Yiqi Ni

In recent years, online cognitive behavioral therapy (CBT) interventions have played an increasing role in treating late-life depression. Previous studies have reported that online CBT interventions can be effective in treating depression and promoting behavioral changes among older participants, but inadequate engagement will potentially weaken the effectiveness. Most previous investigations of engagement in online CBT have collected data from self-reported symptom scales or questionnaires and used statistical approaches to establish associations between engagement and various predictors like demographics, personality, disease symptoms or intervention design factors. In this study, we considered engagement as an important aspect of user experiences and employed multiple methods on log data and qualitative data to understand engagement of individual user and in group environments. We analyzed data from MoodTech, a pilot study of an online CBT intervention for older adults with depression, characterizing participants’ engagement and exploring motivations and barriers that may cause differences in observed patterns. There were three aims. First, we identified patterns of engagement through visual analysis of log data. Second, we conducted a network analysis of the participants who had access to the social interaction features and compared the three kinds of peer interactions (comments, likes and nudges) as representatives of group engagement. Third, we performed a qualitative analysis of the textual data, including messages, posts, comments and thought records from the participants, to identify the application of CBT principles and explore how participants engaged with the intervention. From the learning and practice experiences of the older participants, we identified several themes that affected the engagement and attitudes toward the intervention. Future intervention designs may take these findings into consideration and adjust lesson contents for different patterns of participants, as well as improve the usability to meet the needs of older adults.