■数字心理健康干预(DMHI)是解决全球前所未有的精神疾病的有效和可获得的手段。目前,然而,在现实环境中,患者参与DMHI通常不足以观察临床获益.为了实现DMHIs的潜力,有必要更好地了解是什么促使患者参与。
■我们讨论了与患者参与DMHI相关的现有文献的启示,并强调了需要通过进一步研究解决的差距。研究结果表明,参与受患者的影响-,干预和系统层面的因素。在病人层面,变量,如性别,教育,人格特质,种族,种族,年龄和症状严重程度似乎与参与有关。在干预层面,整合人类支持,游戏化,财务激励和有说服力的技术功能可能会提高参与度。最后,尽管系统层面的因素还没有得到广泛的探索,现有证据表明,实现参与将需要解决组织和社会障碍,并利用实施科学领域。
■未来的研究澄清了患者-,推动参与的干预和系统级因素将至关重要。此外,为了促进对DMHI参与的理解,我们提出以下建议:(a)广泛采用最少必要的5要素参与报告框架;(b)更广泛地应用替代临床试验设计;(c)致力于建立DMHI参与的初步简约概念模型.
UNASSIGNED: Digital mental health interventions (DMHIs) are an effective and accessible means of addressing the unprecedented levels of mental illness worldwide. Currently, however, patient engagement with DMHIs in real-world settings is often insufficient to see clinical benefit. In order to realize the potential of DMHIs, there is a need to better understand what drives patient engagement.
UNASSIGNED: We discuss takeaways from the existing literature related to patient engagement with DMHIs and highlight gaps to be addressed through further research. Findings suggest that engagement is influenced by patient-, intervention- and systems-level factors. At the patient-level, variables such as sex, education, personality traits, race, ethnicity, age and symptom severity appear to be associated with engagement. At the intervention-level, integrating human support, gamification, financial incentives and persuasive technology features may improve engagement. Finally, although systems-level factors have not been widely explored, the existing evidence suggests that achieving engagement will require addressing organizational and social barriers and drawing on the field of implementation science.
UNASSIGNED: Future research clarifying the patient-, intervention- and systems-level factors that drive engagement will be essential. Additionally, to facilitate improved understanding of DMHI engagement, we propose the following: (a) widespread adoption of a minimum necessary 5-element engagement reporting framework; (b) broader application of alternative clinical trial designs; and (c) directed efforts to build upon an initial parsimonious conceptual model of DMHI engagement.