Engagement with a nationally-implemented digital behaviour change intervention: Usage patterns over the 9-month duration of the National Health Service Digital Diabetes Prevention Programme

Rhiannon E. Hawkes, Lisa M. Miles, Ben Ainsworth, Jamie Ross, Rachel Meacock, David P. French

Research output: Contribution to journalArticlepeer-review

3 Citations (SciVal)


Background: Digital behaviour change interventions may offer a scalable way to promote weight loss by increasing physical activity and improving diet. However, user engagement is necessary for such benefits to be achieved. There is a dearth of research that assesses engagement with nationally implemented digital programmes offered in routine practice. The National Health Service Digital Diabetes Prevention Programme (NHS-DDPP) is a nine-month digital behaviour change intervention delivered by independent providers for adults in England who are at high risk of developing type 2 diabetes. This study reports engagement with the NHS-DDPP for users enrolled onto the programme over the nine-month duration. 

Methods: Anonymous usage data was obtained for a cohort of service users (n = 1826) enrolled on the NHS-DDPP with three independent providers, between December 2020 and June 2021. Usage data were obtained for time spent in app, and frequency of use of NHS-DDPP intervention features in the apps including self-monitoring, goal setting, receiving educational content (via articles) and social support (via health coaches and group forums), to allow patterns of usage of these key features to be quantified across the nine-month intervention. Median usage was calculated within nine 30-day engagement periods to allow a longitudinal analysis of the dose of usage for each feature. 

Results: App usage declined from a median of 32 min (IQR 191) in month one to 0 min (IQR 14) in month nine. Users self-monitored their behaviours (e.g., physical activity and diet) a median of 117 times (IQR 451) in the apps over the nine-month programme. The open group discussion forums were utilised less regularly (accessed a median of 0 times at all time-points). There was higher engagement with some intervention features (e.g., goal setting) when support from a health coach was linked to those features. 

Conclusions: App usage decreased over the nine-month programme, although the rate at which the decrease occurred varied substantially between individuals and providers. Health coach support may promote engagement with specific intervention features. Future research should assess whether engagement with particular features of digital diabetes prevention programmes is associated with outcomes such as reduced bodyweight and HbA1c levels.

Original languageEnglish
Article number100647
Number of pages12
JournalInternet Interventions
Early online date12 Jul 2023
Publication statusPublished - 30 Sept 2023

Bibliographical note

Funding Information:
This work is independent research funded by the National Institute for Health and Care Research (The Health and Social Care Delivery Research (HSDR) Programme, 16/48/07 – Evaluating the NHS Diabetes Prevention Programme (NHS DPP): the DIPLOMA research programme (Diabetes Prevention – Long Term Multimethod Assessment)). The views and opinions expressed in this manuscript are those of the authors and do not necessarily reflect those of the National Institute for Health and Care Research or the Department of Health and Social Care.

Availability of data and materials:
The anonymous engagement data from the current study are not publicly available due to confidentiality agreements with the provider organisations. Some datasets are available from the corresponding author on reasonable request, although authors will require the explicit permission of the relevant provider organisations.


  • Behaviour change
  • Diabetes prevention
  • Digital interventions
  • User engagement

ASJC Scopus subject areas

  • Health Informatics


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