A study entitled ‘User engagement in mobile apps for people with schizophrenia: A scoping review’ has been published in Frontiers, aiming to better understand the factors and strategies that may encourage user engagement and facilitate extended use of apps for people living with schizophrenia.
Authors Raquel Simões de Almeida and António Marques sought to examine what influences user engagement and how to measure it in order to design mobile apps and deliver scalable solutions.
A scoping review was conducted and consisted of searching four electronic databases for chosen keywords based around schizophrenia, self-help and apps. Following this process, 27 papers from 2012 to 2022 were selected for use in the study; the majority originated from the UK, with others from Canada, Australia, Denmark, Poland, Portugal, The Netherlands and Spain.
Downloading the apps referenced in the papers was integrated into the process, with the researchers noting that it “is important to comprehend how to enhance all the ways users interact with the apps, from buttons they click to time spent with the app open”.
The study found that almost every app uses push notifications or prompts, with frequency of notifications “usually at least daily”. Personalisation and customisation was a strategy used in ten studies. Another common strategy, present in six of the studies, is goal-setting. Some studies included game-like features such as points, challenges and badges, or the use of different multimedia formats.
The researchers commented that benefits to long-term engagement may occur using real-time data monitoring and passive monitoring, whilst peer-to-peer communication, access to professionals, reliability of content and quality of feedback were also important strategies used to improve user engagement in the identified studies.
With regards to factors that influence engagement, age, illness severity and technical support were highlighted as the factors that “constantly arise”. Other identified factors include gender, education level and socioeconomic status; issues around data privacy and security were also raised, along with integration with other medical record systems. An additional factor is how well the app fits into users’ routines, along with whether the use is encouraged by clinicians or based on evidence.
“There are also some putative factors which could influence engagement as well, such as whether patients were involved in the app design process, incentives for participation, etc,” the researchers wrote. They commented that most of the apps included user involvement at some stage in the development process and added: “Any engagement strategies used should consider the need for initial training for using the app (including training sessions, smooth onboarding, possibility to ask questions and contact a support team to manage any technical difficulties) since some users could lack digital literacy/fluency.”
The researchers added that it is important to consider that user motivation to use mental health apps may decline over time.
“Future work should continue to explore innovative intervention strategies by which apps can support mental health in ways that appeal to people with schizophrenia,” the researchers conclude, “since a key component of the effectiveness of mental health apps is user engagement.”
Citation: Simões de Almeida R and Marques A (2023) User engagement in mobile apps for people with schizophrenia: A scoping review. Front. Digit. Health 4:1023592. doi: 10.3389/fdgth.2022.1023592
