Factors associated with adolescents' engagement with a Healthy Lifestyles app

Louise Thornton*, Hannah M. Brown, Bridie Osman, Courtney Stewart, Jesse Whife, Katrina E. Champion, Lauren A. Gardner, Nyanda McBride, Steve Allsop, Bonnie Spring, Maree Teesson

*Corresponding author for this work

Research output: Contribution to journalConference articlepeer-review

6 Scopus citations


Background: Digital approaches are frequently described as an ideal way to engage young people with health interventions. However, uptake and adherence to these interventions is often poor. Identifying factors associated with engagement, and the best methods to encourage engagement, is a critical issue for the digital health field. This presentation will discuss young peoples' engagement with a healthy lifestyles app (the Health4Life app). Methods: The Health4Life app is a self-monitoring app for adolescents targeting six key health risk behaviours. Participants were students (n=3610) and teachers randomized to the intervention condition of a cluster randomized controlled trial of the 'Health4Life Initiative'. Students completed an online baseline assessment assessing their health behaviours, mental health and socio-demographic factors and were provided with access to the Health4Life app to complement the in-class Health4Life module. Teachers were asked to complete a logbook documenting if they prompted students to download and use the app. The date and time users accessed the Health4Life app and any self-reported data were also automatically collected. A series of hierarchical regressions were performed to ascertain factors associated with the likelihood that students accessed the app (uptake) and factors associated with how much and for how long students used the app and how much information they entered (use). Results: Of the 3610 students provided access to the Health4Life app, 407 accessed it. Factors associated with increased likelihood to access the app included teacher prompts, living in a major city and being female. Psychological distress was not a significant predictor of likelihood to access the app. When investigating factors potentially associated with app use all models were found not to be significant. Conclusion: Teachers are critical in the process of prompting at least initial engagement with health interventions within a school-based context and the need for targeted engagement strategies for a number of sub-groups of young people (e.g. males, those in regional communities). There is a need for more research investigating predictors of actual app use and engagement. Implications: These findings indicate that many clinical factors (e.g., psychological distress) may not be significant barriers to adolescents engaging with digital health interventions. Researchers should carefully consider the implications of excluding participants experiencing mental illness or psychological distress, as is common in research. The results also highlight the importance of researchers establishing good relationships with teachers and clinicians working in a school-based context.

Original languageEnglish (US)
Pages (from-to)56-67
Number of pages12
JournalProcedia Computer Science
StatePublished - 2022
Event11th Scientific Meeting of the International Society for Research on Internet Interventions, ISRII 2022 - Pittsburgh, United States
Duration: Sep 18 2022Sep 22 2022


  • Adolescents
  • engagement
  • healthy lifestyles
  • mHealth
  • smartphone

ASJC Scopus subject areas

  • General Computer Science


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