Engagement in Digital Mental Health Interventions: Can Monetary Incentives Help?

Boucher, Eliane M.; Ward, Haley E; Mounts, Amelia C.; Parks, Acacia C.

doi:10.3389/fpsyg.2021.746324

Cited by 13 publications

(6 citation statements)

References 65 publications

(79 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Online mental health interventions for PSP also have low participant adherence and completion, despite significantly reducing post-traumatic stress injuries and improving wellbeing, coping, and resilience (102). Although there are different facilitators of user engagement (118,119), the two most relevant to CWs are (1) the importance of developing programs that acknowledge their unique experiences and (2) consideration of interpersonal relationships.…”

Section: Enhancing Engagement By Acknowledging Unique Experiences And...mentioning

confidence: 99%

Benefits of Digital Mental Health Care Interventions for Correctional Workers and Other Public Safety Personnel: A Narrative Review

et al. 2022

View full text Add to dashboard Cite

Chronic exposure to stressors and potentially psychologically traumatic events contributes to the high prevalence of mental health disorders in correctional workers (CWs) and other public safety personnel (PSP). Digital mental health interventions are an accessible and scalable method of improving and maintaining the mental health of this population. The current review explores the benefits of digital mental health interventions for PSP–with a focus on CWs–and how these innovations can address the limitations in in-person mental health care. A systematic literature search of five databases (Medline, PsycInfo, Embase, CINAHL, Google Scholar) was conducted until March 2022. The search yielded 16 publications that focused on digital mental health interventions or care available to CWs and other PSP. The benefits of digital innovations were summarized into five categories which discussed (1) their ability to enhance accessibility and reduce stigma; (2) the provision of evidence-based and structured psychotherapy programs; (3) variability in the degree of therapist engagement; (4) the integration of proactive interventions; and (5) enhancing engagement by acknowledging unique experiences and interpersonal relationships. Although digital mental health technologies for CWs are still in their infancy, there is strong evidence to support their effectiveness in ameliorating symptoms of mental distress. Future research should consider how ethnicity, gender, culture, sexual orientation, and socioeconomic status can be integrated into these therapies and how the interplay between different stakeholders and organizations can impact the effectiveness of online therapies and programs.

show abstract

Section: Enhancing Engagement By Acknowledging Unique Experiences And...mentioning

confidence: 99%

Benefits of Digital Mental Health Care Interventions for Correctional Workers and Other Public Safety Personnel: A Narrative Review

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Time spent within the study may be a greater driver for attrition, as can be seen in the higher attrition rates for longer-term studies found in our results. However, research on the impact of monetary incentives on participants’ retention in digital health interventions is still in its infancy [ 96 ]. More needs to be done to understand how monetary incentives affect participants’ retention as well as effective engagement in the intervention.…”

Section: Discussionmentioning

confidence: 99%

Attrition in Conversational Agent–Delivered Mental Health Interventions: Systematic Review and Meta-Analysis

Jabir,

Lin,

Martinengo

et al. 2024

J Med Internet Res

View full text Add to dashboard Cite

Background Conversational agents (CAs) or chatbots are computer programs that mimic human conversation. They have the potential to improve access to mental health interventions through automated, scalable, and personalized delivery of psychotherapeutic content. However, digital health interventions, including those delivered by CAs, often have high attrition rates. Identifying the factors associated with attrition is critical to improving future clinical trials. Objective This review aims to estimate the overall and differential rates of attrition in CA-delivered mental health interventions (CA interventions), evaluate the impact of study design and intervention-related aspects on attrition, and describe study design features aimed at reducing or mitigating study attrition. Methods We searched PubMed, Embase (Ovid), PsycINFO (Ovid), Cochrane Central Register of Controlled Trials, and Web of Science, and conducted a gray literature search on Google Scholar in June 2022. We included randomized controlled trials that compared CA interventions against control groups and excluded studies that lasted for 1 session only and used Wizard of Oz interventions. We also assessed the risk of bias in the included studies using the Cochrane Risk of Bias Tool 2.0. Random-effects proportional meta-analysis was applied to calculate the pooled dropout rates in the intervention groups. Random-effects meta-analysis was used to compare the attrition rate in the intervention groups with that in the control groups. We used a narrative review to summarize the findings. Results The systematic search retrieved 4566 records from peer-reviewed databases and citation searches, of which 41 (0.90%) randomized controlled trials met the inclusion criteria. The meta-analytic overall attrition rate in the intervention group was 21.84% (95% CI 16.74%-27.36%; I2=94%). Short-term studies that lasted ≤8 weeks showed a lower attrition rate (18.05%, 95% CI 9.91%- 27.76%; I2=94.6%) than long-term studies that lasted >8 weeks (26.59%, 95% CI 20.09%-33.63%; I2=93.89%). Intervention group participants were more likely to attrit than control group participants for short-term (log odds ratio 1.22, 95% CI 0.99-1.50; I2=21.89%) and long-term studies (log odds ratio 1.33, 95% CI 1.08-1.65; I2=49.43%). Intervention-related characteristics associated with higher attrition include stand-alone CA interventions without human support, not having a symptom tracker feature, no visual representation of the CA, and comparing CA interventions with waitlist controls. No participant-level factor reliably predicted attrition. Conclusions Our results indicated that approximately one-fifth of the participants will drop out from CA interventions in short-term studies. High heterogeneities made it difficult to generalize the findings. Our results suggested that future CA interventions should adopt a blended design with human support, use symptom tracking, compare CA intervention groups against active controls rather than waitlist controls, and include a visual representation of the CA to reduce the attrition rate. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42022341415; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341415

show abstract

“…16 Low engagement, including accrual rates, uptake, and adherence, is an identified barrier to success, as it does not allow the expected benefits to be realised. 17,18 Guided delivery from health professionals can potentially increase engagement by enhancing patient motivation and accountability to adhere. 19 Guided interventions involve realtime (synchronous) or delayed (asynchronous) communication with health or research professionals, 20 often weekly or ad hoc, [20][21][22] potentially limiting scalability and cost-effectiveness.…”

Section: Introductionmentioning

confidence: 99%

“…Engagement can be characterised as the subjective experience of interest and attention, and extent of intervention usage 16 . Low engagement, including accrual rates, uptake, and adherence, is an identified barrier to success, as it does not allow the expected benefits to be realised 17,18 . Guided delivery from health professionals can potentially increase engagement by enhancing patient motivation and accountability to adhere 19 .…”

Section: Introductionmentioning

confidence: 99%

Guided versus non‐guided digital psychological interventions for cancer patients: A systematic review and meta‐analysis of engagement and efficacy

Akdemir,

Smith,

et al. 2024

Psycho-Oncology

View full text Add to dashboard Cite

ObjectiveTo evaluate engagement with and efficacy of guided versus non‐guided digital interventions targeting psychological symptoms of cancer via a systematic review of current evidence.MethodsPubMed, Scopus, PsychINFO, MEDLINE, and CINAHL databases were searched. Eligible publications were randomised controlled trials of guided or non‐guided digital psychological interventions used in cancer settings reporting intervention efficacy and/or engagement. Study methodological quality was assessed using the Cochrane risk of bias (RoB) tool. Random effects meta‐analyses were performed on outcomes with sufficient data, with sub‐group analyses of intervention type and follow‐up period.ResultsForty‐three studies were included. Studies varied by level of guidance, type of technology used, duration, and outcomes assessed. Most studies had a high overall RoB. Meta‐analysis indicated that guided interventions significantly reduced distress, anxiety, and fatigue, while non‐guided did not. For depression and quality of life, both guided and non‐guided interventions produced significant improvements. Guided interventions reported higher levels of intervention engagement than non‐guided.ConclusionsGuided digital psychological interventions were likely to be more effective than non‐guided ones for cancer patients, particularly in reducing distress, anxiety, and fatigue. Whilst both types were found to improve depression and life quality, guided interventions were associated with higher patient engagement. These findings suggest digital interventions could supplement traditional cancer care, warranting further research concerning long‐term effects and cost‐efficiency.

show abstract

Engagement in Digital Mental Health Interventions: Can Monetary Incentives Help?

Cited by 13 publications

References 65 publications

Benefits of Digital Mental Health Care Interventions for Correctional Workers and Other Public Safety Personnel: A Narrative Review

Benefits of Digital Mental Health Care Interventions for Correctional Workers and Other Public Safety Personnel: A Narrative Review

Attrition in Conversational Agent–Delivered Mental Health Interventions: Systematic Review and Meta-Analysis

Guided versus non‐guided digital psychological interventions for cancer patients: A systematic review and meta‐analysis of engagement and efficacy

Contact Info

Product

Resources

About