University of California Irvine, Irvine, CA, United States.
University of California San Diego, San Diego, CA, United States.
J Med Internet Res. 2021 Mar 24;23(3):e24387. doi: 10.2196/24387.
Digital mental health interventions (DMHIs), which deliver mental health support via technologies such as mobile apps, can increase access to mental health support, and many studies have demonstrated their effectiveness in improving symptoms. However, user engagement varies, with regard to a user's uptake and sustained interactions with these interventions.
This systematic review aims to identify common barriers and facilitators that influence user engagement with DMHIs.
A systematic search was conducted in the SCOPUS, PubMed, PsycINFO, Web of Science, and Cochrane Library databases. Empirical studies that report qualitative and/or quantitative data were included.
A total of 208 articles met the inclusion criteria. The included articles used a variety of methodologies, including interviews, surveys, focus groups, workshops, field studies, and analysis of user reviews. Factors extracted for coding were related to the end user, the program or content offered by the intervention, and the technology and implementation environment. Common barriers included severe mental health issues that hampered engagement, technical issues, and a lack of personalization. Common facilitators were social connectedness facilitated by the intervention, increased insight into health, and a feeling of being in control of one's own health.
Although previous research suggests that DMHIs can be useful in supporting mental health, contextual factors are important determinants of whether users actually engage with these interventions. The factors identified in this review can provide guidance when evaluating DMHIs to help explain and understand user engagement and can inform the design and development of new digital interventions.
数字心理健康干预（DMHIs）通过移动应用等技术提供心理健康支持，可以增加获得心理健康支持的机会，许多研究已经证明它们在改善症状方面的有效性。然而，用户参与度存在差异，涉及到用户对这些干预措施的接受程度和持续互动。
本系统评价旨在确定影响用户参与 DMHI 的常见障碍和促进因素。
在 SCOPUS、PubMed、PsycINFO、Web of Science 和 Cochrane Library 数据库中进行了系统搜索。纳入了报告定性和/或定量数据的实证研究。
共有 208 篇文章符合纳入标准。纳入的文章采用了多种方法，包括访谈、调查、焦点小组、研讨会、实地研究和用户评论分析。提取用于编码的因素与最终用户、干预措施提供的计划或内容以及技术和实施环境有关。常见的障碍包括严重的心理健康问题，这阻碍了参与度、技术问题和缺乏个性化。常见的促进因素包括干预措施促进的社交联系、对健康的深入了解以及对自己健康的控制感。
尽管先前的研究表明，DMHIs 在支持心理健康方面可能是有用的，但情境因素是用户是否实际参与这些干预措施的重要决定因素。本评价中确定的因素可以在评估 DMHIs 时提供指导，以帮助解释和理解用户参与度，并为新的数字干预措施的设计和开发提供信息。
