model, referred to as "Supportive Accountability." We argue that human support increases adherence through accountability to a coach who is seen as trustworthy, benevolent, and having expertise. Accountability should involve clear, process-oriented expectations that the patient is involved in determining. Reciprocity in the relationship, through which the patient derives clear benefits, should be explicit. The effect of accountability may be moderated by patient motivation. The more intrinsically motivated patients are, the less support they likely require. The process of support is also mediated by the communications medium (eg, telephone, instant messaging, email). Different communications media each have their own potential benefits and disadvantages. We discuss the specific components of accountability, motivation, and CMC medium in detail. The proposed model is a first step toward understanding how human support enhances adherence to eHealth interventions. Each component of the proposed model is a testable hypothesis. As we develop viable human support models, these should be manualized to facilitate dissemination.
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ISSN:1438-8871
1438-8871
DOI:10.2196/jmir.1602