基于网络的正念计划可能有助于改善患有慢性病的人的福祉结果。坚持计划是改善成果的关键指标;然而,随着程序的数字化,有必要加强参与度,鼓励人们重返数字健康平台。需要更多有关如何在基于网络的正念计划中使用参与策略来鼓励坚持的信息。
这项研究的目的是制定基于网络的正念计划的参与策略列表,并评估参与策略对依从性的影响。
在MEDLINEComplete,CINAHL完成,APAPsycINFO,和Embase数据库,并遵循PRISMA(系统审查和荟萃分析的首选报告项目)指南。使用人群筛选文章,干预,比较器,和成果框架。研究包括年龄>18岁的患有慢性健康状况的成年人。正念干预,包括结合基于正念的认知疗法,包括通过互联网或智能手机技术在网络上交付。干预持续至少2周。包括随机对照试验设计或先导随机对照试验设计的研究。参与战略,包括基于网络的程序功能和主持人主导的策略,坚持,和保留,包括在内。
共筛选了1265篇文章,其中19项是相关的,并被纳入审查。平均而言,70.98%(2258/3181)的研究参与者是平均年龄为46(SD13)岁的女性。最常见的是,正念计划被提供给有精神健康状况的人(8/19,42%)。在19项研究中,8(42%)仅使用程序功能来鼓励坚持,5(26%)使用促进者主导的策略,和6(32%)使用两者的组合。鼓励计划的坚持是最常用的参与策略,77%(10/13)的促进者主导研究和57%(8/14)的程序特征研究中使用。近三分之二(63%)的研究提供了依从性的定义,在不同的研究中,完成度在50%到100%之间。参与者对正念计划的总体平均依从性为56%(SD为15%)。大多数研究(10/19,53%)进行了长期随访,最常见的随访期是干预后12周(3/10,30%)。干预之后,平均保留率为78%(SD为15%).
基于网络的正念程序中的参与策略包括使用该程序的提醒。其他功能可能适用于鼓励坚持干预措施,和推动者主导的组件可能会导致更高的保留。测量依从性的方式存在差异,干预时间和随访时间不一致。需要更彻底的报告和衡量遵守情况的标准化框架,以便更准确地评估遵守情况和参与战略。
Web-based mindfulness programs may be beneficial in improving the well-being outcomes of those living with chronic illnesses. Adherence to programs is a key indicator in improving outcomes; however, with the digitization of programs, it is necessary to enhance engagement and encourage people to return to digital health platforms. More information is needed on how engagement strategies have been used in web-based mindfulness programs to encourage adherence.
The aim of this study is to develop a list of engagement strategies for web-based mindfulness programs and evaluate the impact of engagement strategies on adherence.
A narrative systematic review was conducted across the MEDLINE Complete, CINAHL Complete, APA PsycINFO, and Embase databases and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Articles were screened using the population, intervention, comparator, and outcome framework. Adults aged >18 years with chronic health conditions were included in the study. Mindfulness interventions, including those in combination with mindfulness-based cognitive therapy, delivered on the web through the internet or smartphone technology were included. Interventions lasted at least 2 weeks. Studies with a randomized controlled trial design or a pilot randomized controlled trial design were included. Engagement strategies, including web-based program features and facilitator-led strategies, adherence, and retention, were included.
A total of 1265 articles were screened, of which 19 were relevant and were included in the review. On average, 70.98% (2258/3181) of the study participants were women with a mean age of 46 (SD 13) years. Most commonly, mindfulness programs were delivered to people living with mental health conditions (8/19, 42%). Of the 19 studies, 8 (42%) used only program features to encourage adherence, 5 (26%) used facilitator-led strategies, and 6 (32%) used a combination of the two. Encouraging program adherence was the most common engagement strategy used, which was used in 77% (10/13) of the facilitator-led studies and 57% (8/14) of the program feature studies. Nearly two-thirds (63%) of the studies provided a definition of adherence, which varied between 50% and 100% completion across studies. The overall mean participant compliance to the mindfulness programs was 56% (SD 15%). Most studies (10/19, 53%) had a long-term follow-up, with the most common follow-up period being 12 weeks after intervention (3/10, 30%). After the intervention, the mean retention was 78% (SD 15%).
Engagement strategies in web-based mindfulness programs comprise reminders to use the program. Other features may be suitable for encouraging adherence to interventions, and a facilitator-led component may result in higher retention. There is variance in the way adherence is measured, and intervention lengths and follow-up periods are inconsistent. More thorough reporting and a standardized framework for measuring adherence are needed to more accurately assess adherence and engagement strategies.