University of Twente Student Theses


The Role of Personalization and Engagement in Digital Health Interventions for Depression

Vögeding, Kai (2022) The Role of Personalization and Engagement in Digital Health Interventions for Depression.

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Abstract:Background. Due to different reasons, people with mental problems encounter difficulties in seeking sufficient help. The healthcare system cannot serve the demand for mental health treatment. Compared to traditional treatment, technologies like Digital Health Interventions (DHIs) have advantages that may help to regulate these difficulties. Research has shown that DHIs are effective in treating health problems. However, a low level of engagement was found to be the main barrier to reaching the desired effects. This study aimed to investigate the influence of personalization of DHIs on the engagement outcome scores as well as the depression outcome scores. A mediation model was used to determine the mediating role of engagement in the relationship between personalization and depression outcome scores. Methods. The final sample size consisted of 176 participants who participated in a 14-day mobile (digital) health intervention (TIIM App) with daily tasks based on evidence-based treatment approaches such as positive psychology. Participants were randomly assigned to the experimental or control group. A personalization approach was used to determine the best matching version of the intervention for the participants within the experimental group. Personalization was conducted through three interventions and technological factors (ITFS) namely content, feedback, and design. Independent sample t-tests and repeated measure ANOVA were used to determine the main effects of personalization on both engagement and depression. A mediation analysis was performed to test whether engagement mediated the relation between personalization and depression. Results. A main effect for time on change in depression scores was found (Wilks lambda = .908 F(1,173) =17.56, p < .001). No significant differences between the conditions experimental group (with personalization) and the control group (no personalization) were found in the outcome measures of depression and engagement. In addition, no mediating effect of engagement has been found for the relationship between personalization and engagement. Within the mediation analysis, a negatively significant effect was found for the relationship between engagement and depression (B = -.23, SE= .04, p= <.01). Conclusion. The non-significant results found in this study were quite surprising and not expected. The negative relation between engagement and depression scores could be interpreted in two different ways. However, these results were expected and confirmed the hypothesis. Future research is recommended to improve the overall design and quality of the intervention as well as the personalization procedure. Moreover, besides personalization, other factors should be considered regarding their influence on engagement and personalization.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:02 science and culture in general, 10 humanities in general, 44 medicine, 70 social sciences in general, 77 psychology
Programme:Psychology MSc (66604)
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