amount, frequency, duration, depth) of usage and (2) a subjective experience characterised by attention, interest and affect” (p. Drawing from the computer science and behavioral science literatures, they define engagement with digital interventions as “the extent (e.g. (2017) conducted a systematic review from an interdisciplinary perspective to create a conceptual framework explaining how engagement with digital interventions leads to behavior change. A better understanding of factors that influence engagement in mHealth interventions for depression is needed to fully realize their potential.Įngagement with digital health interventions is a complex, multifaceted construct.
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This is broadly true of commercially available smartphone apps, which typically lose about 70% of users within one week of download ( Sigg et al., 2016). Studies of publicly accessible mHealth programs for mental health find that many people stop using these programs shortly after downloading them, before they are likely to achieve any clinical benefit ( Lattie et al., 2016). Meta-analyses examining clinical trials of smartphone-based mHealth programs for depression have demonstrated that they significantly reduce depression symptoms ( Firth et al., 2017 Weisel et al., 2019), but attrition and low engagement with these programs are a significant concern. Delivering treatment via smartphone creates a substantial opportunity to expand access to mental health treatment, as there are an estimated 3.5 billion smartphone users worldwide ( Statista, 2019) and relatively low disparities in smartphone ownership along racial and socioeconomic lines in the U.S. mHealth refers to “medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants and other wireless devices” ( van Heerden et al., 2012). Mobile health, or “mHealth,” is viewed as a promising way to overcome well-documented barriers to in-person treatment and increase access to mental health services, particularly among underserved communities. There are effective medications and psychotherapies that improve depressive symptoms, but there are not enough trained mental health professionals to deliver them ( Liu et al., 2017 World Health Organization, 2017). Depressive disorders have an enormous impact on global health and quality of life, affecting over 250 million people worldwide, ranking as the third leading cause of global disability ( James et al., 2018), and being associated with unemployment, poor physical health, poor social function, and suicide ( Hawton et al., 2013 World Health Organization, 2017).
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