Attrition and Adherence in the Online Treatment of Chronic Insomnia

This study examined the ability of the Theory of Planned Behavior (TPB; Ajzen, 1985 Ajzen, I. 1985. “From intentions to actions: A theory of planned behaviour.”. In Action control: From cognition to behavior Edited by: Kuhl, J. and Beckmann, J. 11–39. Heidelberg, , Germany: Springer. [Crossref] , [Google Scholar]) and the Transtheoretical Model of Behavior Change (TTM; Prochaska & DiClemente, 1983 Prochaska, J. O. and DiClemente, C. C. 1983. Stages and processes of self-change in smoking: Towards an integrated model of change. Journal of Consulting and Clinical Psychology, 51: 390–395. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) to explain adherence and attrition in an online treatment program for chronic insomnia. Responses to questionnaire measures of the TPB and TTM were used to predict adherence and dropout over the subsequent 5 weeks of treatment. Results showed that there was a 17% dropout rate and that perceived behavioral control, social support, and intention to complete the program were significantly associated with adherence to sleep hygiene homework. Attrition was predicted only by symptom severity and psychiatric comorbidity. Implications are that these models should be considered to maximize adherence.