Bernard Aynsley, de Ossorno Garcia Santiago, Salhi Louisa, John Ann, DelPozo-Banos Marcos
Kooth Digital Health, London, United Kingdom.
Swansea University Medical School, Swansea, United Kingdom.
Front Psychiatry. 2023 Jul 27;14:1143272. doi: 10.3389/fpsyt.2023.1143272. eCollection 2023.
The COVID-19 pandemic increased public use of digital mental health technologies. However, little is known about changes in user engagement with these platforms during the pandemic. This study aims to assess engagement changes with a digital mental healthcare service during COVID-19.
A cohort study based on routinely collected service usage data from a digital mental health support service in the United Kingdom. Returning users aged 14-25 years that interacted for a maximum of two months were included. The study population was divided into pre-COVID and COVID cohorts. Demographic and usage information between cohorts were compared and usage clusters were identified within each cohort. Differences were tested using Chi-squared, two-sample Kolmogorov-Smirnov tests and logit regressions.
Of the 624,103 users who joined the service between May 1, 2019, and October 1, 2021, 18,889 (32.81%) met the inclusion criteria: 5,048 in the pre-COVID cohort and 13,841 in the COVID cohort. The COVID cohort wrote more journals; maintained the same focus on messaging practitioners, posting discussions, commenting on posts, and having booked chats; and engaged less in writing journals, setting personal goals, posting articles, and having chats. Four usage profiles were identified in both cohorts: one relatively disengaged, one focused on contacting practitioners through chats/messages, and two broadly interested in writing discussions and comments within the digital community. Despite their broad similarities, usage patterns also exhibited differences between cohorts. For example, all four clusters had over 70% of users attempting to have chats with practitioners in the pre-COVID cohort, compared to one out of four clusters in the COVID cohort. Overall, engagement change patterns during the COVID-19 pandemic were not equal across clusters. Sensitivity analysis revealed varying strength of these defined clusters.
Our study identified changes in user activity and engagement behavior within a digital mental healthcare service during the COVID-19 pandemic. These findings suggest that usage patterns within digital mental health services may be susceptible to change in response to external events such as a pandemic. Continuous monitoring of engagement patterns is important for informed design and personalized interventions.
新冠疫情增加了公众对数字心理健康技术的使用。然而，对于疫情期间用户与这些平台的参与度变化知之甚少。本研究旨在评估新冠疫情期间数字心理健康服务的参与度变化。
一项队列研究，基于英国一项数字心理健康支持服务中定期收集的服务使用数据。纳入年龄在14至25岁之间、互动时间最长为两个月的回访用户。研究人群分为新冠疫情前队列和新冠疫情队列。比较了队列之间的人口统计学和使用信息，并在每个队列中识别出使用集群。使用卡方检验、双样本柯尔莫哥洛夫-斯米尔诺夫检验和逻辑回归进行差异检验。
在2019年5月1日至2021年10月1日期间加入该服务的624,103名用户中，18,889名（32.81%）符合纳入标准：新冠疫情前队列中有5,048名，新冠疫情队列中有13,841名。新冠疫情队列撰写的日志更多；在向从业者发送消息、发布讨论、对帖子进行评论以及预约聊天方面保持相同的关注度；而在撰写日志、设定个人目标、发布文章和进行聊天方面的参与度较低。在两个队列中都识别出了四种使用模式：一种参与度相对较低，一种专注于通过聊天/消息联系从业者，还有两种对在数字社区中撰写讨论和评论普遍感兴趣。尽管它们有广泛的相似之处，但不同队列的使用模式也存在差异。例如，在新冠疫情前队列中，所有四个集群中有超过70%的用户试图与从业者进行聊天，而在新冠疫情队列中，四个集群中只有一个是这样。总体而言，新冠疫情期间不同集群的参与度变化模式并不相同。敏感性分析揭示了这些定义集群的不同强度。
我们的研究确定了新冠疫情期间数字心理健康服务中用户活动和参与行为的变化。这些发现表明，数字心理健康服务中的使用模式可能容易因疫情等外部事件而发生变化。持续监测参与模式对于明智的设计和个性化干预很重要。
