Valentine Lee, Hinton Jordan D X, Bajaj Kriti, Boyd Larissa, O'Sullivan Shaunagh, Sorenson Rory P, Bell Imogen H, Vega Miguel Sobredo, Liu Ping, Peters Wilma, Mangelsdorf Shaminka N, Wren Thomas W, Moller Carl, Cross Shane, McEnery Carla, Bendall Sarah, Nicholas Jennifer, Alvarez-Jimenez Mario
Orygen, Melbourne, VIC, Australia.
Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.
NPJ Digit Med. 2025 Apr 29;8(1):229. doi: 10.1038/s41746-025-01567-5.
This systematic review and meta-analysis examined the efficacy of digital mental health apps and the impact of persuasive design principles on intervention engagement and outcomes. Ninety-two RCTs and 16,728 participants were included in the meta-analyses. Findings indicate that apps significantly improved clinical outcomes compared to controls (g = 0.43). Persuasive design principles ranged from 1 to 12 per app (mode = 5). Engagement data were reported in 76% of studies, with 25 distinct engagement metrics identified, the most common being the percentage of users who completed the intervention and the average percentage of modules completed. No significant association was found between persuasive principles and either efficacy or engagement. With 25 distinct engagement metrics and 24% of studies not reporting engagement data, establishing overall engagement with mental health apps remains unfeasible. Standardising the definition of engagement and implementing a structured framework for reporting engagement metrics and persuasive design elements are essential steps toward advancing effective, engaging interventions in real-world settings.
本系统评价和荟萃分析考察了数字心理健康应用程序的疗效以及劝导性设计原则对干预参与度和结果的影响。荟萃分析纳入了92项随机对照试验和16728名参与者。研究结果表明，与对照组相比，应用程序显著改善了临床结果（g = 0.43）。每个应用程序的劝导性设计原则数量从1到12不等（众数 = 5）。76%的研究报告了参与度数据，共确定了25种不同的参与度指标，最常见的是完成干预的用户百分比和完成模块的平均百分比。未发现劝导性原则与疗效或参与度之间存在显著关联。由于存在25种不同的参与度指标，且24%的研究未报告参与度数据，因此确定与心理健康应用程序的总体参与度仍然不可行。标准化参与度的定义并实施报告参与度指标和劝导性设计元素的结构化框架，是在现实环境中推进有效、有吸引力的干预措施的关键步骤。
