An Evaluation of the Effectiveness of Digital Health Technology to support Mental Health and Well-being

数字健康技术在支持心理健康和福祉方面具有巨大潜力。它越来越容易获得和接受，比面对面的干预措施有很大的好处，包括更高的成本效益、更广泛的覆盖面和减少寻求支持的障碍。除了支持一般人群的心理健康和福祉外，一个特别受益于数字心理健康和福祉支持的人群是自闭症患者（包括具有高度自闭症特征的成年人，自我认定为自闭症患者）。自闭症患者的心理健康和幸福水平明显较差，在社交和面对面互动方面面临进一步挑战。一个关键问题是心理健康和幸福应用程序如何有效工作，以及为谁工作。必须确定什么是有效参与，以实现干预措施的预期成果。以前的研究表明，有效的参与模式可能因干预措施和人群而异。因此，需要进行深入的使用分析，以评估数字心理健康和幸福支持的有效性。第二个关键问题是为什么心理健康应用程序不起作用，以及为谁服务。尽管数字心理健康和福祉支持的潜力，但它受到高水平的辍学和“非使用损耗”（人们不持续参与干预）的阻碍。了解非使用损耗至关重要（例如，干预措施是否已充分使用以达到预期结果，或者人们是否因设计/开发问题而过早停止使用？）。研究目的和目标：目前的研究项目旨在评估数字健康技术在支持心理健康和福祉方面的有效性。首先，将调查文献中报道的数字健康技术的优点和缺点。第二，将在普通人群和明确定义的目标自闭症人群中评估数字心理健康和幸福支持应用程序（AIME-Health）的参与情况。将使用基于个人的方法（PBA）对数字干预进行深入分析。PBA是数字干预开发的迭代深入定性方法。PBA强调并解决了干预用户的需求和观点，作为干预开发的重要组成部分，确保干预将是可用的，并吸引其目标受众。潜在应用和益处：PBA将应用于数字干预“AIME-Health”，该数字干预目前正在由Cyberlimbic systems（该研究项目的部分资助者）开发。AIME-health是一个智能手机应用程序（“应用程序”），提供基于证据的心理健康和福祉支持。匿名数据将从应用程序中收集（符合GDPR）。与AIME-Health的合作将使该研究项目产生直接的社会影响。深入了解如何提高数字心理健康和福祉支持的参与度，有可能有益于公众的心理健康和福祉，并减轻心理健康服务的压力。这与ESRC概述的2020/30年心理健康研究目标直接吻合：开发新的心理健康干预措施和支持，并改善心理健康护理的选择和获得。此外，我们将采用应用自闭症研究中心（CAAR）和巴斯正念和Compensation中心（BCMC）之间的合作，以及BCMC，CAAR和人机交互（HCI）研究小组之间的进一步新合作。随着AIME-health等智能应用程序大规模支持心理健康，这种合作在支持有效治疗方面越来越重要。

Context:Digital health technology has a great potential to support mental health and well-being. It is becoming increasingly accessible and acceptable and has substantial benefits over face-to-face interventions, including higher cost-effectiveness, wider reach, and reduced support-seeking barriers. Alongside supporting mental health and well-being in the general population, a population group that could particularly benefit from digital mental health and well-being support is autistic people (including adults with high levels of autistic traits, self-identifying as autistic). Autistic people experience significantly poorer levels of mental health and well-being and further challenges in social communication and face-to-face interaction.A crucial question is how mental health and well-being apps work effectively, and for whom. It is important to determine what constitutes effective engagement to reach the intervention's desired outcomes. Previous research has shown that effective engagement patterns can differ across interventions and populations. Therefore, an in-depth usage analysis to evaluate the effectiveness of digital mental health and well-being support is needed.A second crucial question is why mental health apps do not work, and for whom. Despite the potential of digital mental health and well-being support, it is impeded by high levels of drop-out and 'non-usage attrition' (people not sustaining engagement with an intervention). It is crucial to understand non-usage attrition (e.g. has the intervention been used sufficiently to reach its desired outcomes or have people stopped using it prematurely due to design/development issues?). Research aims and objectives:The current research project aims to evaluate the effectiveness of digital health technology to support mental health and well-being. Firstly, the strengths and weaknesses of digital health technology reported in the literature will be investigated. Secondly, engagement with a digital mental health and well-being support app (AIME-Health) will be evaluated in the general population as well as in a well-defined target autistic population.An in-depth analysis of a digital intervention will be conducted using the Person-Based Approach (PBA). The PBA is an iterative in-depth qualitative approach to digital intervention development. PBA elicits and addresses the needs and perspectives of an intervention user as a vital part of the intervention development, ensuring the intervention will be usable and engaging to its target audience. This will increase engagement and could reduce the risk of non-usage attrition.Potential applications and benefit:The PBA will be applied to a digital intervention 'AIME-Health', which is currently being developed by Cyberlimbic systems (partial funders of the research project). AIME-health is a smartphone application ('app') providing evidence-based mental health and well-being support. Anonymised data will be collected from the app (compliant with GDPR). The collaboration with AIME-Health will allow for the research project to have a direct societal impact. Providing insights into ways to increase engagement in digital mental health and well-being support has the potential to benefit public mental health and well-being and reduce pressure on mental health services. This fits directly with ESRC outlined mental health research goals 2020/30: to develop new interventions and support for mental health and to improve choice and access to mental health care. Additionally, we will employ a collaboration between the Centre for Applied Autism Research (CAAR) and the Bath Centre for Mindfulness and Compassion (BCMC), and further new collaboration between BCMC, CAAR and the Human Computer Interaction (HCI) Research Group. As intelligent apps like AIME-health support mental health at scale such collaborations are increasingly important in underpinning effective treatment.