The Acceptability and Usability of Digital Health Interventions for Adults With Depression, Anxiety, and Somatoform Disorders: Qualitative Systematic Review and Meta-Synthesis

Abstract

<jats:sec> <jats:title>Background</jats:title> <jats:p>The prevalence of mental health disorders continues to rise, with almost 4% of the world population having an anxiety disorder and almost 3.5% having depression in 2017. Despite the high prevalence, only one-third of people with depression or anxiety receive treatment. Over the last decade, the use of digital health interventions (DHIs) has risen rapidly as a means of accessing mental health care and continues to increase. Although there is evidence supporting the effectiveness of DHIs for the treatment of mental health conditions, little is known about what aspects are valued by users and how they might be improved.</jats:p> </jats:sec> <jats:sec> <jats:title>Objective</jats:title> <jats:p>This systematic review aimed to identify, appraise, and synthesize the qualitative literature available on service users’ views and experiences regarding the acceptability and usability of DHIs for depression, anxiety, and somatoform disorders.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>A systematic search strategy was developed, and searches were run in 7 electronic databases. Qualitative and mixed methods studies published in English were included. A meta-synthesis was used to interpret and synthesize the findings from the included studies.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 24 studies were included in the meta-synthesis, and 3 key themes emerged with descriptive subthemes. The 3 key themes were initial motivations and approaches to DHIs, personalization of treatment, and the value of receiving personal support in DHIs. The meta-synthesis suggests that participants’ initial beliefs about DHIs can have an important effect on their engagement with these types of interventions. Personal support was valued very highly as a major component of the success of DHIs. The main reason for this was the way it enabled individual personalization of care.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Findings from the systematic review have implications for the design of future DHIs to improve uptake, retention, and outcomes in DHIs for depression, anxiety, and somatoform disorders. DHIs need to be personalized to the specific needs of the individual. Future research should explore whether the findings could be generalized to other health conditions.</jats:p> </jats:sec>

Understanding New Zealand Adults’ Attitudes Towards Digital Interventions for Health

“…Positive attitudes are associated with an increased likelihood of behaviour and behavioural intentions (Davis, 1989;Fishbein & Ajzen, 1975;McEachan, Conner, Taylor, & Lawton, 2011;Rosenstock, Strecher, & Becker, 1988). Such as in the case of DI, people with more favourable attitudes to DI are more likely to have positive intentions to use DI, and this is supported by research (Askari, 2020;Patel et al, 2020;Wangberg, Gammon, & Spitznogle, 2007). Therefore, people's attitudes are crucial to understanding people's readiness to engage with DI.…”

“…It is also essential to consider what shapes these attitudes to DI to provide insight into how people come to have these attitudes and potential avenues of modification. Several factors shape people's attitudes to DI including knowledge (Mayer et al, 2019), confidence using DI (Davis, 1989(Davis, , 1993 and perceptions of accessibility (Patel et al, 2020).…”

A Direct-to-Public Peer Support Program (Big White Wall) Versus Web-Based Information to Aid the Self-management of Depression and Anxiety: Results and Challenges of an Automated Randomized Controlled Trial

“…Our research group has published a systematic review and meta-synthesis of qualitative data on enrollment and retention in the study or treatment from 24 trials of digital interventions with varying degrees of human engagement in enrollment, follow-up, or treatment of people with depression and anxiety. It identified that enrollment and retention to studies were determined by the participants’ initial beliefs about digital health interventions, the offer of personal support, and the enablement of personalization of care [ 52 ]. Taking our results together with this meta-synthesis, the public health campaign and automated enrollment only provided a superficial understanding of what was being offered by the trial.…”

Just know it : The role of explicit knowledge in internet-based cognitive behaviour therapy for adolescents

“…Also, qualitative studies focusing on knowledge gain and usage in ICBT are very rare. A meta-synthesis identified 24 studies reporting qualitative data about adult clients' experiences of digital health interventions (Patel et al, 2020). They found three key themes revealing the experienced value of personalizing treatment content to the unique individual, how pre-intervention beliefs such as hope can affect participant engagement, and the importance of receiving personal support in order to understand and engage with the program properly.…”