scholarly journals Gamification and Adherence to Web-Based Mental Health Interventions: A Systematic Review

2016 ◽  
Vol 3 (3) ◽  
pp. e39 ◽  
Author(s):  
Menna Brown ◽  
Noelle O'Neill ◽  
Hugo van Woerden ◽  
Parisa Eslambolchilar ◽  
Matt Jones ◽  
...  

Background Adherence to effective Web-based interventions for common mental disorders (CMDs) and well-being remains a critical issue, with clear potential to increase effectiveness. Continued identification and examination of “active” technological components within Web-based interventions has been called for. Gamification is the use of game design elements and features in nongame contexts. Health and lifestyle interventions have implemented a variety of game features in their design in an effort to encourage engagement and increase program adherence. The potential influence of gamification on program adherence has not been examined in the context of Web-based interventions designed to manage CMDs and well-being. Objective This study seeks to review the literature to examine whether gaming features predict or influence reported rates of program adherence in Web-based interventions designed to manage CMDs and well-being. Methods A systematic review was conducted of peer-reviewed randomized controlled trials (RCTs) designed to manage CMDs or well-being and incorporated gamification features. Seven electronic databases were searched. Results A total of 61 RCTs met the inclusion criteria and 47 different intervention programs were identified. The majority were designed to manage depression using cognitive behavioral therapy. Eight of 10 popular gamification features reviewed were in use. The majority of studies utilized only one gamification feature (n=58) with a maximum of three features. The most commonly used feature was story/theme. Levels and game leaders were not used in this context. No studies explicitly examined the role of gamification features on program adherence. Usage data were not commonly reported. Interventions intended to be 10 weeks in duration had higher mean adherence than those intended to be 6 or 8 weeks in duration. Conclusions Gamification features have been incorporated into the design of interventions designed to treat CMD and well-being. Further research is needed to improve understanding of gamification features on adherence and engagement in order to inform the design of future Web-based health interventions in which adherence to treatment is of concern. Conclusions were limited by varied reporting of adherence and usage data.

2020 ◽  
Author(s):  
Jacqueline Sin ◽  
Gian Galeazzi ◽  
Elicia McGregor ◽  
Jennifer Collom ◽  
Anna Taylor ◽  
...  

BACKGROUND Digital interventions targeting common mental disorders (CMDs) or symptoms of CMDs are growing rapidly and gaining popularity, probably in response to the increased prevalence of CMDs and better awareness of early help-seeking and self-care. However, no previous systematic reviews that focus on these novel interventions were found. OBJECTIVE This systematic review aims to scope entirely web-based interventions that provided screening and signposting for treatment, including self-management strategies, for people with CMDs or subthreshold symptoms. In addition, a meta-analysis was conducted to evaluate the effectiveness of these interventions for mental well-being and mental health outcomes. METHODS Ten electronic databases including MEDLINE, PsycINFO, and EMBASE were searched from January 1, 1999, to early April 2020. We included randomized controlled trials (RCTs) that evaluated a digital intervention (1) targeting adults with symptoms of CMDs, (2) providing both screening and signposting to other resources including self-care, and (3) delivered entirely through the internet. Intervention characteristics including target population, platform used, key design features, and outcome measure results were extracted and compared. Trial outcome results were included in a meta-analysis on the effectiveness of users’ well-being and mental health outcomes. We also rated the meta-analysis results with the Grading of Recommendations, Assessment, Development, and Evaluations approach to establish the quality of the evidence. RESULTS The electronic searches yielded 21 papers describing 16 discrete digital interventions. These interventions were investigated in 19 unique trials including 1 (5%) health economic study. Most studies were conducted in Australia and North America. The targeted populations varied from the general population to allied health professionals. All interventions offered algorithm-driven screening with measures to assess symptom levels and to assign treatment options including automatic web-based psychoeducation, self-care strategies, and signposting to existing services. A meta-analysis of usable trial data showed that digital interventions improved well-being (3 randomized controlled trials [RCTs]; n=1307; standardized mean difference [SMD] 0.40; 95% CI 0.29 to 0.51; I<sup>2</sup>=28%; fixed effect), symptoms of mental illness (6 RCTs; n=992; SMD −0.29; 95% CI −0.49 to −0.09; I<sup>2</sup>=51%; random effects), and work and social functioning (3 RCTs; n=795; SMD −0.16; 95% CI −0.30 to −0.02; I<sup>2</sup>=0%; fixed effect) compared with waitlist or attention control. However, some follow-up data failed to show any sustained effects beyond the post intervention time point. Data on mechanisms of change and cost-effectiveness were also lacking, precluding further analysis. CONCLUSIONS Digital mental health interventions to assess and signpost people experiencing symptoms of CMDs appear to be acceptable to a sufficient number of people and appear to have enough evidence for effectiveness to warrant further study. We recommend that future studies incorporate economic analysis and process evaluation to assess the mechanisms of action and cost-effectiveness to aid scaling of the implementation.


10.2196/20581 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e20581
Author(s):  
Jacqueline Sin ◽  
Gian Galeazzi ◽  
Elicia McGregor ◽  
Jennifer Collom ◽  
Anna Taylor ◽  
...  

Background Digital interventions targeting common mental disorders (CMDs) or symptoms of CMDs are growing rapidly and gaining popularity, probably in response to the increased prevalence of CMDs and better awareness of early help-seeking and self-care. However, no previous systematic reviews that focus on these novel interventions were found. Objective This systematic review aims to scope entirely web-based interventions that provided screening and signposting for treatment, including self-management strategies, for people with CMDs or subthreshold symptoms. In addition, a meta-analysis was conducted to evaluate the effectiveness of these interventions for mental well-being and mental health outcomes. Methods Ten electronic databases including MEDLINE, PsycINFO, and EMBASE were searched from January 1, 1999, to early April 2020. We included randomized controlled trials (RCTs) that evaluated a digital intervention (1) targeting adults with symptoms of CMDs, (2) providing both screening and signposting to other resources including self-care, and (3) delivered entirely through the internet. Intervention characteristics including target population, platform used, key design features, and outcome measure results were extracted and compared. Trial outcome results were included in a meta-analysis on the effectiveness of users’ well-being and mental health outcomes. We also rated the meta-analysis results with the Grading of Recommendations, Assessment, Development, and Evaluations approach to establish the quality of the evidence. Results The electronic searches yielded 21 papers describing 16 discrete digital interventions. These interventions were investigated in 19 unique trials including 1 (5%) health economic study. Most studies were conducted in Australia and North America. The targeted populations varied from the general population to allied health professionals. All interventions offered algorithm-driven screening with measures to assess symptom levels and to assign treatment options including automatic web-based psychoeducation, self-care strategies, and signposting to existing services. A meta-analysis of usable trial data showed that digital interventions improved well-being (3 randomized controlled trials [RCTs]; n=1307; standardized mean difference [SMD] 0.40; 95% CI 0.29 to 0.51; I2=28%; fixed effect), symptoms of mental illness (6 RCTs; n=992; SMD −0.29; 95% CI −0.49 to −0.09; I2=51%; random effects), and work and social functioning (3 RCTs; n=795; SMD −0.16; 95% CI −0.30 to −0.02; I2=0%; fixed effect) compared with waitlist or attention control. However, some follow-up data failed to show any sustained effects beyond the post intervention time point. Data on mechanisms of change and cost-effectiveness were also lacking, precluding further analysis. Conclusions Digital mental health interventions to assess and signpost people experiencing symptoms of CMDs appear to be acceptable to a sufficient number of people and appear to have enough evidence for effectiveness to warrant further study. We recommend that future studies incorporate economic analysis and process evaluation to assess the mechanisms of action and cost-effectiveness to aid scaling of the implementation.


Author(s):  
Mandeep Sekhon ◽  
Claire White ◽  
Emma Godfrey ◽  
Aliya Amirova ◽  
Åsa Revenäs ◽  
...  

Abstract Objective The aim of this systematic review was to assess the evidence from randomised controlled trials (RCT) and cohort studies for the effectiveness of digital interventions designed to enhance adherence to physical activity (PA) for people with inflammatory arthritis (IA) and describe the intervention content using established coding criteria. Methods Six electronic databases were searched for published and unpublished studies. Independent data extraction and quality assessment (Cochrane risk of bias II or ROBIN I) were conducted by two reviewers. The primary outcome was self-reported adherence to PA post-intervention. Secondary outcomes included self-reported adherence to PA at other timepoints, level of PA or engagement with intervention at any follow-up timepoint. Intervention content was assessed using the Consensus on Exercise Reporting Template and the Behaviour Change Techniques taxonomy version 1. Results From 11,136 reports, four moderate risk of bias studies (three RCTs, one cohort study) including 1,160 participants with rheumatoid arthritis or juvenile inflammatory arthritis were identified. Due to heterogeneity of outcomes, a narrative synthesis was conducted. Only one RCT reported a small between group difference in adherence to PA [mean difference (95% confidence intervals) -0.46 (-0.82. -0.09)] in favour of the intervention. There were no between group differences in any secondary outcomes. Interventions included between 3–11 behaviour change techniques but provided minimal exercise prescription information. Conclusion There is currently limited moderate quality evidence available to confidently evaluate the effect of web-based and mobile health interventions on adherence to PA or level of PA post intervention in people with IA.


2020 ◽  
Vol 134 ◽  
pp. 104003 ◽  
Author(s):  
Jael Lorca-Cabrera ◽  
Carme Grau ◽  
Rut Martí-Arques ◽  
Laia Raigal-Aran ◽  
Anna Falcó-Pegueroles ◽  
...  

2021 ◽  
Author(s):  
Dilan Hulaj ◽  
Sophie Antesberger ◽  
Tabea Blum ◽  
Raffaela Böswald ◽  
Hannah M. Brandl ◽  
...  

Importance: Although young adults are on average less affected by the physical consequences of COVID-19 infections, showing less severe disease progression and lower mortality risk, they suffer strongly from the mental health impact of the pandemic.Objective: We, a group of psychology students experiencing these impacts, aim to provide an overview of the existing literature on prevention and intervention efforts to effectively reduce the development of, or suffering from, mental health problems in young adults (18-35) during the COVID-19 pandemic.Evidence Review: A rapid systematic review was conducted to identify studies focusing on the implementation of mental health interventions for young adults of the general population during the COVID-19 pandemic. Literature was searched with Pubmed and Web of Science on June 17, 2021. The quality of each study was assessed by two reviewers with the Standard Quality Assessment Criteria for Evaluating Primary Research Papers.Findings: Of N = 76 records initially screened, eight studies met the inclusion criteria. Six applied web-based interventions, of which four were randomized controlled trials. Interventions were based on Cognitive Behavioral Therapy approaches (n = 5), mindfulness practices, logo-autobiography, and synergistic thinking methods. The interventions varied in length from single sessions to multiple sessions over a period of up to 10 weeks. All interventions were effective in reducing depression and anxiety symptoms, as well as stress with small to medium effect sizes and a symptom reduction up to 78.9%. With only three studies being of high quality, the overall quality was low.Conclusions and Relevance: Research on mental health interventions for young adults in the general population during the pandemic is sparse. However, all interventions resulted in symptoms reductions and thus have been shown to be effective ways of counteracting the potential development of mental disorders during times of uncertainty, with high levels of stress, such as during a pandemic. Therefore, we propose a concept for an innovative and cost-effective web-based platform to structure and raise awareness for existing measures.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046856
Author(s):  
Sapna Desai ◽  
Kala M Mehta ◽  
Roopal Jyoti Singh ◽  
Allie K Westley ◽  
Osasuyi Dirisu ◽  
...  

IntroductionEconomic groups, such as microfinance or self-help groups are widely implemented in low-income and middle-income countries (LMICs). Women’s groups are voluntary groups, which aim to improve the well-being of members through activities, such as joint savings, credit, livelihoods development and/or health activities. Health interventions are increasingly added on to existing women’s economic groups as a public health intervention for women and their families. Here, we present the protocol for a mixed-methods systematic review we will conduct of the evidence on integrated economic and health interventions on women’s groups to assess whether and how they improve health-related knowledge, behaviour and outcomes in LMICs.Methods and analysisWe will search seven electronic databases for published literature, along with manual searches and consultation. The review will include (1) randomised trials and non-randomised quasiexperimental studies of intervention effects of integrated economic and health interventions delivered through women’s groups in LMICs, and (2) sibling studies that examine factors related to intervention content, context, implementation processes and costs. We will appraise risk of bias and study quality using standard tools. High and moderate quality studies will be grouped by health domain and synthesised without meta-analysis. Qualitative evidence will be thematically synthesised and integrated into the quantitative synthesis using a matrix approach.Ethics and disseminationThis protocol was reviewed and deemed exempt by the institutional review board at the American Institutes for Research. Findings will be shared through peer-reviewed publication and disseminated with programme implementers and policymakers engaged with women’s groups.PROSPERO registration numberCRD42020199998.


2018 ◽  
Author(s):  
Chiara Marzorati ◽  
Chiara Renzi ◽  
Samuel William Russell-Edu ◽  
Gabriella Pravettoni

BACKGROUND The number of published studies and systematic reviews examining different telehealth interventions targeting patients and their effects on patients’ well-being and quality of life have grown in recent decades. However, the use of telemedicine tools aimed at the family members and caregivers of adult cancer patients is less defined. OBJECTIVE We aimed to conduct a systematic review to provide a more complete picture regarding telemedicine tools for informal caregivers (usually family members or close friends) implemented in all phases of cancer care. More specifically, the review aimed to better describe the study samples’ characteristics, to analyze measured outcomes and the specific questionnaires used to assess them, and to describe in depth the implemented interventions and their formats. Finally, we examined the role of telehealth, and usability and feasibility trends in supporting patients’ caregivers. METHODS We systematically searched the literature in the following databases: Web of Science, Cochrane Library, PubMed, Scopus, CINAHL, MEDLINE, EMBASE, Google Scholar, and PsycINFO. Inclusion criteria were being written in English, published in peer-reviewed journals, describing a telehealth-implemented intervention, and focusing on caregivers of adult cancer patients at any stage of the disease. We selected studies published up to November 2017. We critically appraised included articles using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and graded the quality of evidence by outcome using the Centre for Evidence-Based Medicine framework. RESULTS We included 24 studies in the final selection. In 21 of the 24 studies, the patient-caregiver dyad was analyzed, and the study population dealt with different types of cancer at different stages. Included studies considered the caregiver’s condition from both an individual and a relational point of view. Along with psychosocial variables, some studies monitored engagement and user satisfaction regarding Web-based platforms or telehealth interventions. All studies reported significant improvements in some of the investigated areas, but they often showed small effect sizes. Two types of telehealth intervention formats were used: Web-based platforms and telephone calls. Some of the included studies referred to the same project, but on study samples with different cancer diagnoses or with new versions of previously developed interventions. CONCLUSIONS Reported outcomes seem to suggest that we are in an exploratory phase. More detailed and targeted research hypotheses are still needed. Clarifying caregivers’ needs related to telehealth tools and better defining outcome measures may yield more significant results.


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