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A questionnaire was distributed among adults (aged\u2009\u2265\u200918\u00a0years) who participated in a summative eHealth evaluation. This questionnaire focused on participants\u2019 reason to enroll, their expectations, and on whether the study met their expectations. Answers to open-ended questions were coded by two researchers independently. With the generalized estimating equations method we tested whether there is a difference between the type of reasons in use of the eHealth service. One hundred and thirty-one adults participated (64.9% female; mean age 62.5\u00a0years (SD\u2009=\u200910.5)). Their reasons for participating were mainly health-related (e.g., being more active). Between two types of motivations there was a difference in the use of the eHealth service: Participants with an intellectual motivation were more likely to drop out, compared to participants with an altruistic motivation. The most prevalent expectations when joining a summative eHealth evaluation were health-related (like expecting to improve one\u2019s health). 38.6% of the participants said their expectation was fulfilled by the study. In conclusion, We encourage eHealth evaluators to learn about adults\u2019 motivation to participate in their summative evaluation, as this motivation is very likely to affect their results. Including altruistically motivated participants biases the results by their tendency to continue participating in a study.\n<\/jats:p>","DOI":"10.1007\/s41666-023-00131-8","type":"journal-article","created":{"date-parts":[[2023,3,4]],"date-time":"2023-03-04T13:02:33Z","timestamp":1677934953000},"page":"125-140","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["How to Prevent the Drop-Out: Understanding Why Adults Participate in Summative eHealth Evaluations"],"prefix":"10.1007","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0070-5521","authenticated-orcid":false,"given":"Marian Z. 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