Understanding What Drives Long-term Engagement in Digital Mental Health Interventions: Secondary Causal Analysis of the Relationship Between Social Networking and Therapy Engagement
BackgroundLow engagement rates with digital mental health interventions are a major challenge in the field. Multicomponent digital interventions aim to improve engagement by adding components such as social networks. Although social networks may be engaging, they may not be s...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2023-05-01
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| Series: | JMIR Mental Health |
| Online Access: | https://mental.jmir.org/2023/1/e44812 |
| _version_ | 1797734117726486528 |
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| author | Shaunagh O'Sullivan Niels van Berkel Vassilis Kostakos Lianne Schmaal Simon D'Alfonso Lee Valentine Sarah Bendall Barnaby Nelson John F Gleeson Mario Alvarez-Jimenez |
| author_facet | Shaunagh O'Sullivan Niels van Berkel Vassilis Kostakos Lianne Schmaal Simon D'Alfonso Lee Valentine Sarah Bendall Barnaby Nelson John F Gleeson Mario Alvarez-Jimenez |
| author_sort | Shaunagh O'Sullivan |
| collection | DOAJ |
| description |
BackgroundLow engagement rates with digital mental health interventions are a major challenge in the field. Multicomponent digital interventions aim to improve engagement by adding components such as social networks. Although social networks may be engaging, they may not be sufficient to improve clinical outcomes or lead users to engage with key therapeutic components. Therefore, we need to understand what components drive engagement with digital mental health interventions overall and what drives engagement with key therapeutic components.
ObjectiveHoryzons was an 18-month digital mental health intervention for young people recovering from first-episode psychosis, incorporating therapeutic content and a private social network. However, it is unclear whether use of the social network leads to subsequent use of therapeutic content or vice versa. This study aimed to determine the causal relationship between the social networking and therapeutic components of Horyzons.
MethodsParticipants comprised 82 young people (16-27 years) recovering from first-episode psychosis. Multiple convergent cross mapping was used to test causality, as a secondary analysis of the Horyzons intervention. Multiple convergent cross mapping tested the direction of the relationship between each pair of social and therapeutic system usage variables on Horyzons, using longitudinal usage data.
ResultsResults indicated that the social networking aspects of Horyzons were most engaging. Posting on the social network drove engagement with all therapeutic components (r=0.06-0.36). Reacting to social network posts drove engagement with all therapeutic components (r=0.39-0.65). Commenting on social network posts drove engagement with most therapeutic components (r=0.11-0.18). Liking social network posts drove engagement with most therapeutic components (r=0.09-0.17). However, starting a therapy pathway led to commenting on social network posts (r=0.05) and liking social network posts (r=0.06), and completing a therapy action led to commenting on social network posts (r=0.14) and liking social network posts (r=0.15).
ConclusionsThe online social network was a key driver of long-term engagement with the Horyzons intervention and fostered engagement with key therapeutic components and ingredients of the intervention. Online social networks can be further leveraged to engage young people with therapeutic content to ensure treatment effects are maintained and to create virtuous cycles between all intervention components to maintain engagement.
Trial RegistrationAustralian New Zealand Clinical Trials Registry: ACTRN12614000009617; https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12614000009617 |
| first_indexed | 2024-03-12T12:39:39Z |
| format | Article |
| id | doaj.art-bd0009b0b1fe483d8bf6607666e85d06 |
| institution | Directory Open Access Journal |
| issn | 2368-7959 |
| language | English |
| last_indexed | 2024-03-12T12:39:39Z |
| publishDate | 2023-05-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Mental Health |
| spelling | doaj.art-bd0009b0b1fe483d8bf6607666e85d062023-08-28T23:57:43ZengJMIR PublicationsJMIR Mental Health2368-79592023-05-0110e4481210.2196/44812Understanding What Drives Long-term Engagement in Digital Mental Health Interventions: Secondary Causal Analysis of the Relationship Between Social Networking and Therapy EngagementShaunagh O'Sullivanhttps://orcid.org/0000-0002-5234-5727Niels van Berkelhttps://orcid.org/0000-0001-5106-7692Vassilis Kostakoshttps://orcid.org/0000-0003-2804-6038Lianne Schmaalhttps://orcid.org/0000-0001-9822-048XSimon D'Alfonsohttps://orcid.org/0000-0001-7407-8730Lee Valentinehttps://orcid.org/0000-0001-7481-6537Sarah Bendallhttps://orcid.org/0000-0003-1486-6190Barnaby Nelsonhttps://orcid.org/0000-0002-6263-2332John F Gleesonhttps://orcid.org/0000-0001-7969-492XMario Alvarez-Jimenezhttps://orcid.org/0000-0002-3535-9086 BackgroundLow engagement rates with digital mental health interventions are a major challenge in the field. Multicomponent digital interventions aim to improve engagement by adding components such as social networks. Although social networks may be engaging, they may not be sufficient to improve clinical outcomes or lead users to engage with key therapeutic components. Therefore, we need to understand what components drive engagement with digital mental health interventions overall and what drives engagement with key therapeutic components. ObjectiveHoryzons was an 18-month digital mental health intervention for young people recovering from first-episode psychosis, incorporating therapeutic content and a private social network. However, it is unclear whether use of the social network leads to subsequent use of therapeutic content or vice versa. This study aimed to determine the causal relationship between the social networking and therapeutic components of Horyzons. MethodsParticipants comprised 82 young people (16-27 years) recovering from first-episode psychosis. Multiple convergent cross mapping was used to test causality, as a secondary analysis of the Horyzons intervention. Multiple convergent cross mapping tested the direction of the relationship between each pair of social and therapeutic system usage variables on Horyzons, using longitudinal usage data. ResultsResults indicated that the social networking aspects of Horyzons were most engaging. Posting on the social network drove engagement with all therapeutic components (r=0.06-0.36). Reacting to social network posts drove engagement with all therapeutic components (r=0.39-0.65). Commenting on social network posts drove engagement with most therapeutic components (r=0.11-0.18). Liking social network posts drove engagement with most therapeutic components (r=0.09-0.17). However, starting a therapy pathway led to commenting on social network posts (r=0.05) and liking social network posts (r=0.06), and completing a therapy action led to commenting on social network posts (r=0.14) and liking social network posts (r=0.15). ConclusionsThe online social network was a key driver of long-term engagement with the Horyzons intervention and fostered engagement with key therapeutic components and ingredients of the intervention. Online social networks can be further leveraged to engage young people with therapeutic content to ensure treatment effects are maintained and to create virtuous cycles between all intervention components to maintain engagement. Trial RegistrationAustralian New Zealand Clinical Trials Registry: ACTRN12614000009617; https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12614000009617https://mental.jmir.org/2023/1/e44812 |
| spellingShingle | Shaunagh O'Sullivan Niels van Berkel Vassilis Kostakos Lianne Schmaal Simon D'Alfonso Lee Valentine Sarah Bendall Barnaby Nelson John F Gleeson Mario Alvarez-Jimenez Understanding What Drives Long-term Engagement in Digital Mental Health Interventions: Secondary Causal Analysis of the Relationship Between Social Networking and Therapy Engagement JMIR Mental Health |
| title | Understanding What Drives Long-term Engagement in Digital Mental Health Interventions: Secondary Causal Analysis of the Relationship Between Social Networking and Therapy Engagement |
| title_full | Understanding What Drives Long-term Engagement in Digital Mental Health Interventions: Secondary Causal Analysis of the Relationship Between Social Networking and Therapy Engagement |
| title_fullStr | Understanding What Drives Long-term Engagement in Digital Mental Health Interventions: Secondary Causal Analysis of the Relationship Between Social Networking and Therapy Engagement |
| title_full_unstemmed | Understanding What Drives Long-term Engagement in Digital Mental Health Interventions: Secondary Causal Analysis of the Relationship Between Social Networking and Therapy Engagement |
| title_short | Understanding What Drives Long-term Engagement in Digital Mental Health Interventions: Secondary Causal Analysis of the Relationship Between Social Networking and Therapy Engagement |
| title_sort | understanding what drives long term engagement in digital mental health interventions secondary causal analysis of the relationship between social networking and therapy engagement |
| url | https://mental.jmir.org/2023/1/e44812 |
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