Engagement and retention in digital mental health interventions: a narrative review

BMC Digital Health, Journal Year: 2024, Volume and Issue: 2(1)

Published: Aug. 7, 2024

Abstract Background While many digital mental health interventions (DMHIs) have been shown to be effective, such also criticized for poor engagement and retention rates. However, several questions remain about how users engage with DMHIs, define engagement, what factors might help improve DMHI engagement. Main abstract In this narrative review, we show that although DMHIs are research suggests rates quite variable across studies DMHIs. some instances, high, even in real-world settings where there is evidence of a subset who could considered ‘superusers’. We then review on the barriers facilitators highlighting qualitative users’ perceptions does not always align quantitative assessing relationships between these barriers/facilitators actual introduce potential issues conceptualizations may explain mixed findings, including inconsistent definitions assumptions linear outcomes. Finally, outline suggesting comparable mobile application use broadly as well more traditional forms care (i.e., pharmacological, psychotherapy). Conclusions order increase number people can benefit from additional necessary. Importantly, believe it critical move away existing misconceptions make three recommendations believe, if addressed, likely substantially impact DMHIs: (1) need adopt clearly defined, common definition , (2) importance exploring patterns optimal rather than taking ‘one size fits all’ approach, (3) defining success within based outcomes frequency or duration user’s DMHI.

Language: Английский

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Digital cognitive behavioral therapy for insomnia on depression and anxiety: a systematic review and meta-analysis

npj Digital Medicine, Journal Year: 2023, Volume and Issue: 6(1)

Published: March 25, 2023

Abstract Despite research into the development of digital cognitive behavioral therapy for insomnia (dCBT-I), outcomes dCBT-I on and associated clinical conditions depression anxiety have been limited. The PubMed, PsycINFO (Ovid), Embase, Cochrane databases were searched randomized controlled trials (RCTs) adult patients with also having reported measures depressive or symptoms. In total, 2504 articles identified after duplicate removal, 22 RCTs included in final meta-analysis. At post-treatment assessment, group had a small to moderate effect alleviating (standardized mean difference (SMD) = −0.42; 95% CI: −0.56, −0.28; p < 0.001; k 21) symptoms (SMD −0.29; −0.40, −0.19; 18), but large sleep outcome −0.76; −0.95, −0.57; 22). When considering treatment adherence, effects those high adherent groups more robust outcome, showing greater sizes than low depression, anxiety, outcomes. Furthermore, additional subgroup analysis studies that used fully automated without support human therapists significant results demonstrated intervention yielded as well Specifically, study above when adherence implementing dCBT-I.

Language: Английский

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The Effectiveness of eHealth Interventions for Weight Loss and Weight Loss Maintenance in Adults with Overweight or Obesity: A Systematic Review of Systematic Reviews

Current Obesity Reports, Journal Year: 2023, Volume and Issue: 12(3), P. 371 - 394

Published: June 24, 2023

PURPOSE OF REVIEW: The purpose of this study is to evaluate the effectiveness eHealth interventions for weight loss and maintenance among adults with overweight or obesity through a systematic review reviews. RECENT FINDINGS: This included 26 reviews, covering total 338 original studies, published between 2018 2023. indicates that are more effective than control no care comparable face-to-face interventions. effect sizes remain relatively small when comparing any conditions, mean differences results from - 0.12 kg (95% CI 0.64 0.41 kg) in 4.32 (- 5.08 3.57 care. methodological quality studies varies considerably. However, it can be concluded human contact work better those fully automated. In conclusion, reviews provides an updated understanding development digital recent years their obesity. findings suggest valuable tool delivering patients economically. Further research needed determine which specific types most how best integrate them into clinical practice.

Language: Английский

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The Use of Mobile Technologies to Promote Physical Activity and Reduce Sedentary Behaviors in the Middle East and North Africa Region: Systematic Review and Meta-Analysis

Journal of Medical Internet Research, Journal Year: 2024, Volume and Issue: 26, P. e53651 - e53651

Published: March 19, 2024

Background The Middle East and North Africa (MENA) region faces unique challenges in promoting physical activity reducing sedentary behaviors, as the prevalence of insufficient is higher than global average. Mobile technologies present a promising approach to delivering behavioral interventions; however, little known about effectiveness user perspectives on these MENA region. Objective This study aims evaluate mobile interventions targeting behaviors explore users’ well any other outcomes that might influence adoption use (eg, appropriateness cultural fit). Methods A systematic search 5 databases (MEDLINE, Embase, CINAHL, Scopus, Global Index Medicus) was performed. Any primary studies (participants all ages regardless medical condition) conducted investigated reported measures activity, or perceptions were included. We narrative synthesis meta-analysis randomized controlled trials (RCTs). Cochrane risk-of-bias tool used assess quality included RCTs; assessment rest completed using relevant Joanna Briggs Institute critical appraisal tools. Results In total, 27 articles describing 22 (n=10, 37% RCTs) 4 (15%) nonexperimental (n=6141, 46% women). Half (11/22, 50%) apps, whereas half examined SMS. main app functions goal setting self-monitoring SMS primarily deliver educational content. Users experimental described several benefits gaining knowledge receiving reminders be active). Engagement with poorly reported; few (8/27, 30%) fit interventions. Nonexperimental apps fitness trackers, reporting barriers their use, such perceived lack usefulness, loss interest, technical issues. RCTs showed positive effect (standardized mean difference=0.45, 95% CI 0.17-0.73); sensitivity analyses similar results. trim-and-fill method possible publication bias. Only 20% (2/10) measured behaviors; both changes. Conclusions for its early stages, preliminary evidence effectiveness. Policy makers researchers should invest high-quality long-term effectiveness, intervention engagement, implementation outcomes, which can inform design culturally socially appropriate countries Trial Registration PROSPERO CRD42023392699; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392699

Language: Английский

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Unlocking human-like conversations: Scoping review of automation techniques for personalized healthcare interventions using conversational agents

International Journal of Medical Informatics, Journal Year: 2024, Volume and Issue: 185, P. 105385 - 105385

Published: Feb. 24, 2024

Conversational agents (CAs) offer a sustainable approach to deliver personalized interventions and improve health outcomes.

Language: Английский

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Dietary Behavioural Preferences of Spanish and German Adults and Their Translation to the Dietary Recommendations of a Personalised Nutrition App in the Framework of the Stance4Health Project

Nutrients, Journal Year: 2025, Volume and Issue: 17(5), P. 912 - 912

Published: March 6, 2025

Background/Objectives: The influence of individual differences in the selection food portions can have a deep effect on recommendations for personalised nutrition. In addition to typical aspects such us energy density and nutrient composition, portion size is important dietary recommendations. This study examined behaviours 224 subjects Spain Germany use information improve adherence nutrition app. Methods: An online questionnaire administered adults collected sociodemographic data habits. measurement sizes was derived from classification ranging XXS XL across 22 groups, with assistance photographic atlas. Results: Significant dimensions were found. Dietary habits showed that omnivores majority both countries, significant consumption bread, desserts, beverages. Mediterranean diet significantly followed by Spanish group, reflecting cultural differences. Body mass index (BMI) slightly higher among Germans, although populations fell within normal ranges. Portion comparisons revealed statistically various items between two countries. Spaniards consumed amounts rice, meat, legumes, while Germans larger stews, lasagne, pizza. These variations highlight differing influenced preferences guidelines. Conclusions: findings support development novel apps consider user enhance adherence, thereby contributing improved health outcomes.

Language: Английский

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Enrollment and Retention of Participants in Remote Digital Health Studies: Scoping Review and Framework Proposal

Journal of Medical Internet Research, Journal Year: 2022, Volume and Issue: 24(9), P. e39910 - e39910

Published: July 31, 2022

Digital technologies are increasingly used in health research to collect real-world data from wider populations. A new wave of digital studies relies primarily on conduct entirely remotely. Remote hold promise significant cost and time advantages over traditional, in-person studies. However, such have been reported typically suffer participant attrition, the sources for which still largely understudied.To contribute future remote study planning, we present a conceptual framework hypotheses enrollment completion. The introduces 3 participation criteria that impact outcomes: (1) motivation profile incentives or nudges, (2) task complexity, (3) scientific requirements. goal this is inform planning implementation person-centered perspective.We conducted scoping review information studies, focusing methodological aspects retention. Comprehensive searches were PubMed, CINAHL, Web Science databases, additional included our citation searching. We fully remotely, at least one during recruitment, onboarding retention phases completion outcomes. Qualitative analyses performed synthesize findings studies.We report qualitative 37 reveal high values achieved median based target sample size calculations, 128% (IQR 100%-234%), completion, 48% 35%-76%). Increased observed provided nudges extrinsically motivated participants (62%, IQR 43%-78%). Reducing complexity absence did not improve (103%, 102%-370%) (43%, 22%-60%) observational comparison interventional more (median rate 55%, 38%-79%). Furthermore, there inconsistencies measures across assessed where only around half with (14/27, 52%) throughout period.Few participatory factors outcomes consistent manner, may limited evidence base study. Our assessment also suffered publication bias unrepresentative samples due an preference literacy skills Nevertheless, find can benefit targeting specific profiles, providing reducing

Language: Английский

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A framework for integrating artificial intelligence for clinical care with continuous therapeutic monitoring

Nature Biomedical Engineering, Journal Year: 2023, Volume and Issue: unknown

Published: Nov. 6, 2023

Language: Английский

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Influences on Patient Uptake of and Engagement With the National Health Service Digital Diabetes Prevention Programme: Qualitative Interview Study

Journal of Medical Internet Research, Journal Year: 2023, Volume and Issue: 25, P. e40961 - e40961

Published: Feb. 28, 2023

Digital diabetes prevention programs (digital-DPPs) are being implemented as population-based approaches to type 2 mellitus in several countries address problems with the uptake of traditional face-to-face programs. However, assessments digital-DPPs have largely focused on clinical outcomes and usability among those who taken them up, whereas crucial information decision-making about (eg, whether a user downloads registers an app) engagement extent use app or its components over time) is limited. Greater understanding factors that influence decisions may support large-scale deployments real-world settings.

Language: Английский

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The Synergistic Effect of Nurse Proactive Phone Calls With an mHealth App Program on Sustaining App Usage: 3-Arm Randomized Controlled Trial

Journal of Medical Internet Research, Journal Year: 2023, Volume and Issue: 25, P. e43678 - e43678

Published: May 1, 2023

Background Although mobile health application (mHealth app) programs have effectively promoted disease self-management behaviors in the last decade, usage rates tended to fall over time. Objective We used a case management approach led by nurse and supported health-social partnership team with aim of sustaining app among community-dwelling older adults evaluated outcome differences (i.e, self-efficacy, levels depression, total service usages) between those who continued use app. Methods This was 3-arm randomized controlled trial. A 221 hypertension, diabetes, or chronic pain were into 3 groups: mHealth (n=71), interactivity (mHealth+I; n=74), control (n=76). The given mHealth+I groups. group also received 8 proactive calls months from encourage no interventions. Data collected at preintervention (T1), postintervention (T2), months’ (T3) ascertain sustained effect. Results 37.8% 18.3% participants using least twice per week until end sixth month. difference across 2 groups T2 T3 significant (χ21=6.81, P=.009). Improvements self-efficacy (β=4.30, 95% CI 0.25-8.35, P=.04) depression (β=–1.98, –3.78 –0.19, P=.03) T1 observed scores improved group, mean values decreased T3. Health for all (β=–1.38, –1.98 –0.78, P<.001), marginal increase Conclusions relatively low follow-up are comparable reported literature. More work is needed merge technology-driven in-person aspects mHealth. Trial Registration ClinicalTrials.gov NCT03878212; https://clinicaltrials.gov/ct2/show/NCT03878212 International Registered Report Identifier (IRRID) RR2-10.1159/000509129

Language: Английский

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