Impact of educational level on dropout and appreciation of eHealth interventions: example of seven RCTs

Objective: High rates are a major issue in computer-tailored (CT) eHealth interventions. The aim of this study is to assess if people with a low level more frequently and to what extent this depends on appreciation of the program. Method: Seven longitudinal CT eHealth intervention trials were used to investigate dropout rates participants with different educational levels and to pool data regarding appreciation. Regression analysis was used to assess whether program appreciation predicted at follow-up. Results: Among the studies, five found a higher rate among participants with a lower educational level. In two studies, there was no significant difference with regard to different educated participants. Two of the seven studies showed that participants with a lower education appreciated the significantly better than high educated participants. Appreciation of the interventions did not predict at follow-up in any of the studies. Conclusion: As appreciation does not seem to be related to high rates, future research must try to identify alternative explanations.