Engagement With a Remote Symptom-Tracking Platform Among Participants With Major Depressive Disorder: Randomized...

Area of Science:

• Digital Health
• Mental Health Technology
• Clinical Research Methodologies

Background:

• Multiparametric remote measurement technologies (RMTs) using smartphones and wearables show promise for understanding major depressive disorder (MDD).
• Effective engagement with RMTs is crucial for research validity and long-term use, encompassing both objective data availability and subjective user experience.
• The Behavior Change Wheel framework can guide the design of user interfaces to maximize RMT engagement.

Purpose of the Study:

• To evaluate if an adapted RMT system, featuring theoretically informed notifications, progress tracking, and support access, enhances engagement in remote symptom monitoring for MDD.
• To test the hypothesis that participants using the adapted app would demonstrate higher objective and subjective engagement in symptom monitoring compared to standard care.

Main Methods:

• A 12-week, 2-arm randomized controlled trial involving 100 participants with MDD.
• Participants used the RADAR-base system (smartphone app and wearable Fitbit); the intervention group received additional in-app components.
• Objective engagement (weekly questionnaire completion) and subjective engagement (system usability, user engagement, emotional self-awareness) were primary and secondary outcomes, respectively.

Main Results:

• No significant difference in objective engagement (questionnaire completion rates) was observed between the intervention and control groups (68% vs. 69%).
• While the intervention group reported slightly higher scores for user engagement, emotional self-awareness, and system usability, these differences were not statistically significant.
• Process evaluation indicated participants found the in-app components helpful for task completion, despite the lack of significant impact on overall engagement metrics.

Conclusions:

• The adapted RMT system did not significantly improve objective or subjective engagement in remote symptom tracking among individuals with MDD in this study.
• This research provides valuable insights into RMT engagement and methodologies for future replication in community and clinical settings.
• Understanding and optimizing user engagement remains a critical factor for the successful implementation of RMTs in mental health research.