Exploring two subdimensions of participation, involvement and engagement: A scoping review

Figures & data

Figure 1. Flowchart of the search process.

Table 1. Detailed overview of database search.

Search-term/key words	Databases	Results	Used filter	Results with filter	Relevant abstracts	Relevant fulltext
Patient engagement	PubMed	51,011	Keywords added
Patient engagement AND rehabilitation	PubMed	7665	Child 0–18 years	1054	19	2
Updated search 2018–2020	PubMed	29	Child 0–18 years	–	–	–
Client engagement	PubMed	9153	Index words added
Client engagement AND rehabilitation	PubMed	1196		1196	11	5
Updated search 2018–2020	PubMed	–		–	–	–
Engagement	MEDLINE	4386	Index words added
Engagement AND Rehabilitation	MEDLINE	11	–	–	2	1
Updated search 2018–2020	MEDLINE	18	–	–	1	1
Student engagement	Academic Search Complete	2443	Index words added
Student engagement AND disability	Academic Search Complete	53	–	–	3	2
Updated search 2018–2020	Academic Search Complete	12	–	–	–	–
Student engagement	PsychINFO	3124	Index words added
Student engagement AND disabilities	PsychINFO	54	–	–	2	2
Updated search 2018–2020	PsychINFO	11	–	–	1	–
Job involvement (suggested as key word for engagement)	Business Source Complete	855	–	–	16	7
Updated search 2018–2020	Business Source Complete	17	–	–	–	–
School Involvement	Academic Search Complete	238	–	–	2	1 (Transferred to engagement)
Updated search 2018–2020	Academic Search Complete	89	–	–	–	–
Leisure involvement	Academic Search Complete	716	–	–	9	4
Updated search 2018–2020	Academic Search Complete	121	–	–	1	1
Involvement	PsychINFO	11,820	Index words added
Involvement AND disabilities	PsychINFO	213	–	–	3	0
Updated search 2018–2020	PsychINFO	34	–	–	–	–
Involvement AND leisure	PsychINFO	160	–	–	4	2
Updated search 2018–2020	PsychINFO	18	–	–	–	–
Involvement	MEDLINE	333,843	Index words added
Involvement AND rehabilitation	MEDLINE	117	–	–	–	–
Updated search 2018–2020	MEDLINE	7	–	–	–	–
Involvement	PubMed	373,987	Index words added
Involvement AND rehabilitation	PubMed	7491	Index words added
Involvement AND rehabilitation AND disability	PubMed	1881	–	–	–	–
Updated search 2018–2020	PubMed	174	–	–	–	–
Duplications of fulltexts from database researches						− 2
Total number of studies included from database researches						26
Publications added through snowball research
Engagement						7
Involvement						4
Total number of studies included from snowball research						11
Total number of studies included						37

Table 2. Publications included in the involvement construct (* publications added through snowball research).

Author Year Country Reference	Field of research	Type of study	Researched population	Definition (quoted from full text)	Key content/results on involvement construct; used/developed measures
Zaichkowsky* 1985 USA [21]	Marketing	Instrument development	268 undergraduate psychology students 49 MBA students 57 clerical and administrative staff members	A persons perceived relevance of the object based on inherent needs, values, and interests	Specific measures: developed instrument: Personal Involvement Inventory (PII) instrument was testes for validity and reliability PII is sensitive to different situations if people and product remain constant
Laurent and Kapferer* 1985 USA [29]	Marketing	Instrument development	Face-to-face interviews with 207 housewives	Perceived importance of a product	Specific measures: developed instrument: ‘Consumer Involvement Profiles’ (CIP) scale About the involvement construct: based on social judgement theory antecedents of involvement: perceived importance of product or situation; perceived sign value; perceived pleasure; perceived risk different facets of involvement have different influences on consumer behaviour
Havitz and Dimanche* 1997 USA [30]	Leisure Research	Theoretical article		Involvement has been defined as an unobservable state of motivation, arousal or interest towards a recreational activity or associated product. It is evoked by a particular stimulus or situation and has drive properties (adapted from Rothschild, 1984).	About the involvement construct: leisure involvement refers to how one thinks about leisure and recreation four facets: importance, pleasure, sign, and centrality to lifestyle facet best represent enduring leisure involvement involvement affects one’s behaviour On measuring involvement: measures often ‘borrowed’ from consumer research → all instruments has its strength and weaknesses advices for multifaceted instruments since they provide more information than unidimensional instruments
Wiley et al. 2000 Canada [31]	Leisure Research	Theoretical article	205 hockey players and figure skaters	defined involvement as a ‘psychological state of motivation, arousal, or interest between an individual and an activity or product’.	About the involvement construct: locates involvement theory within social judgement theory applied to sports and leisure in the 1970s from consumer research see three facets of involvement: attraction, self-expression, and centrality in sports: attraction seems to be more relevant for women, while centrality seems to be more relevant to men incorporating involvement into the study of leisure has the potential to generate new understandings → assist in explaining particular aspects of leisure behaviour and leisure practice
Funk and James* 2001 USA [28]	Sport Management	Theoretical article		Involvement is defined as a ‘state of motivation, arousal or interest towards a recreational activity or associated product’	About the involvement construct: set within the ‘Psychological Continuum Model’ (PCM) five facets of involvement: attraction, sign, centrality to lifestyle, risk probability, risk consequence
Funk, Ridinger and Moorman 2004 USA [32]	Leisure Research	Theoretical article Instrument development	Focus group interviews with spectators of women’s basketball SII pilot-test n = 73 women’s basketball spectators → main study n = 623	Leisure involvement has been defined as an unobservable state of motivation, arousal, or interest towards a recreational activity or associated product that is evoked by a particular stimulus or situation that possesses drive properties sport involvement was defined as a psychological state of motivation, arousal, or interest in a team and related activities that is evoked by individual characteristics and situational factors that possess drive properties	Specific measures: developed instrument: Sport Involvement Inventory (SII) SII provided a psychometrically sound basis for involvement instrument incorporated in the ‘team sport involvement’ (TSI) model About the involvement construct: involvement initially comes from research in psychology and social judgement theory four facets of involvement: attraction, self-expression, centrality to lifestyle, and risk aim of leisure involvement research to understand antecedents and behavioural consequences for participation in recreational activities and hobbies
Kyle et al. 2007 USA [33]	Leisure Research	Instrument development	424 campers in Sumter National Forest 430 consumers enquiring about angling opportunities in Santee Cooper Country	Involvement is said to reflect the degree to which people devote themselves to an activity or associated product. … Additionally, involvement refers to the strength or extent of the cognitive linkage between the self and stimulus object	Specific measures: tested instrument: Modified involvement Scale (MIS) MIS is psychometrically sound solid support for conceptualisation and measure of enduring leisure involvement About the involvement construct: involvement consists of five dimensions: attraction, centrality, social bonding, identity affirmation, and identity expression. enduring leisure involvement is best conceptualised as a multidimensional construct
Jun et al. 2012 USA/Greece/Australia [34]	Leisure Research	Theoretical article	424 recreationists in Sumter National Forest (USA) 260 participants in exercise in health centres (Greece)	Havitz and Dimanche’s [30] often-used definition states that involvement is an ‘ . . . unobservable state of motivation, arousal or interest towards a recreational activity or associated product, evoked by a particular stimulus or situation, and which has drive properties’	About the involvement construct: five facets of enduring involvement: attraction, centrality, social bonding, identity affirmation and identity expression specific measures: used instrument: Modified Involvement Scale (MIS; Kyle et al. [33]) measures may shift from context to context to account for subtleties within populations and activities
Havitz, Kaczynski and Mannell 2013 USA/Canada [35]	Leisure Research	Theoretical article	384 adults	defined by Havitz and Dimanche [30] as an ‘unobservable state of motivation, arousal or interest towards a recreational activity or associated product, evoked by a particular stimulus or situation, and which has drive properties’	Specific measures: used instrument: Modified involvement Scale (MIS) About the involvement construct: leisure involvement has demonstrated influences on various types of leisure behaviour, yet has received only limited attention in the physical activity literature five dimensions of leisure involvement: attraction, centrality, identity expression, identity affirmation, social bonding leisure involvement has together with self-efficacy and motivation strong influence on behaviour
Surhartanto et al. 2019 Indonesia [36]	Leisure research/tourism	Theoretical article	313 adults	Refer to different definitions of involvement, starting with Havitz and Dimanche [32]	Abaout the construct consensus that involvement is a multi-dimensional construct depending on literature between three and 5 key-dimensions most important dimensions: importance, centrality, and self-expression

Table 3. Publications included in the Engagement construct (* publications added through snowball research).

Author Year Country Reference	Field of research	Type of study	Researched population	Definition (quoted from full text)	Key content/results on engagement construct; used/developed measures
Kahn* 1990 USA [40]	Economics/Management	Conceptual article		Personal engagement: ‘harnessing of organisation members’ selves to their work roles; in engagement, people employ and express themselves physically, cognitively, and emotionally during role performances’	About the engagement construct: focuses on the work-setting personal engagement has a physical, cognitive and emotional component personal engagement is an outcome of job-involvement
Fredricks, Blumenfeld and Paris* 2004 USA [50]	Educational Psychology	Review		A meta-construct that includes behavioural, emotional and cognitive engagement Behavioural (i.e. time on task) Emotional (i.e. interest and value) Cognitive (i.e. self-regulation and learning strategies)	About the engagement construct: engagement can be thought of as a ‘meta’ construct engagement literature is marked by duplication of concepts and lack of differentiation in definitions across various types of engagement engagement is multidimensional: behavioural, academic, emotional, and cognitive engagement-construct has the potential to link areas of research about antecedents and consequences of students behaviour, emotions, and thought process engagement-construct is inclusive: it combines constructs that usually are researched separately research has yet not capitalised on the potential of the construct
Appleton et al.* 2006 USA [45]	Educational Psychology	Instrument Development (validation)	Ninth-graders (N = 1938)	Engagement is viewed as a multi-dimensional construct comprised of four subtypes: academic, behavioural, cognitive, and psychological. Other definitions quoted in main-text: Energy in action, the connection between person and activity Reflects a person’s active involvement in a task or activity	Specific measures: instrument: Student Engagement Instrument (SEI) – measuring the students level of cognitive and affective engagement in theri school setting statistical support for the validity of the SEI was found in numerous ways model extends the engagement literature by providing empirical support for a self-reporting scale that includes unobservable aspects of engagement About the engagement construct: behavioural and academic engagement as observable components, that more easily can be quantified cognitive and psychological engagement includes less observable, more internal indicators on measuring engagement: research thus far has focussed on observable components focus on emotional/cognitive components of engagement crucial to better understand education outcome
Kortte et al. 2007 USA [60]	Healthcare and rehabilitation	Instrument development	206 patients with different physical and cognitive impairments	Engagement in rehabilitation therapy may be defined as an interest in, and an intentional effort to, work towards the rehabilitation goals. Rehabilitation engagement is conceptualised as a construct that captures multiple elements, including a patient’s attitude towards the therapy, his/her level of under-standing or acknowledgment of a need for treatment, the need for verbal or physical prompts to participate, the level of active participation in therapy activities, and the level of attendance throughout the rehabilitation program.	Specific measures: Hopkins Rehabilitation Engagement Rating Scale (HRERS). Questionnaire for therapists HRERS is reliable and valid instrument measures aspects of the rehabilitation process that relate to short- and long-term outcomes HRERS is useful for measuring engagement as part of the medical rehabilitation process
Appleton, Christenson and Furlong* 2008 USA [44]	Educational psychology	Review		Energy in action, the connection between person and activity Engagement reflects a person’s active involvement in a task or activity	About the engagement construct: all definitions for student engagement include behavioural components – many also contained emotional/psychological components far fewer conceptualisations include academic or cognitive components in their definition necessary to move beyond indicators of academic and behavioural engagement to understanding the underlying cognitive and psychological needs of all students knowledge of more cognitive and psychological subtypes of student engagement may enhance effective interventions researchers need to clearly define their conceptualisation in each study
Duchan 2009 USA [52]	Psychology	Discourse analysis		Engagement has been employed in different literatures to describe the feelings one has about a relationship or about the activity taking place	About the engagement construct: both engagement and involvement can be used to describe a person’s avid and active connection with another person engagement portrays degrees of involvement
Axelson and Flick 2010 USA [48]	Educational psychology	Conceptual article		Quote Astin’s definition of student involvement for student engagement: ‘the quantity and quality of physical and psychological energy that students invest in the college experience’	About the engagement construct: Alexander Astin’s student involvement research in the 1980s builds foundation for what would eventually become modern engagement research not all educational theorists agree that involvement and engagement are the same thing engagement is seen primarily in emotional, cognitive, or behavioural terms or as a meta concept modern definitions of the construct often confusing both semantically and conceptually
Lequerica and Kortte 2010 USA [61]	Healthcare and rehabilitation	Conceptual article		The concept of ‘engagement in rehabilitation’ is operationally defined here as a deliberate effort and commitment to working towards the goals of rehabilitation interventions, typically demonstrated through active, effortful participation in therapies and cooperation with treatment providers	About the engagement construct: engagement as one construct that incorporates several rehabilitation process elements engagement critical for patients fully benefiting from medical rehabilitation interventions engagement is differentiated from participation as a separate but related construct → participation signifies the behavioural component of engagement, it does not necessarily require high levels of invested interest motivation and engagement as two related but distinct constructs → motivation is energy directed in a particular way vs. engagement is that energy put into action therapeutic engagement as a primarily cognitive model of engagement
Finn and Zimmer* 2012 USA [49]	Educational psychology	review		Define sub-components: Academic (behavioural): observable behaviours related directly to the learning process Social (behavioural): the extent to which a student follows written and unwritten classroom rules of behaviour Cognitive (behavioural internal): the expenditure of thoughtful energy needed to comprehend complex ideas in order to go beyond the minimal requirements Affective: emotional response characterised by feelings of involvement in school as a place and a set of activities worth pursuing	About the engagement construct: early definition of engagement: ‘the student’s psychological investment in and effort directed towards learning, under-standing, or mastering the knowledge, skills, or crafts that academic work is intended to promote’ newer models with three, four or more components: academic, social, cognitive, affective still no clarity on the definition of the construct
Liem and Martin* 2012 Australia [54]	Educational psychology	Instrument development	Collection of multiple studies/samples	Motivation is defined as individuals’ energy and drive to learn, work effectively and achieve to their potential, and engagement as the behaviours aligned with this energy and drive	Specific measures: developed instrument: Motivation and Engagement Scale (MES), measuring the students motivation, cognitive and affective engagement, as well as his perception for himself as a studnet MES-High School (MES-HS) has strong psychometric properties MES-HS is sensitive to detecting changes in students’ motivation and engagement after motivation and engagement intervention. MES-Work (MES-W), MES-Music (MES-M), and MES-Sport (MES-S) – have been developed MES-S has been validated with sub-elite young athletes at a specialist sports high school About the engagement construct: Motivation and Engagement Wheel was developed as a multidimensional framework representing salient cognition and behaviour pertinent to motivation and engagement
Kemp et al. 2013 Australia [53]	Educational psychology	Study on engagement of young children with disabilities in childcare settings	Young children with disabilities (n = 37; age 13 − 36 month)	Child engagement was defined as ‘situationally appropriate interactions with the physical environment, materials, or other persons’	Specific measures measure used: ICERR, which has been previously field tested and validated
Alegria et al. 2014 USA [56]	Medicine	Clinical Trial/Intervention Study	722 patients (18–70 years)	Engagement was defined as the proportion of behavioural health visits attended of those scheduled in the 6 months after the baseline assessment,	Specific measures medical records review or by querying electronic health records
Bhuvanaiah and Raya 2014 India [37]	Management	Review		Engagement is a degree, which exists to certain extent. During the process of engagement, employee gets motivated either of self-motivation or by external motivation which drives employee to be energised to perform a task. Employee engagement is said to be so called ‘energy’ utilised in accomplishing purpose.	About the engagement construct: even though engagement is a well-researched construct, it lacks a universally acceptable definition that distinguishes employee engagement from other relative constructs researchers defined the concept in the view of individual perspective or organisational perspective in relation to the purpose of their study
King, Currie and Peterson* 2014 Canada [24]	Healthcare and rehabilitation	Conceptual article/scoping review		We define engagement as a multifaceted state of affective, cognitive, and behavioural commitment or investment in the client role over the intervention process We therefore define client engagement as a multifaceted state of motivational commitment or investment in the client role over the treatment process.	About the engagement construct: engagement as both a child and family level construct older frameworks focus more on overcoming barriers for therapy and not on optimising engagement or the role of the therapist three components: affective involvement (emotional involvement in the process and with the therapist); (b) cognitive involvement (beliefs about the need for intervention and therapy effectiveness); and behavioural involvement (in-session participation; behavioural collaboration; and beliefs about personal self-efficacy to carry out agreed-upon intervention outside of treatment) engagement components reciprocally influence one another
Bright et al. 2015 New Zealand [57]	Healthcare and rehabilitation	review		Engagement is a co-constructed process and state. It incorporates a process of gradually connecting with each other and/or a therapeutic program, which enables the individual to become an active, committed and invested collaborator in healthcare.	About the engagement construct: engagement conceptualised in two inter-related ways, as a process (engaging with) and a state (engaged in) the state of engagement as an internal state expressed through observable behaviours important to see differences to other concepts: involvement exists on a continuum from being passive recipients of information through to autonomously making decisions on measuring engagement measures that consider engagement should include items that better represent this multidimensional concept → need to consider how to best measure the internal state of engagement
Harashitha 2015 India [39]	Management	Review		Employee engagement is an employee's commitment to, involvement with, emotional attachment to, and satisfaction with their work and organisation	About the engagement construct: three dimensions of employee engagement: psychological process; emotional state; behavioural state
Moreira et al. 2015 Portugal [55]	Educational psychology	Study on student engagement of students with and without SEN	388 students with and without SEN (mean age 13,46)	‘School engagement is a multidimensional construct including contextual, behavioural, emotional, and cognitive components’	Specific measures: used instrument Student Engagement Instrument (SEI) About the engagement construct: school engagement as a multi-dimensional construct students’ engagement with school as an interactive process → result of how school meets the cognitive and psychological needs of the student
Rieckmann et al. 2015 International [63]	Healthcare and Rehabilitation	Conceptual article	Workshops/expert panel with researchers und experts from practice (multiple sclerosis)	The US Centre for Advancing Health defines patient engagement (sometimes known as ‘patient activation’) as ‘actions individuals must take to obtain the greatest benefit from the healthcare services available to them’	About the engagement construct: represent the primary thoughts of the MS in the 21st Century Steering Group patients are required to change their role from healthcare ‘receiver’ to ‘engager’ role of the health- care professional also needs to evolve from being a ‘provider’ of healthcare to become a ‘motivator’ and ‘supporter’ Patient engagement can be practiced at the macro (system), meso (institution), and micro (medical encounter) levels
Kumar and Pansari 2016 USA [42]	Economics/Marketing	Instrument development	CE: 762 customers from different firms EE: 750 employees of 30 companies	We define engagement as the attitude, behaviour, the level of connectedness (1) among customers, (2) between customers and employees, and (3) of customers and employees within a firm Employee engagement (EE) has been defined as a multi-dimensional construct which comprises of all the different facets of the attitudes and behaviours of employees towards the organisation.	Specific measures: develop survey measures for CE (Study 1) and refine existing scales for EE (Study 2) 16-item survey for measuring CE survey items used to measure EE were adapted and refined from earlier research of the authors About the engagement construct: customer engagement (CE): engagement is represented as either a state of mind or an activity beyond purchases. study also provides a strong theoretical rationale and empirical evidence for the positive impact of high engagement scores on firm performance
Megha 2016 India [43]	Management	Review		Quote 15 different definitions: Earliest: Kahn [40] Latest: an individual employees’ cognitive, emotional and behavioural state directed towards desired organisational outcomes.	About the engagement construct: term engagement has become so ambiguous that it is rare to find two researchers defining it in the same way no perfect consensus from all the official definition in the research literature for the term engagement different approaches to phenomenon: Need-satisfying Approach; Born-Out Antithesis Approach; Work-Engagement Approach; Satisfaction-Engagement Approach; Multidimensional Approach
Dhanesh 2017 Dubai [47]	Educational Psychology	Conceptual article		Engagement is an affective, cognitive, and behavioural state wherein publics and organisations who share mutual interests in salient topics interact along continua that range from passive to active and from control to collaboration, and is aimed at goal attainment, adjustment, and adaptation for both publics and organisations.	About the engagement construct: despite a lack of clarity on the concept, research on engagement has been booming conceptualisation of engagement as a multidimensional concept need to include affective and cognitive elements in definition
Graffigna, Barello and Bonanomi 2017 Italy [58]	Healthcare and Rehabilitation	Conceptual article	352 Italian-speaking adult chronic patients	In previous studies, patients' engagement refers to the ability of patients to give sense and to adjust to their disease and their actual care condition.	Specific measures: self-administered online questionnaire used: included validated measures and ad hoc items - Patient Health Engagement Scale (PHE-S); Patient Activation Measure (PAM-13); Morisky Medication Adherence Scale (MMAS-4); Health Care Climate Questionnaire (HCCQ); Self-Assessment Manikin Scale (SAM); demographic and clinical characteristics results confirmed relationship by demonstrating that patients' activation is associated to their reported treatment adherence About the engagement construct: concept of patient activation often overlaps with one of patient engagement described process of healthcare journey in its four evolving phases (blackout, arousal, adhesion, eudaimonic project) → Patient Health Engagement Model (PHE-model)
Hollingshead et al. 2017 USA [52]	Educational Psychology	Review	Students without; at risk; and with disability	‘engagement as a multilayered, complex concept that involves emotional, cognitive, and behavioural components’.	About the engagement construct: engagement as a multi-layered, dynamic concept incorporates an emotional, cognitive and behavioural components ecobehavioural approach and behavioural approach both focussed on behavioural/observable aspects → miss complexity/interaction with cognitive and emotional aspects on measuring engagement: concept of engagement for students without and with disability is the same, yet often studied/defined differently
Ho Kim, Park and Kwon 2017 South Korea/USA [41]	Management	Instrument development (validation)	Study 1: 307 workers from 12 companies Study 2: 342 workers from 12 companies	Engagement is defined as ‘‘a positive, fulfilling, work-related state of mind that is characterised by vigour, dedication, and absorption’’	Specific measures: Used instrument: Korean version of Utrecht Work Engagement Scale nine-item UWES-K has been determined to be an adequate measure of work engagement in Korean white-collar workers results of this study show that the concept of work engagement can be used in the South Korean context
King et al. 2017 Canada [59]	Healthcare and Rehabilitation	Instrument development	Samples 1–3: total of 10 observers who made ratings while taking part in training sessions Sample 4: 10 service providers in an interview study	engagement was defined as a multifaceted state of affective, cognitive and behavioural involvement in the intervention process, which motivates clients to work on intervention tasks outside of therapy	Specific measures: described the development and initial properties of a conceptually grounded measure developed instrument: Paediatric Rehabilitation Intervention Measure of Engagement-Observation (PRIME-O) measure’s utility and psychometric properties emerges through examination and use over time more behavioural signs were observed/reported for children and more cognitive signs of engagement were observed/reported for youth and parents evidence of excellent interrater consensus, construct and content validity of the instrument About the engagement construct: consider engagement to be a multifaceted optimal client state comprising a hopeful stance (affective involvement); conviction with respect to the appropriateness of intervention goals and processes (cognitive involvement); and confidence in personal ability to carry out the intervention plan (behavioural involvement) engagement in children’s services is likely different from adult health care. unidimensional measures are not as useful or valid as multidimensional ones
Madan 2017 India [38]	Management	Conceptual article		Employee engagement: employees’ willingness and ability to contribute to company success. Another way to think about engagement is the extent to which employees put discretionary effort into their work, in the form of extra time, brainpower and energy.	About the engagement construct: employee engagement is so vast that it covers almost all the aspects that come under the scope of human resource management multiple components to engagement: cognitive, affective, behavioural multiple stages of engagement (based on Maslow’s need hierarchy): satisfied; motivated; committed; and advocate stage
Mayhew et al. 2019 United Kingdom [62]	Healthcare and Rehabilitation	Instrument development		Engagement as a purposeful act, with collaboration and cooperation being an active choice on the part of the patient and done in order to maximise outcomes or improve their experience of receiving an intervention	About the engagement construct: comprised five dimensions: attendance, need for physical or verbal prompts to participate, positive attitude towards the therapy activity, acknowledgement/acceptance of need for services, active participation Specific measure: Hopkins Rehabilitation Engagement Scale (HRERS-RV) Measure developed for the rehabilitation-setting Adapted for reablement context in England (reablement version – RV)

Figure 2. Relation between involvement and engagement.

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