Design for Engagement of Online Positive Psychology Interventions

  • Saskia M. KeldersEmail author


Online Positive Psychology Interventions (oPPIs) can provide a low-cost way to improve wellbeing in the general population. However, for these interventions to be effective, participants need to use them for a longer period of time and need to practice the content in their daily lives. This means that participants need to feel engaged with the intervention in a certain way. The first part of this chapter introduces this need for engagement with online interventions and provides insight in what engagement might actually be in this context. The next part of the chapter will focus on ways technology can be designed to positively influence engagement. This will be illustrated by means of two cases of oPPIs. Next, the chapter will discuss the way engagement might be used to personalize interventions and thereby increase the individual effectiveness. The chapter concludes with a summary of the main learning points.


Online positive psychology interventions Engagement Intervention design Personalization Gamification 


  1. Abras, C., Maloney-Krichmar, D., & Preece, J. (2004). User-centered design. In W. Bainbridge (Ed.), Encyclopedia of Human-Computer Interaction (Vol. 37, No. 4, pp. 445–456). Thousand Oaks: Sage.Google Scholar
  2. Andrews, G., & Williams, A. D. (2014). Internet psychotherapy and the future of personalized treatment. Depression and Anxiety, 31(11), 912–915.CrossRefGoogle Scholar
  3. Appleton, J. J., Christenson, S. L., & Furlong, M. J. (2008). Student engagement with school: Critical conceptual and methodological issues of the construct. Psychology in the Schools, 45(5), 369–386.CrossRefGoogle Scholar
  4. Bakker, A. B., Schaufeli, W. B., Leiter, M. P., & Taris, T. W. (2008). Work engagement: An emerging concept in occupational health psychology. Work & Stress, 22(3), 187–200.CrossRefGoogle Scholar
  5. Bolier, L., & Abello, K. M. (2014). Online positive psychological interventions: State of the art and future directions. In The Wiley Blackwell handbook of positive psychological interventions (pp. 286–309).Google Scholar
  6. Bolier, L., Haverman, M., Westerhof, G. J., Riper, H., Smit, F., & Bohlmeijer, E. (2013). Positive psychology interventions: A meta-analysis of randomized controlled studies. BMC Public Health, 13(1), 119.CrossRefGoogle Scholar
  7. Christensen, H., Griffiths, K. M., & Farrer, L. (2009). Adherence in internet interventions for anxiety and depression: Systematic review. Journal of Medical Internet Research, 11(2).Google Scholar
  8. Cuijpers, P., Reynolds, C. F., III, Donker, T., Li, J., Andersson, G., & Beekman, A. (2012). Personalized treatment of adult depression: Medication, psychotherapy, or both? A systematic review. Depression and Anxiety, 29(10), 855–864.CrossRefGoogle Scholar
  9. Deterding, S., Dixon, D., Khaled, R., & Nacke, L. (2011). From game design elements to gamefulness: defining gamification. Paper presented at the Proceedings of the 15th international academic MindTrek conference: Envisioning future media environments.Google Scholar
  10. Donkin, L., Christensen, H., Naismith, S. L., Neal, B., Hickie, I. B., & Glozier, N. (2011). A Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies. Journal of Medical Internet Research, 13(3).Google Scholar
  11. Donkin, L., Hickie, I. B., Christensen, H., Naismith, S. L., Neal, B., Cockayne, N. L., & Glozier, N. (2013). Rethinking the dose-response relationship between usage and outcome in an online intervention for depression: randomized controlled trial. Journal of Medical Internet Research, 15(10).Google Scholar
  12. Duckworth, A. L., Steen, T. A., & Seligman, M. E. (2005). Positive psychology in clinical practice. Annual Review of Clinical Psychology, 1, 629–651.CrossRefGoogle Scholar
  13. Eysenbach, G. (2005). The law of attrition. Journal of Medical Internet Research, 7(1).CrossRefGoogle Scholar
  14. Hamari, J., Koivisto, J., & Sarsa, H. (2014). Does gamification work?—A literature review of empirical studies on gamification. Paper presented at the 2014 47th Hawaii International Conference on System Sciences.Google Scholar
  15. Hyland, M. E., & Whalley, B. (2008). Motivational concordance: An important mechanism in self-help therapeutic rituals involving inert (placebo) substances. Journal of Psychosomatic Research, 65(5), 405–413.CrossRefGoogle Scholar
  16. Hyrynsalmi, S., Smed, J., & Kimppa, K. K. (2017). The dark side of gamification: How we should stop worrying and study also the negative impacts of bringing game design elements to everywhere. Paper presented at the Proceedings of the 1st International GamiFIN Conference.Google Scholar
  17. Jiménez, F. J. R. (2012). Acceptance and commitment therapy versus traditional cognitive behavioral therapy: A systematic review and meta-analysis of current empirical evidence. International Journal of Psychology and Psychological Therapy, 12(3), 333–358.Google Scholar
  18. Kelders, S. M. (2015). Involvement as a Working Mechanism for Persuasive Technology. In Persuasive Technology (pp. 3–14): Springer International Publishing.Google Scholar
  19. Kelders, S. M., Bohlmeijer, E. T., Pots, W. T., & van Gemert-Pijnen, J. E. (2015). Comparing human and automated support for depression: Fractional factorial randomized controlled trial. Behaviour Research and Therapy, 72, 72–80.CrossRefGoogle Scholar
  20. Kelders, S. M., Kok, R. N., Ossebaard, H. C., & Van Gemert-Pijnen, J. E. W. C. (2012). Persuasive system design does matter: A systematic review of Adherence to web-based interventions. Journal of Medical Internet Research, 14(6), 17–40.CrossRefGoogle Scholar
  21. Kelders, S. M., Sommers-Spijkerman, M., & Goldberg, J. (2018). Investigating the direct impact of a gamified versus nongamified well-being intervention: An exploratory experiment. Journal of Medical Internet Research, 20(7).Google Scholar
  22. Kelders, S.M. & Kip, H. (2019). Development and initial validation of a scale to measure engagement with eHealth technologies. In CHI Conference on Human Factors in Computing Systems Extended Abstracts (CHI’19 Extended Abstracts), May 4–9, 2019, Glasgow, Scotland UK . ACM, New York, NY, USA, 7 pages.Google Scholar
  23. Keyes, C. L., Dhingra, S. S., & Simoes, E. J. (2010). Change in level of positive mental health as a predictor of future risk of mental illness. American Journal of Public Health, 100(12), 2366–2371.CrossRefGoogle Scholar
  24. Kip, H., & van Gemert-Pijnen, L. J. (2018). Holistic development of eHealth technology. In eHealth Research, Theory and Development (pp. 151–186). Routledge.Google Scholar
  25. Lamers, S. M., Westerhof, G. J., Glas, C. A., & Bohlmeijer, E. T. (2015). The bidirectional relation between positive mental health and psychopathology in a longitudinal representative panel study. The Journal of Positive Psychology, 10(6), 553–560.CrossRefGoogle Scholar
  26. Ludden, G. D., Kelders, S. M., & Snippert, B. H. (2014). This is your life! Paper presented at the International Conference on Persuasive Technology.Google Scholar
  27. O’Brien, H. L., & Toms, E. G. (2008). What is user engagement? A conceptual framework for defining user engagement with technology. Journal of the American Society for Information Science and Technology, 59(6), 938–955.CrossRefGoogle Scholar
  28. Perski, O., Blandford, A., West, R., & Michie, S. (2016). Conceptualising engagement with digital behaviour change interventions: A systematic review using principles from critical interpretive synthesis. Translational Behavioral Medicine.Google Scholar
  29. Ryff, C. D. (2014). Psychological well-being revisited: Advances in the science and practice of eudaimonia. Psychotherapy and Psychosomatics, 83(1), 10–28.CrossRefGoogle Scholar
  30. Schotanus-Dijkstra, M., Drossaert, C. H., Pieterse, M. E., Boon, B., Walburg, J. A., & Bohlmeijer, E. T. (2017). An early intervention to promote well-being and flourishing and reduce anxiety and depression: A randomized controlled trial. Internet Interventions, 9, 15–24.CrossRefGoogle Scholar
  31. Schueller, S. M., & Parks, A. C. (2012). Disseminating self-help: Positive psychology exercises in an online trial. Journal of Medical Internet Research, 14(3).Google Scholar
  32. Seligman, M. E., Ernst, R. M., Gillham, J., Reivich, K., & Linkins, M. (2009). Positive education: Positive psychology and classroom interventions. Oxford review of education, 35(3), 293–311.CrossRefGoogle Scholar
  33. Short, C. E., DeSmet, A., Woods, C., Williams, S. L., Maher, C., Middelweerd, A., … Poppe, L. (2018). Measuring engagement in eHealth and mHealth behavior change interventions: Viewpoint of methodologies. Journal of Medical Internet Research, 20(11), e292.CrossRefGoogle Scholar
  34. Sieverink, F., Kelders, S. M., & van Gemert-Pijnen, J. E. (2017). Clarifying the concept of adherence to eHealth technology: Systematic review on when usage becomes adherence. Journal of Medical Internet Research, 19(12).Google Scholar
  35. Sin, N. L., & Lyubomirsky, S. (2009). Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: A practice-friendly meta-analysis. Journal of Clinical Psychology, 65(5), 467–487.CrossRefGoogle Scholar
  36. Talbot, F. (2012). Client contact in self-help therapy for anxiety and depression: Necessary but can take a variety of forms beside therapist contact. Behaviour Change, 29(02), 63–76.CrossRefGoogle Scholar
  37. van Gemert-Pijnen, J. E., Kelders, S. M., Beerlage-de Jong, N., & Oinas-Kukkonen, H. (2018). Persuasive health technology. In eHealth research, theory and development: A multi-disciplinary approach. Routledge.Google Scholar
  38. van Gemert-Pijnen, J. E., Nijland, N., van Limburg, M., Ossebaard, H. C., Kelders, S. M., Eysenbach, G., & Seydel, E. R. (2011). A holistic framework to improve the uptake and impact of eHealth technologies. Journal of Medical Internet Research, 13(4).Google Scholar
  39. Whalley, B., & Hyland, M. E. (2009). One size does not fit all: Motivational predictors of contextual benefits of therapy. Psychology and Psychotherapy: Theory, Research and Practice, 82(Pt 3), 291–303.CrossRefGoogle Scholar
  40. Yardley, L., Spring, B. J., Riper, H., Morrison, L. G., Crane, D. H., Curtis, K., … Blandford, A. (2016). Understanding and promoting effective engagement with digital behavior change interventions. American Journal of Preventive Medicine, 51(5), 833–842.CrossRefGoogle Scholar
  41. Youssef, C. M., & Luthans, F. (2007). Positive organizational behavior in the workplace: The impact of hope, optimism, and resilience. Journal of Management, 33(5), 774–800.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Centre for eHealth and Wellbeing ResearchUniversity of TwenteEnschedeThe Netherlands
  2. 2.Optentia Research Focus AreaNorth-West UniversityVanderbijlparkSouth Africa

Personalised recommendations