Background: Multicomponent digital interventions offer the potential for tailored and flexible interventions that aim to address high attrition rates and increase engagement, an area of concern in digital mental health. However, increased flexibility in use makes it difficult to determine which components lead to improved treatment outcomes. Objective: This study aims to identify user profiles on Horyzons, an 18-month digital relapse prevention intervention for first-episode psychosis that incorporates therapeutic content and social networking, along with clinical, vocational, and peer support, and to examine the predictive value of these user profiles for treatment outcomes. A secondary objective is to compare each user profile with young people receiving treatment as usual (TAU). Methods: Participants comprised 82 young people (aged 16-27 years) with access to Horyzons and 84 receiving TAU, recovering from first-episode psychosis. In addition, 6-month use data from the therapy and social networking components of Horyzons were used as features for K-means clustering for joint trajectories to identify user profiles. Social functioning, psychotic symptoms, depression, and anxiety were assessed at baseline and 6-month follow-up. General linear mixed models were used to examine the predictive value of user profiles for treatment outcomes and between each user profile with TAU. Results: A total of 3 user profiles were identified based on the following system use metrics: low use, maintained use of social components, and maintained use of both therapy and social components. The maintained therapy and social group showed improvements in social functioning (F_2,51=3.58; P=.04), negative symptoms (F_2,51=4.45; P=.02), and overall psychiatric symptom severity (F_2,50=3.23; P=.048) compared with the other user profiles. This group also showed improvements in social functioning (F_1,62=4.68; P=.03), negative symptoms (F_1,62=14.61; P<.001), and overall psychiatric symptom severity (F_1,63=5.66; P=.02) compared with the TAU group. Conversely, the maintained social group showed increases in anxiety compared with the TAU group (F_1,57=7.65; P=.008). No differences were found between the low use group and the TAU group on treatment outcomes. Conclusions: Continued engagement with both therapy and social components might be key in achieving long-term recovery. Maintained social use and low use outcomes were broadly comparable with TAU, emphasizing the importance of maintaining engagement for improved treatment outcomes. Although the social network may be a key ingredient to increase sustained engagement, as users engaged with this more consistently, it should be leveraged as a tool to engage young people with therapeutic content to bring about social and clinical benefits. Trial Registration:

中文翻译：

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表征使用多分量数字干预来预测首发精神病治疗结果：聚类分析

背景：多组成部分数字干预提供了量身定制和灵活干预的潜力，旨在解决高流失率和增加参与度，这是数字心理健康的一个关注领域。然而，随着使用灵活性的提高，很难确定哪些成分可以改善治疗效果。目的：本研究旨在确定 Horyzons 的用户资料，这是一种为期 18 个月的首发精神病数字复发预防干预措施，包含治疗内容和社交网络，以及临床、职业和同伴支持，并检查预测价值这些用于治疗结果的用户资料。次要目标是将每个用户资料与接受照常治疗的年轻人 (TAU) 进行比较。方法：参与者包括 82 名可以使用 Horyzons 的年轻人（年龄 16-27 岁）和 84 名接受 TAU，从首发精神病中恢复。此外，来自 Horyzons 治疗和社交网络组件的 6 个月使用数据被用作K均值聚类联合轨迹的特征，以识别用户资料。在基线和 6 个月的随访中评估了社会功能、精神病症状、抑郁和焦虑。一般线性混合模型用于检查用户资料对治疗结果的预测值以及每个用户资料与 TAU 之间的预测值。结果：根据以下系统使用指标确定了总共 3 个用户配置文件：低使用、社交组件的持续使用以及治疗和社交组件的持续使用。维持治疗和社会团体在社会功能（F 2,51 ₌ 3.58；P =.04）、阴性症状（F _2,51 =4.45；P =.02）和整体精神症状严重程度（F _{2, 50} =3.23；P =.048）与其他用户配置文件相比。该组还表现出社会功能的改善（F _1,62 =4.68；P =.03），阴性症状（F_1,62 =14.61；与 TAU 组相比，P <.001）和总体精神症状严重程度（F _1,63 =5.66；P =.02）。相反，与 TAU 组相比，维持社交组的焦虑增加（F _1,57 =7.65；P =.008）。低使用组和 TAU 组在治疗结果上没有发现差异。结论：继续参与治疗和社交活动可能是实现长期康复的关键。维持社会使用和低使用结果与 TAU 大致相当，强调了保持参与以改善治疗结果的重要性。尽管社交网络可能是提高持续参与度的关键因素，但随着用户更加一致地参与其中，它应该被用作一种工具，让年轻人参与治疗内容，以带来社会和临床效益。试用注册：