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Evaluation ViewAttendees 5

Technology/Digital Health
Symposia

Symposium 109 - Redefining engagement in digital mental health to center users and improve real world impact

Saturday, November 16, 2024
4:30 PM – 6:00 PM EST
Location: Liberty B, Level 3, Marriott Downtown
CE: 1.5

Keywords: Technology / Mobile Health, Treatment, Transdiagnostic
Level of Familiarity: All
Recommended Readings: Hoffman, V., Flom, M., Mariano, T. Y., Chiauzzi, E., Williams, A., Kirvin-Quamme, A., ... & Perski, O. (2023). User Engagement Clusters of an 8-Week Digital Mental Health Intervention Guided by a Relational Agent (Woebot): Exploratory Study. Journal of Medical Internet Research, 25, e47198.,   Weingarden, H., Calleja, R. G., Greenberg, J. L., Snorrason, I., Matic, A., Quist, R., ... & Wilhelm, S. (2023). Characterizing observed and effective behavioral engagement with smartphone cognitive behavioral therapy for body dysmorphic disorder: A methods roadmap and use case. Internet interventions, 32, 100615.,    Su, L. & Anderson, P.L. (2022). User Behavior of a publicly available, free-to-use, self-guided mHealth app for depression: Observational study in a global sample. Journal of Medical Internet Research: Formative Research, 6(10): e35538. https://doi.org/10.2196/35538 ,   Borghouts, J., Eikey, E., Mark, G., De Leon, C., Schueller, S. M., Schneider, M., ... & Sorkin, D. H. (2021). Barriers to and facilitators of user engagement with digital mental health interventions: systematic review. Journal of medical Internet research, 23(3), e24387.,  

Delivery of cognitive behavioral therapies via smartphone has excellent potential to address America’s mental health treatment gap. Over 85% of the U.S. population owns a smartphone, and ownership rates are similar across racial, ethnic, and sexual minority populations and among adults in outpatient community-based clinics. Thus, the majority of people in need of mental healthcare in the U.S. could access smartphone therapy if the appropriate intervention were available. A growing body of research also shows that smartphone therapy is efficacious for many emotional concerns. As many validated smartphone therapies can be implemented with minimal clinician time, these solutions are highly scalable and could rapidly reach historically excluded communities.

Despite the proliferation and promise of smartphone therapies, these treatments have not yet significantly improved care. One issue is that it remains unclear how people should be using these tools. We know that uptake and retention with digital treatments are problematically low and that some amount of use is necessary for said treatments to yield positive clinical effects. Beyond that, however, the field lacks data-driven guidance for optimal engagement. How often should patients log into an app or communicate with their coach? Do longer, less frequent sessions lead to better outcomes than short, frequent log-ins? Does it matter what content patients come back to or when? Should we nudge patients towards a specific way of using a treatment or support a more self-directed journey? What design or implementation strategies will keep patients coming back? How do we know if a patient is using digital treatment “correctly”?

It is necessary to think beyond early, one-size-fits-all, overly simplified metrics like number of log-ins or minutes spent on an app. It is time to work with patients and real world data to redefine engagement and move us closer to personalized, precision solutions. This symposium brings together multidisciplinary perspectives from researchers, clinicians, and industry leaders to address these critical questions. We will present new research on novel approaches for operationalizing meaningful engagement and using insights to inform treatment design and implementation. Speakers will investigate how to tailor their methods and recommendations for diverse products or populations and center users’ preferences and perspectives to prioritize equity, sustainability, and impact. Audience members will be introduced to multiple types of digital tools (e.g., guided and unguided apps, chatbots) and hear about studies with various populations (e.g., Gen Z, users with diverse gender identities, adults with body image concerns).

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Describe at least three ways to define or measure treatment engagement with digital mental health.
  2. Critically evaluate strengths and weaknesses of at least three approaches to defining and measuring engagement with digital mental health tools.
  3. Explain challenges to enhancing uptake and sustained engagement with digital mental health tools.
  4. Apply principles of behavioral science to explore novel strategies to promote engagement with digital mental health.
  5. Consider ways to ensure inclusivity when operationalizing and implementing engagement metrics.

Presentations:

  • 4:30 PM – 6:00 PM EST
    (SYM 109) Patterns of Engagement with Coaches During Smartphone App-based Cognitive Behavioral Therapy for Body Dysmorphic Disorder: What Users Want and Need

    Speaker: Emily E. Bernstein, Ph.D. (she/her/hers) – Massachusetts General Hospital/Harvard Medical School

    Co-author: Jennifer L. L. Greenberg, Psy.D. – Massachusetts General Hospital/Harvard Medical School

    Co-author: Hilary Weingarden, Ph.D. (she/her/hers) – Massachusetts General Hospital

    Co-author: Ivar Snorrason, PhD (he/him/his) – Massachusetts General Hospital / Harvard Medical School

    Co-author: Berta Summers, PhD (she/her/hers) – Massachusetts General Hospital

    Co-author: Jasmine Williams, B.A. – Massachusetts General Hospital

    Co-author: Rachel E. Quist, B.A. – Massachusetts General Hospital

    Co-author: Joshua Curtiss, M.A., Ph.D. – Northeastern University

    Co-author: Oliver Harrison, MA, MBBS, MPH – Koa Health

    Co-author: Sabine Wilhelm, Ph.D. (she/her/hers) – Harvard Medical School

  • 4:30 PM – 6:00 PM EST
    (SYM 109) Engagement Metrics That Matter: Associations with Clinical and Wellness Outcomes Among Users of an Nlp-informed Relational Agent

    Speaker: Valerie Forman-Hoffman, M.P.H., Ph.D. (she/her/hers) – Woebot Health

    Co-author: Megan Flom, Ph.D. – Woebot Health

    Co-author: Stephanie Eaneff, MSP (she/her/hers) – Woebot Health

    Co-author: Timothy Campellone, PhD (he/him/his) – Woebot Health

    Co-author: timothy Mariano, MD, PhD, MSc, MSIEEE (he/him/his) – Woebot Health

  • 4:30 PM – 6:00 PM EST
    (SYM 109) Engagement in a Full Spectrum Mental Health Platform Offering Mindfulness Content and Virtual Coaching and Therapy

    Speaker: Leah Tanner, M.P.H. (she/her/hers) – Headspace

  • 4:30 PM – 6:00 PM EST
    (SYM 109) Evaluating Our Assumptions: Is Engagement with and Perceived Quality of Mental Health Apps Associated with Improvements in Symptoms and Support?

    Speaker: Page L. Anderson, ABPP (she/her/hers) – Georgia State University

    Co-author: Heather D. Quirk, None – Georgia State University