Engagement in Digital Mental Health Interventions: Can Monetary Incentives Help?

Digital mental health interventions (DMHI) are scalable and cost-effective strategies for increasing access to mental health care; however, dropout rates associated with digital interventions are high, particularly for open-access digital interventions. While some studies have focused on predictors of dropout from digital mental health programs, few studies have focused on engagement features that might improve engagement. In this perspective article, we discuss whether monetary incentives (MI) are one avenue to increasing user engagement in DMHI. We begin by reviewing the literature on the effects of MI for behavior change in health domains (e.g., dietary behaviors, substance use, and medication adherence). Then, drawing on a pilot study we conducted to test the effects of different levels of MI on usage and improvement in subjective well-being among users of a DMHI (Happify), we discuss the potential applications of MI for DMHI, the potential drawbacks of financial incentives in this context, and open questions for future research.

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Stakeholder perspectives on evidence for digital mental health interventions: Implications for accreditation systems

Digital Health ◽

10.1177/2055207619878069 ◽

2019 ◽

Vol 5 ◽

pp. 205520761987806

Author(s):

Philip J Batterham ◽

Alison L Calear ◽

Bridianne O’Dea ◽

Mark E Larsen ◽

David J Kavanagh ◽

...

Keyword(s):

Mental Health ◽

Lived Experience ◽

Empirical Evidence ◽

Mental Health Problems ◽

Treatment Guidelines ◽

Routine Care ◽

Health Interventions ◽

User Engagement ◽

Digital Interventions ◽

Mental Health Interventions

Background Digital mental health interventions can be effective for treating mental health problems, but uptake by consumers and clinicians is not optimal. The lack of an accreditation pathway for digital mental health interventions is a barrier to their uptake among clinicians and consumers. However, there are a number of factors that may contribute to whether a digital intervention is suitable for recommendation to the public. The aim of this study was to identify the types of evidence that would support the accreditation of digital interventions. Method An expert workshop was convened, including researcher, clinician, consumer (people with lived experience of a mental health condition) and policymaker representatives. Results Existing methods for assessing the evidence for digital mental health interventions were discussed by the stakeholders present at the workshop. Empirical evidence from randomised controlled trials was identified as a key component for evaluating digital interventions. However, information on the safety of users, data security, user ratings, and fidelity to clinical guidelines, along with data from routine care including adherence, engagement and clinical outcomes, were also identified as important considerations when evaluating an intervention. There are considerable challenges in weighing the evidence for a digital mental health intervention. Conclusions Empirical evidence should be the cornerstone of any accreditation system to identify appropriate digital mental health interventions. However, robust accreditation systems should also account for program and user safety, user engagement and experience, and fidelity to clinical treatment guidelines.

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Mobile Virtual Reality to Enhance Subjective Well-Being

Advances in Computer and Electrical Engineering - Advanced Methodologies and Technologies in Network Architecture, Mobile Computing, and Data Analytics ◽

10.4018/978-1-5225-7598-6.ch076 ◽

2019 ◽

pp. 1040-1052

Author(s):

Federica Pallavicini ◽

Luca Morganti ◽

Barbara Diana ◽

Olivia Realdon ◽

Valentino Zurloni ◽

...

Keyword(s):

Mental Health ◽

Virtual Reality ◽

Subjective Wellbeing ◽

Low Cost ◽

Well Being ◽

Health Interventions ◽

Subjective Well Being ◽

Virtual Reality System ◽

Current Application ◽

Mental Health Interventions

Focusing on healthcare, in the last few decades advanced technologies have become crucial keys in supporting subjective wellbeing. Among them, virtual reality has been proven to be effective for mental health promotion in several research studies. Although the dramatic development in the field of virtual reality system, there are still important problems related to the use of this technology. Within this perspective, the growing availability, low-cost and easy-to-use mobile virtual reality (i.e., the integration of virtual reality system on mobile devices such as smartphone and tablet) represents a meaningful opportunity to support mental health interventions. The chapter will first briefly describe mobile virtual reality. Then, a mobile virtual reality design practice will be presented. Finally, the current application of mobile virtual reality to enhance subjective wellbeing will be discussed with the support of concrete examples and research study analysis.

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Mobile Virtual Reality to Enhance Subjective Well-Being

Encyclopedia of Information Science and Technology, Fourth Edition ◽

10.4018/978-1-5225-2255-3.ch541 ◽

2018 ◽

pp. 6223-6233 ◽

Cited By ~ 1

Author(s):

Federica Pallavicini ◽

Luca Morganti ◽

Barbara Diana ◽

Olivia Realdon ◽

Valentino Zurloni ◽

...

Keyword(s):

Mental Health ◽

Virtual Reality ◽

Low Cost ◽

Well Being ◽

Health Interventions ◽

Subjective Well Being ◽

Virtual Reality System ◽

Current Application ◽

Mental Health Interventions ◽

Research Studies

Focusing on health-care, in the last few decades advanced technologies have become crucial keys in supporting subjective well-being. Among them, Virtual Reality has been proven to be effective for mental health promotion in several research studies. Although the dramatic development in the field of Virtual Reality system, there are still important problems related to the use of this technology. Within this perspective, the growing availability, low-cost and easy-to-use of Mobile Virtual Reality (i.e., the integration of Virtual Reality system on mobile devices such as smartphone and tablet) represents a meaningful opportunity to support mental health interventions. The present chapter will first briefly describe Mobile Virtual Reality. Then, a Mobile Virtual Reality design practice will be presented. Finally, the current application of Mobile Virtual Reality to enhance subjective well-being will be discussed, with the support of concrete examples and research studies-analysis.

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Out of tune: Perceptions of, engagement with, and responses to mental health interventions by professional popular musicians—A scoping review

Psychology of Music ◽

10.1177/03057356211019477 ◽

2021 ◽

pp. 030573562110194

Author(s):

Amy Visser ◽

Megan Lee ◽

Timothy Barringham ◽

Nasim Salehi

Keyword(s):

Mental Health ◽

Scoping Review ◽

Distinct Group ◽

Well Being ◽

Health Interventions ◽

Therapeutic Approaches ◽

Increased Risk ◽

Mental Health Interventions ◽

Industry Peers

Professional popular musicians are at increased risk of psychological distress, substance use problems, and suicide, yet little evidence is available on effective psychotherapeutic practices to address these issues. This scoping review aims to understand how professional popular musicians perceive, engage with, and respond to mental health interventions. Four databases were searched, garnering a total of 310 articles. Of these, six met inclusion criteria. Four thematic categories were explored: (1) amenability of professional popular musicians to particular therapeutic approaches; (2) attribution of treatment outcomes to tailored approaches; (3) professional popular musicians’ perceived barriers to treatment; and (4) recommendations for treatment approaches. The scoping review supports the importance of considering the characteristics of professional popular musicians as a distinct group with unique well-being needs, challenges, and strengths. There is a clear preference for tailored, affordable, and accessible approaches that consider the uniquities of musicianship and the need to explore the role of nonclinical support, such as friends, family, and industry peers.

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Online Indicated Preventive Mental Health Interventions for Youth: A Scoping Review

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.580843 ◽

2021 ◽

Vol 12 ◽

Author(s):

Marilon van Doorn ◽

Laurens A. Nijhuis ◽

Mees D. Egeler ◽

Joost G. Daams ◽

Arne Popma ◽

...

Keyword(s):

Mental Health ◽

Scoping Review ◽

Mental Health Problems ◽

Well Being ◽

Health Interventions ◽

Health Complaints ◽

Preventive Interventions ◽

Online Interventions ◽

Preventive Mental Health ◽

Mental Health Interventions

Objective: Between the ages of 12 and 25 the onset of mental disorders typically occurs, and the burden of mental health problems is greatest for this group. Indicated preventive interventions to target individuals with subclinical symptoms to prevent the transition to clinical levels of disorders have gained considerable traction. However, the threshold to seek help appears to be high even when help is needed. Online interventions could offer a solution, especially during the COVID-19 pandemic. This scoping review will present an overview of the recent research of indicated online preventive interventions for youth (12–25 years) experiencing the early stages of mental health complaints with the aim of identifying the nature and extent of the research evidence.Methods: The 5-stage framework by Arksey and O'Malley was used. Academic literature published from 2013 onwards in printed or electronic format was included from Scopus, PsychINFO, and Ovid MEDLINE(R) ALL.Results: The search yielded 11,122 results, with the final selection resulting in inclusion of 30 articles for this review. In total, the articles included 4,950 participants. 26.7% of the selected articles focused on youth between 12 and 25 years. Of the articles 60% did not screen for, nor exclude participants with clinical levels of symptoms. Most studies used a common evidence-based therapy for the disorder-category targeted. More than half of the online interventions included some form of human support. Adherence levels ranged between 27.9 and 98%. The results indicate general effectiveness, usability and acceptability of online indicated preventive interventions. The most commonly used approach was CBT (n = 12 studies). Studies varied in their size, rigor of study, effectiveness and outcome measures. Online interventions with a combination of clinical and peer moderation (n = 3 studies) appear to result in the most stable and highest effect sizes.Conclusion: Online indicated preventive mental health interventions for youth with emerging mental health issues show promise in reducing various mental health complaints, and increasing positive mental health indicators such as well-being and resilience. Additionally, high levels of usability and acceptability were found. However, the included studies show important methodological shortcomings. Also, the research has mainly focused on specific diagnostic categories, meaning there is a lack of transdiagnostic approaches. Finally, clear definitions of- as well as instruments to measure- emerging or subclinical mental health symptoms in youth remain are missing.

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Mental Health Screening in General Practices as a Means for Enhancing Uptake of Digital Mental Health Interventions: An Observational Cohort Study (Preprint)

10.2196/preprints.28369 ◽

2021 ◽

Author(s):

Alexis Estelle Whitton ◽

Rebecca Hardy ◽

Kate Cope ◽

Chilin Gieng ◽

Leanne Gow ◽

...

Keyword(s):

Mental Health ◽

Critical Role ◽

Health Screening ◽

Mental Health Screening ◽

Health Interventions ◽

Treatment Recommendation ◽

Digital Interventions ◽

Digital Intervention ◽

Mental Health Interventions ◽

General Practices

BACKGROUND Digital mental health interventions will play a critical role in managing the mental health impacts of the COVID-19 pandemic. Thus, enhancing their uptake is a key priority. General Practitioners (GPs) are well-positioned to facilitate access to digital interventions, but tools that assist GPs in identifying suitable patients are lacking. OBJECTIVE This study evaluated the effectiveness of a web-based mental health screening and treatment-recommendation tool (‘StepCare’) for improving the detection of anxiety and depression in general practice, and subsequently, uptake of digital mental health interventions. METHODS StepCare screens patients for symptoms of depression (PHQ-9) and anxiety (GAD-7) in the GP waiting room. It provides GPs with stepped treatment recommendations that include digital mental health interventions for mild-to-moderate symptoms. Patients (n=5,138) from 85 general practices across Australia were invited to take part in screening. RESULTS Depression and/or anxiety was detected in 43.1% of patients screened (one quarter were previously undiagnosed/untreated). The majority (89.5%) of previously undiagnosed/untreated patients had mild-to-moderate symptoms and were candidates for digital mental health interventions. Although less than half were prescribed a digital intervention by their GP, when a digital intervention was prescribed, over two thirds of patients used it. CONCLUSIONS Implementing mental health screening in general practices can increase patient access to digital mental health interventions. Although GPs prescribed digital interventions less frequently than in-person psychotherapy or medication, the promising rates of uptake by GP-referred patients suggests that GPs can play a critical role in championing digital interventions and maximising the associated benefits.

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Community Gardening: Stress, Well-Being, and Resilience Potentials

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186740 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6740

Author(s):

Way Inn Koay ◽

Denise Dillon

Keyword(s):

Mental Health ◽

Health Benefits ◽

Well Being ◽

Analysis Of Covariance ◽

Future Research ◽

Control Group ◽

Subjective Well Being ◽

Community Gardening ◽

Home Gardening ◽

Mental Health Benefits

The financial and health burdens of stress associated with increased urbanization have led to a demand for mental health enhancement strategies. While some extant literature details mental health benefits of community gardening, a coherent narrative on the construct of resilience and its relationship with the mental health benefits of community gardening is lacking. The present study examined the relationship between community gardening and a number of mental health benefits, in the forms of subjective well-being, stress, resilience potentials, and resilience factors (self-esteem, optimism, and openness). A total of 111 residents in Singapore completed a survey. Results from Multivariate Analysis of Covariance (MANCOVA) and Pearson’s correlation analyses show that, after controlling for age and levels of connection to nature, community gardeners reported significantly higher levels of subjective well-being than individual/home gardeners and non-gardeners, indicating that engagement in community gardening may be superior to individual/home gardening or non-gardening outdoor activities. Community gardeners reported higher levels of resilience and optimism than the non-gardening control group. These novel results indicate some potential for mental health benefits in urban environments, specifically in terms of subjective well-being and resilience. These findings have implications for future research in clinical psychology, mental health promotion, and policy.

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The Eight Ujarait (Rocks) Model: Supporting Inuit Adolescent Mental Health With an Intervention Model Based on Inuit Ways of Knowing

International Journal of Indigenous Health ◽

10.18357/ijih111201614394 ◽

2016 ◽

Vol 11 (1) ◽

pp. 92 ◽

Cited By ~ 4

Author(s):

Gwen Katheryn Healey ◽

Jennifer Noah ◽

Ceporah Mearns

Keyword(s):

Mental Health ◽

Literature Review ◽

Peer Relationships ◽

Grey Literature ◽

Ways Of Knowing ◽

Youth Mental Health ◽

Well Being ◽

Evidence Base ◽

Health Interventions ◽

Mental Health Interventions

Objective: This study responded to a community-identified need to form an evidence base for interventions to promote mental health and wellness among youth in Nunavut. Methods: A literature review was conducted using the terms adolescence and Inuit and intervention or program or camp or land-based. PubMed and Google Scholar databases were used to find peer-reviewed and grey literature on community-based youth programs. The literature review was presented to parents, elders, and youth for discussion over several months in 2009-2010. Results: Key themes included: self-esteem, physical activity, stress and coping, positive peer relationships, Inuit identity, mental health and well-being, and the effects of intergenerational trauma on youth in Nunavut. Themes were incorporated into a model for youth mental health interventions based on Inuit terminology, philosophy, and societal values—the Eight Ujarait/Rocks Model. The model was implemented as a camp program in 6 pilots in 5 communities from 2011 to 2013. Data were collected before and after the camp. Results indicated that the program fostered physical, mental, emotional, and spiritual wellness among youth. Parent observations of participants included an improvement in behaviour and attitude, strong cultural pride, greater confidence in identity, and improved family and community relationships. Conclusion: Evidence-based, community-driven models for youth mental health interventions in the North hold promise. The application of one such model through a camp program had a lasting impact on the individuals involved, beyond their immediate participation. Long-term monitoring of the participants, and ongoing evaluations of camps as they continue to unfold across Nunavut, are needed to contribute to the robust evidence base for this program over time.

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A Process Evaluation of a Web-Based Mental Health Portal (WalkAlong) Using Google Analytics

JMIR Mental Health ◽

10.2196/mental.8594 ◽

2018 ◽

Vol 5 (3) ◽

pp. e50 ◽

Cited By ~ 5

Author(s):

Michael Jae Song ◽

John Ward ◽

Fiona Choi ◽

Mohammadali Nikoo ◽

Anastasia Frank ◽

...

Keyword(s):

Mental Health ◽

Process Evaluation ◽

Vital Role ◽

Health Interventions ◽

Utilization Rate ◽

User Engagement ◽

Improvement Strategy ◽

Attrition Rates ◽

Web Based ◽

Mental Health Interventions

Background Despite the increasing amount of research on Web-based mental health interventions with proven efficacy, high attrition rates decrease their effectiveness. Continued process evaluations should be performed to maximize the target population’s engagement. Google Analytics has been used to evaluate various health-related Web-based programs and may also be useful for Web-based mental health programs. Objective The objective of our study was to evaluate WalkAlong.ca, a youth-oriented mental health web-portal, using Google Analytics to inform the improvement strategy for the platform and to demonstrate the use of Google Analytics as a tool for process evaluation of Web-based mental health interventions. Methods Google Analytics was used to monitor user activity during WalkAlong’s first year of operation (Nov 13, 2013-Nov 13, 2014). Selected Google Analytic variables were overall website engagement including pages visited per session, utilization rate of specific features, and user access mode and location. Results The results included data from 3076 users viewing 29,299 pages. Users spent less average time on Mindsteps (0 minute 35 seconds) and self-exercises (1 minute 08 seconds), which are important self-help tools, compared with that on the Screener tool (3 minutes 4 seconds). Of all visitors, 82.3% (4378/5318) were desktop users, followed by 12.7 % (677/5318) mobile phone and 5.0% (263/5318) tablet users. Both direct traffic (access via URL) and referrals by email had more than 7 pages viewed per session and longer than average time of 6 minutes per session. The majority of users (67%) accessed the platform from Canada. Conclusions Engagement and feature utilization rates are higher among people who receive personal invitations to visit the site. Low utilization rates with specific features offer a starting place for further exploration of users in order to identify the root cause. The data provided by Google Analytics, although informative, can be supplemented by other evaluation methods (ie, qualitative methods) in order to better determine the modifications required to improve user engagement. Google Analytics can play a vital role in highlighting the preferences of those using Web-based mental health tools.

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Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (Preprint)

10.2196/preprints.11528 ◽

2018 ◽

Author(s):

Hanneke Scholten ◽

Isabela Granic

Keyword(s):

Mental Health ◽

Design Thinking ◽

Health Interventions ◽

New Wave ◽

Digital Interventions ◽

Wide Range ◽

Mental Health Interventions ◽

Principles Of Design ◽

Meta Analyses ◽

Scientific Standards

UNSTRUCTURED Numerous reviews and meta-analyses have indicated the enormous potential of technology to improve the appeal, effectiveness, cost, and reach of mental health interventions. However, the promise of digital mental health interventions for youth has not yet been realized. Significant challenges have been repeatedly identified, including engagement, fidelity, and the lack of personalization. We introduce the main tenets of design thinking and explain how they can specifically address these challenges, with an entirely new toolbox of mindsets and practices. In addition, we provide examples of a new wave of digital interventions to demonstrate the applicability of design thinking to a wide range of intervention goals. In the future, it will be critical for scientists and clinicians to implement their scientific standards, methods, and review outlets to evaluate the contribution of design thinking to the next iteration of digital mental health interventions for youth.

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