Yeager CM, Shoji K, Luszczynska A, Benight CC. 2018. Engagement with a trauma recovery internet intervention explained with the Health Action Process Approach (HAPA): Longitudinal study. JMIR Mental Health. 5(2): e29. doi: 10.2196/mental.9449
Researchers evaluated use of the Health Action Process Approach (HAPA) to predict engagement with a digital trauma intervention (My Trauma Recovery; MTR). HAPA divides factors affecting intervention engagement into two phases: the motivational phase and the volitional phase. People who had experienced at least 1 traumatic event were recruited from trauma registries, listservs, social media, and university psychology classes to use MTR for 2 weeks. Participants completed assessments at weeks 1, 2, and 3. Motivational model assessments measured pre-treatment self-efficacy (week 1), outcome expectancies (weeks 1, 2, 3), perceived need (week 1), post-traumatic stress disorder (PTSD) symptoms (weeks 1, 3), and intentions (week 1). Volitional model assessments measured treatment self-efficacy (weeks 2, 3), planning (weeks 2, 3), and intervention engagement (self-reported use, website usage metrics; week 3). Motivational model results indicated pre-treatment self-efficacy, outcome expectancies, perceived need, and PTSD symptoms significantly predicted greater intention to use MTR. Intention at week-1 significantly predicted planning at week-2. The relationship between planning at week-2 and intervention engagement at week-3 was mediated by treatment self-efficacy when self-efficacy was low. The direct relationship between planning at week-2 and engagement at week-3 was not significant. Results suggest users with low confidence in continuing MTR develop plans that facilitate continued engagement with MTR. Significant relationships supporting the role of motivational and volitional factors in predicting engagement with MTR suggest HAPA could be extended to predicting engagement with digital interventions for trauma recovery.