Digital mental health platforms for family member co-completion: How do they work? A scoping review (Preprint)

Abstract

BACKGROUND The COVID-19 pandemic has placed an additional mental health burden on individuals and on families. Reviews of e-Mental Health platforms for individual users suggest promise for improved accessibility and similar evidence of utility for dyadic or family use is growing. Attrition rates remain high for online mental health platforms and additional complexities exist when engaging multiple family members together online. OBJECTIVE This scoping review aimed to detail build and design characteristics that enable co-completion by families and discuss reported evidence for engagement and accessibility of platforms designed for such use. 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 April 2023. 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 8,399 papers reviewed, 74 met eligibility criteria. Nineteen unique platforms designed for relational co-use were identified. Relationships between participants included couples; parent-child dyads; family caregiver-care recipient dyads; and families. Most platforms delivered structured programs, and delivery varied with regards to the prescribed nature of tasks, number of sessions, and access duration. Thirteen (13) programs had live contact with therapists. Few platforms offered any tailoring. User engagement indicators and findings varied and included user experience, satisfaction, completion rates and feasibility. No study examined platform build or design characteristics as moderators of intervention effect. No studies performed a formative evaluation of the platform itself, and few studies reported any design and build characteristics that enabled co-participation. 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 the completion of a therapeutic process. There remains a large gap in the literature detailing and evaluating platform design and exists a significant opportunity for cross-disciplinary research. This review details the incentive for undertaking such research and offers recommendations for future development.