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

Abstract

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.