Targeting subjective engagement in experimental therapeutics for digital mental health interventions.
Targeting subjective engagement in experimental therapeutics for digital mental health interventions.
复制标题
针对数字心理健康干预实验治疗的主观参与。
DOI：
10.1016/j.invent.2021.100403
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Mohr DC
中科院分区：
文献类型：
--
作者：
Graham AK;Kwasny MJ;Lattie EG;Greene CJ;Gupta NV;Reddy M;Mohr DC
参与是一个多方面的结构，也是数字干预实现临床改进的可能机制。到目前为止，关于数字心理健康干预(DMHIS)的临床研究已经压倒性地定义了参与度，并通过使用DMHI或与DMHI交互的客观/行为指标来评估其与临床结果的关联，例如登录次数或使用该技术的时间。然而，参与度也会带来用户的主观体验。在很大程度上缺乏测试参与的主观指标和临床结果之间的关系的研究。本研究的目的是提出一项概念验证探索性评估，探讨移动DMHI的主观投入措施与抑郁和焦虑变化之间的关系。筛查出抑郁或焦虑呈阳性的成年初级保健患者(N=9146)被随机分配到立即接受DMHI、IntelliCare或在8周的等待名单之后接受治疗。主观投入是通过有用性、满意度和易用性(使用)问卷来衡量的。在这两种情况下，结果显示，那些认为移动干预更有用、更容易使用和学习、更令人满意的人，在八周内抑郁和焦虑的改善更大。研究结果支持我们提出的实验治疗学框架，该框架假设客观/行为和主观参与度量作为导致临床结果变化的机制，并支持指导DMHIS的干预设计工作，以针对用户体验。参与度是数字心理健康实验疗法的一个关键目标。数字健康研究主要关注客观的、而不是主观的参与。用户的主观体验可能是临床结果改变的一种机制。我们发现更高的主观参与度与更好的临床结果相关。一个人如何使用数字干预可能比多久使用一次更重要。
Engagement is a multifaceted construct and a likely mechanism by which digital interventions achieve clinical improvements. To date, clinical research on digital mental health interventions (DMHIs) has overwhelmingly defined engagement and assessed its association with clinical outcomes through the objective/behavioral metrics of use of or interactions with a DMHI, such as number of log-ins or time spent using the technology. However, engagement also entails users' subjective experience. Research is largely lacking that tests the relationship between subjective metrics of engagement and clinical outcomes. The purpose of this study is to present a proof-of-concept exploratory evaluation of the association between subjective engagement measures of a mobile DMHI with changes in depression and anxiety. Adult primary care patients (N = 146) who screened positive for depression or anxiety were randomized to receive a DMHI, IntelliCare, immediately or following an 8-week waitlist. Subjective engagement was measured via the Usefulness, Satisfaction, and Ease of Use (USE) Questionnaire. Across both conditions, results showed that individuals who perceived a mobile intervention as more useful, easy to use and learn, and satisfying had greater improvements in depression and anxiety over eight weeks. Findings support our proposed experimental therapeutics framework that hypothesizes objective/behavioral and subjective engagement metrics as mechanisms that lead to changes in clinical outcomes, as well as support directing intervention design efforts for DMHIs to target the user experience. Engagement is a key target in experimental therapeutics for digital mental health. Digital health research primarily focuses on objective, not subjective, engagement. Users' subjective experience may be a mechanism for change in clinical outcomes. We found higher subjective engagement was associated with better clinical outcomes. How a person uses a digital intervention may be more important than how often.
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16.6
作者：
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通讯作者：
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