Count something that matters to the person
A person can click every link in a care message and still be unsure what to do. Another may ask one question, receive the answer they need, and leave. Which interaction was more meaningful depends on the purpose of the exchange.
For research and local evaluation, the first task is to define that purpose. “Use the app more” is a product activity. “Understand the agreed next step” is a different aim. Both can be observed, but they should not be treated as the same result.
Use frameworks to sharpen the question
Carman and colleagues (opens in a new tab) offer a framework for degrees of participation and the levels where people can influence care. COM-B (opens in a new tab) draws attention to capability, opportunity, and motivation. Self-determination theory (opens in a new tab) considers autonomy, competence, and relatedness.
These frameworks help organize a question. They do not supply a universal engagement score. Nor does referencing a theory establish that an experience has successfully applied it or produced the hoped-for effect.
Look closely at one ordinary invitation
Imagine a hypothetical health program asking people to complete a short preparation activity before a call. One person completes it immediately. Another has limited time and reads only the part relevant to their question. A third cannot use the sign-in process and asks a family member for help.
A completion chart alone could place the first person at the top and the other two below. A conversation might show that the second person was well prepared, while the third never had a workable opportunity to participate.
The program could respond by making the purpose clearer, allowing a shorter route, and testing the sign-in experience with people who encounter access barriers. These are possible design decisions, not a claim that a particular intervention will work for every group.
Treat access as part of the question
WCAG 2.2 (opens in a new tab) provides a technical reference for accessible web content. For an organization evaluating participation, that reference should sit alongside observation of whether people can complete the intended task.
Our practical recommendation is to ask what happened before interpreting an absence of activity. The person may have chosen another route, encountered a barrier, or decided the invitation was not relevant. Those possibilities lead to different decisions.
Give people a reasonable way to decline or change their preferences. A meaningful interaction can include someone explaining that the proposed support does not fit their situation.
Make the definition reviewable
For a small project, write a one-sentence working definition before selecting indicators. For example: “This activity is useful when a participant can identify the question they want to discuss and knows how to raise it.” That sentence is a hypothetical project definition, not a clinical measure.
The team could then review whether the invitation was accessible, ask participants how they prepared, and observe whether the subsequent conversation addressed their question. It could record the staff effort involved and look for experiences the activity did not accommodate.
If the definition changes, explain why. An evaluation should not quietly redefine success after the results are known.
Keep product activity in its proper place
Usage information can help identify where an experience breaks down or where people choose to stop. It becomes more informative when considered alongside purpose and participant feedback.
For genusConnect, meaningful engagement is a design ambition that should be examined in context. carePhysics is our own organizing approach; external theories and research retain their distinct identities. The work is to connect an explicit purpose with a usable experience and evidence suited to the result being claimed.