The definition and measurement of engagement and adherence for digital mental health interventions
An umbrella review
Bibliographic Data
| ID | 21452499 |
|---|---|
| Authors | Lyen Krenz Yap (0000-0003-2791-6644, University of Ulster, corresponding author), Edel Ennis (0000-0002-9677-0725, University of Ulster), Maurice Mulvenna (0000-0002-1554-0785, University of Ulster), Jorge Martínez Carracedo (0000-0001-8017-2598, University of Ulster) |
| Year | 2026 |
| Pages | 1-20 |
| Publication date | 2026-07-04 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Behaviour and Information Technology (JOURNAL) |
| Journal identifiers | ISSN: 0144-929X • E-ISSN: 1362-3001 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/0144929x.2026.2696826 |
| OpenAlex | W7167355440 |
| Language | EN |
| References cited | 94 |
Digital Mental Health Interventions (DMHIs) are scalable and accessible, but low engagement and adherence limit their effectiveness. Varying definitions and measures of engagement and adherence hinder effective evaluation and comparison. This umbrella review synthesised 61 systematic reviews, meta-analyses, and scoping reviews, which focused on DMHIs and provided a definition or measurement of engagement and/or adherence. Inclusion and exclusion were guided by PICOS, with record counts reported in the PRISMA flowchart. Results showed that adherence and engagement were often undefined. When defined, engagement was most often combined with adherence or described as extent of programme usage, with completion metrics and usage metrics being the two most common measurements. When defined, adherence was most often described as programme/module/session completion or combined with engagement, with completion metrics or a combination of completion and usage metrics being the two most common measurements. Factors influencing engagement and adherence clustered into three themes: (i) participant level factors (e.g. demographic variables), (ii) technology level factors (e.g. privacy concerns), and (iii) programme level factors (e.g. perceived usefulness of the DMHI). Results are discussed in terms of how engagement and adherence to DMHIs are defined, measured, and promoted, highlighting priorities, challenges and recommended practices
Digital health · eHealth · MEDLINE · Mental health · mHealth · Psychological intervention · Qualitative research · Digital Mental Health Interventions · Impact of Technology on Adolescents · Mental Health and Patient Involvement
Updating guidance for reporting systematic reviews
Barriers to and Facilitators of User Engagement With Digital Mental Health Interventions
The Role of Telehealth in Reducing the Mental Health Burden from Covid-19
The PRISMA 2020 statement
Synthesizing Qualitative Research
Longitudinal Patterns of Engagement and Clinical Outcomes
Digital interventions for the treatment of depression
Day Stress Detox
Social Work Literature Searching
Engagement in digital interventions
| Citation velocity | historical |
|---|---|
| Highly cited | No |