Background

Depressive disorders are a major public health problem, and many people face barriers to accessing evidence-based mental health treatment. Mobile health (mHealth) interventions may circumvent logistical barriers to in-person care (e.g., cost, transportation), however the symptoms of depression (low motivation, concentration difficulties) may make it difficult for people with the disorder to engage with mHealth.

Objective

The aim of this systematic review is to examine assessment and reporting of engagement in clinical trials of mHealth interventions for depression, including objective engagement (e.g., number of times program is used), subjective engagement (e.g., qualitative data on users' experiences), and associations between engagement and other clinically important variables (e.g., symptom improvement, participant characteristics).

Methods

Three electronic databases (PsycINFO, Web of Science, PubMed) were searched in February 2020 using search terms for mHealth and depression. Studies were included in the review if they tested a mHealth intervention designed for people with depressive disorders or elevated depression symptoms.

Results

Thirty studies met inclusion criteria and were reviewed. Most studies reported objective engagement (N = 23, 76.7%), approximately half reported subjective engagement (N = 16, 53.3%), and relatively few examined associations between engagement and clinical improvement, participant characteristics, or other clinically relevant variables (N = 13, 43.3%).

Conclusions

Although most studies in this small but rapidly growing literature report at least one measure of engagement, there is substantial heterogeneity. Intentional, theory-driven, and consistent measurement of engagement with mHealth interventions for depression may advance the field's understanding of effective engagement to facilitate clinical improvement, identify dose-response relationships, and maximize generalizability for underserved populations.

中文翻译：

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参与抑郁症的移动健康干预：系统评价

背景

抑郁症是一个主要的公共卫生问题，许多人在获得循证心理健康治疗方面面临障碍。移动健康 (mHealth) 干预措施可能会绕过面对面护理的后勤障碍（例如，成本、交通），但抑郁症的症状（动机低下、注意力不集中）可能会使患有该疾病的人难以参与 mHealth。

客观的

本系统评价的目的是检查参与 mHealth 干预抑郁症临床试验的评估和报告，包括客观参与（例如，使用程序的次数）、主观参与（例如，关于用户体验的定性数据）、以及参与与其他临床重要变量（例如，症状改善、参与者特征）之间的关联。

方法

2020 年 2 月，使用 mHealth 和抑郁症的搜索词搜索了三个电子数据库（PsycINFO、Web of Science、PubMed）。如果研究测试了为患有抑郁症或抑郁症状加重的人设计的 mHealth 干预措施，则这些研究被纳入审查。

结果

30 项研究符合纳入标准并进行了审查。大多数研究报告了客观参与（N  = 23, 76.7%），大约一半报告了主观参与（N  = 16, 53.3%），而研究参与与临床改善、参与者特征或其他临床相关变量之间的关联相对较少（N  = 13, 43.3%)。

结论

尽管在这个规模虽小但增长迅速的文献中的大多数研究都报告了至少一种参与度，但存在很大的异质性。对抑郁症 mHealth 干预的有意识、理论驱动和一致的测量可能会促进该领域对有效参与的理解，以促进临床改进、确定剂量-反应关系并最大限度地提高服务不足人群的普遍性。