Table 2 Potential solutions to the challenges of engagement in digital mental health interventions identified by the consensus meeting
From: Engagement and attrition in digital mental health: current challenges and potential solutions
Theme 1 – definitions and terminology a) Standardisation of reporting of engagement in DHI research studies. • The group did not achieve consensus on the exact definitions of each engagement term, but agreed on core concepts • Engagement is a complex term encompassing usage and adherence, but also cognitive, affective and motivational components • Agreed guidance needs to be developed, standardised and implemented by all studies • More than one engagement statistic should be reported (including both objective and subjective measures) • Transparent reporting of raw data is needed to allow direct comparisons b) Assessment of the appropriate ‘dose’ of an intervention, to maximise engagement and outcomes. • Short or ultra-short interventions may be appropriate in some cases • The target dose needs to be assessed for each intervention |
Theme 2 - demonstrating efficacy (outcomes) and cost effectiveness of effective engagement a) Research studies need to be theory driven. b) Research studies should actively report engagement and outcomes. • Design trials to determine engagement, efficacy/outcomes and their facilitators • It is key to measure both patient-reported outcomes and experiences (PROMS and PREMS) as well as standard outcome measures • More research is needed on the links between engagement and outcomes, including dose relationships and potential (bio)markers for optimal engagement and response. |
Theme 3 – user involvement and user centred design a) Improve standards of user involvement in DHI research studies, with more precise reporting. • Standardised guidance • Co-production and human-centred co-design • User involvement and engagement b) Investigate the mechanisms of engagement to identify the essential elements. • Identifying the relative contribution of different engagement strategies • Maximising theory driven work in trustworthiness and engagement c) Measure and report the potential harms of engagement. d) Include clinicians and the wider workforce as users. |
