Creating wellness apps with high patient engagement to close the intention–action gap

Boardman, Samantha

doi:10.1017/s1041610220003385

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…While digital therapeutics and apps undoubtedly hold promise, relatively little attention has focused on attrition rates. Even effective apps will have limited impact if they are not highly engaging and result in high attrition ( 18 , 19 ). Attrition, the loss of a randomized subject(s) from a study sample, is a very common issue in clinical trials and results from several causes such as refusal to participate after randomization, an early dropout from the study, and loss of subject's study data.…”

Section: High Attrition and Low Engagementmentioning

confidence: 99%

“…As patients typically use apps on their own time, they must be intrinsically motivated to do so and must perceive the benefits from the app as meaningful ( 18 ). Such intrinsic motivation may be low for psychiatric patients with depression, anhedonia, or cognitive difficulties.…”

Section: High Attrition and Low Engagementmentioning

confidence: 99%

“…Fortunately, several constructs are emerging as promising features to increase engagement – both related to external factors of motivation and UX design ( 24 ). Several factors such as ease of use, gamification, ability to personalize app, in-app symptom monitoring, numerical feedback, ability to chart progress, socialization within the app, and integration with clinical services, have been reported to increase engagement ( 17 , 18 ). A machine learning analysis of 54,604 adult patients with depression and anxiety identified 5 distinct engagement patterns for digital cognitive behavior therapy over 14-weeks: low engagers [36.5% of sample], late engagers [21.4%], high engagers with rapid disengagement [25.5%], high engagers with moderate decrease [6.0%], and high persistent engagers [10.6%].…”

Section: High Attrition and Low Engagementmentioning

confidence: 99%

“…Fears around privacy and data security for mental health data may be a factor in engagement and attrition for some participants and this should be addressed upfront. While we do not have all the solutions, encouraging the availability of raw data from clinical trials through trial registries, analyzing long-term real-world data on patient reported outcomes, user experience (engagement and compliance) and product reliability ( 18 ) will be important to enhance their utility.…”

Section: High Attrition and Low Engagementmentioning

confidence: 99%

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Digital therapeutics for mental health: Is attrition the Achilles heel?

2022

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Section: High Attrition and Low Engagementmentioning

confidence: 99%

Section: High Attrition and Low Engagementmentioning

confidence: 99%

Section: High Attrition and Low Engagementmentioning

confidence: 99%

Section: High Attrition and Low Engagementmentioning

confidence: 99%

See 2 more Smart Citations

Digital therapeutics for mental health: Is attrition the Achilles heel?

2022

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“… 10 Additionally, apps require users to be intrinsically motivated, as users typically engage with apps in their own time. 11 Therefore, key to continued engagement is understanding end users’ needs and preferences. 12 In this study, the term ‘end user’ is used to refer to the person who uses or is intended to use the DMHI for mental health support.…”

Section: Introductionmentioning

confidence: 99%

Co-producing digital mental health interventions: A systematic review

Brotherdale,

Berry,

Branitsky

et al. 2024

DIGITAL HEALTH

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Objective Smartphone apps (apps) are widely recognised as promising tools for improving access to mental healthcare. However, a key challenge is the development of digital interventions that are acceptable to end users. Co-production with providers and stakeholders is increasingly positioned as the gold standard for improving uptake, engagement, and healthcare outcomes. Nevertheless, clear guidance around the process of co-production is lacking. The objectives of this review were to: (i) present an overview of the methods and approaches to co-production when designing, producing, and evaluating digital mental health interventions; and (ii) explore the barriers and facilitators affecting co-production in this context. Methods A pre-registered (CRD42023414007) systematic review was completed in accordance with The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Five databases were searched. A co-produced bespoke quality appraisal tool was developed with an expert by experience to assess the quality of the co-production methods and approaches. A narrative synthesis was conducted. Results Twenty-six studies across 24 digital mental health interventions met inclusion criteria. App interventions were rarely co-produced with end users throughout all stages of design, development, and evaluation. Co-producing digital mental health interventions added value by creating culturally sensitive and acceptable interventions. Reported challenges included resource issues exacerbated by the digital nature of the intervention, variability across stakeholder suggestions, and power imbalances between stakeholders and researchers. Conclusions Variation in approaches to co-producing digital mental health interventions is evident, with inconsistencies between stakeholder groups involved, stage of involvement, stakeholders’ roles and methods employed.

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Design of Digital Mental Health Platforms for Family Member Cocompletion: Scoping Review

Welsh,

McIntosh,

Vuong

et al. 2024

J Med Internet Res

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Background:The COVID-19 pandemic placed additional mental health burden on individuals and on families, resulting in widespread service access problems. Digital mental health interventions suggest promise for improved accessibility. Recent reviews show emerging evidence for individual use and early evidence for multi-users. However, attrition rates remain high for digital mental health interventions and additional complexities exist when engaging multiple family members together online.Objective: As such, this scoping review aimed to detail the reported evidence for platforms designed for family use, with a focus on the build and design characteristics that promote accessibility and engagement and enable co-completion by families. Methods:A systematic literature search of MedLine, EMBASE, PsycINFO, Web of Science and CINAHL was conducted for articles published in English Language from 2002 to March 2024. Eligible records included empirical studies of digital platforms containing some elements designed for co-completion by related people as well as some components intended to be completed without therapist engagement. Platforms were included where clinical evidence had been documented.Results: Of the 9,527 papers reviewed, 85 met eligibility criteria. Twenty-four (24) unique platforms designed for co-use by related parties were identified. Relationships between participants included couples; parent-child dyads; family caregiver-care recipient dyads; and families. Common platform features included the delivery of content via structured interventions with no to minimal tailoring or personalisation offered. Some interventions provided live contact with therapists. User engagement indicators and findings varied and included user experience, satisfaction, completion rates and feasibility. Our findings are more remarkable for what is absent in the literature than what is present. Contrary to expectations, few studies reported any design and build characteristics that enabled co-participation. No studies reported on platform features for enabling co-completion, or considerations for ensuring individual privacy and safety. None examined platform build or design characteristics as moderators of intervention effect and none offered a formative evaluation of the platform itself. Conclusions:In this early era of digital mental health platform design, this novel review demonstrates a striking absence of information about design elements associated with the successful engagement of multiple related users in any aspect of a therapeutic process. There remains a large gap in the literature detailing and evaluating platform design, highlighting a significant opportunity for future cross-disciplinary research. This review details the incentive for undertaking such research, suggests design considerations when building digital mental health platforms for use by families, and offers recommendations for future development including platform co-design and formative evaluation.

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Creating wellness apps with high patient engagement to close the intention–action gap

Cited by 6 publications

References 11 publications

Digital therapeutics for mental health: Is attrition the Achilles heel?

Digital therapeutics for mental health: Is attrition the Achilles heel?

Co-producing digital mental health interventions: A systematic review

Design of Digital Mental Health Platforms for Family Member Cocompletion: Scoping Review

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