Principal Findings and Comparison With Previous Work
SECONDARY
This study dealt with the new concept of DWELL. DWELL was found to be a beneficial intervention. This was supported by a robust quantitative questionnaire and by qualitative, open-ended questions. A Facebook group was found to be an effective platform to deliver this online intervention.Our primary outcome, the overall DWELL index, showed no significant difference between the study groups at baseline (The specific items of the DWELL questionnaire also indicated positive results as all 5 measures (knowledge and awareness, 3 levels of engagement, and self-efficacy regarding DWELL) increased significantly in the intervention group from the beginning to the end of the study. Although there was no significant difference in any of the specific questions of the DWELL index at baseline between the study groups, all 5 variables were significantly higher in the intervention group at the second administration than in the control group.Qualitative feedback from participants in the intervention group strengthened the positive results as most of them found the group to be beneficial.The study’s positive results are consistent with those of other studies that strongly indicate that nudge strategies hold promise in public health interventions and have the potential to influence at the population level [Most of the nudging interventions that we found in the public health literature dealt with one component of healthy behaviors, mainly dieting and food consumption behaviors but also physical activity, hygiene, and littering [Although the primary and secondary outcomes of DWELL (objectives 1 and 2) were found to be beneficial, we did not find an improvement in the secondary outcome regarding participants’ well-being (objective 3). For lifestyle interventions, as per the Health Belief Model [Facebook Insights indicated that the group was very active relative to a new group and the short 6-week duration. The high engagement started from the first welcoming post as many of the participants introduced themselves to the group in a revealing and open-hearted way. It looked as if the participants had been waiting for such a group to emerge, enabling them to open up and share their thoughts, difficulties, and dilemmas regarding designing a healthy home environment. The participants shared that they found this group to be supportive and not judgmental and appreciated the chance to participate in a platform that enabled them to share and also learn from others.Although the group was active, we only found a low, positive, and significant correlation between the overall DWELL score and the overall engagement score at the second questionnaire administration (objective 4; This study had a relatively large sample size of 643 participants and a high response rate, both in the intervention group (242/322, 75.2%) and in the control group (234/321, 72.9%). Online interventions usually suffer from high attrition rates as many studies report 10% to 25% retention rates [