University of Twente Student Theses


The Mediating Role of Digital Health Intervention (DHI) Engagement in the Relationship between Feedback Variations and Mental Well-Being

Wehrmeyer, Simon (2021) The Mediating Role of Digital Health Intervention (DHI) Engagement in the Relationship between Feedback Variations and Mental Well-Being.

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Abstract:Background and Objective. In recent years, technological developments and limited resources to meet a global increase in demand for mental healthcare, have led to the emergence of accessible digital mental health interventions (DHIs). Despite consistent reports of effectiveness, disengagement remains the main barricade for successful eMental Health (eMH) implementation. A new personalization approach aims at testing DHI engagement as an underlying mechanism responsible for the relationship between intervention and technological factors (ITFs), such as feedback variations and intervention effectiveness. This study aimed to investigate a mediation role of DHI engagement in the relationship between feedback categories as ITFs and mental well-being as an outcome measure for intervention effectiveness in a 14-day mobile intervention. Methods. In a pretest-posttest study design, ‘The Incredible Intervention Machine’ (TIIM) application was used to collect quantitative data from 153 participants with a mean age of 21.76 (SDage =5.78). Participants were randomly assigned to either an in-text-only feedback condition (n=48), an in-text with a picture of an avatar condition (n=57), or a pre-recorded video of a counselor condition (n=48). DHI engagement scores were retrieved at three measurement points (T1-T3) throughout the intervention. The main effect of time was analyzed by performing an ANOVA comparing the three conditions and testing effect sizes using Cohen’s d. Besides, simple mediation analyses were conducted to test mediation for DHI engagement on posttest mental well-being and well-being change scores. Results. The analyses showed that total mental well-being increased significantly between pretest and posttest. No statistically significant differences between feedback conditions were found in predicting the outcome measures. Feedback variations themselves were not found to have an impact on DHI engagement and total mental well-being, thus a mediation effect of DHI engagement could not be established. Nonetheless, DHI engagement was found to be a predictor of mental well-being. Conclusion. DHI engagement is a promising predictor for eMental health intervention effectiveness. Further testing needs to be conducted to investigate DHI engagement as a mediator. To prepare the mediation model, future research is recommended to improve the relationship between ITFs and intervention effectiveness by a multidirectional personalization approach.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
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