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Patterns of engagement in a digital mental health service during COVID-19: a cohort study for children and young people

Aynsley Bernard, Santiago de Ossorno Garcia, Louisa Salhi, Ann John Orcid Logo, Marcos del Pozo Banos Orcid Logo

Frontiers in Psychiatry, Volume: 14

Swansea University Authors: Ann John Orcid Logo, Marcos del Pozo Banos Orcid Logo

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DOI (Published version): 10.3389/fpsyt.2023.1143272

Abstract

Introduction: The COVID-19 pandemic increased public use of digital mental health technologies. However, little is known about changes in user engagement with these platforms during the pandemic. This study aims to assess engagement changes with a digital mental healthcare service during COVID-19. M...

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Published in: Frontiers in Psychiatry
ISSN: 1664-0640
Published: Frontiers Media SA 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa63779
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However, little is known about changes in user engagement with these platforms during the pandemic. This study aims to assess engagement changes with a digital mental healthcare service during COVID-19. Methods: A cohort study based on routinely collected service usage data from a digital mental health support service in the United Kingdom. Returning users aged 14-25 years that interacted for a maximum of two months were included. The study population was divided into pre-COVID and COVID cohorts. Demographic and usage information between cohorts were compared and usage clusters were identified within each cohort. Differences were tested using Chi-squared, two-sample Kolmogorov-Smirnov tests and logit regressions. Results: Of the 624,103 users who joined the service between May 1, 2019, and October 1, 2021, 18,889 (32.81%) met the inclusion criteria: 5,048 in the pre-COVID cohort and 13,841 in the COVID cohort. The COVID cohort wrote more journals; maintained the same focus on messaging practitioners, posting discussions, commenting on posts, and having booked chats; and engaged less in writing journals, setting personal goals, posting articles, and having ad-hoc chats. Four usage profiles were identified in both cohorts: one relatively disengaged, one focused on contacting practitioners through chats/messages, and two broadly interested in writing discussions and comments within the digital community. Despite their broad similarities, usage patterns also exhibited differences between cohorts. For example, all four clusters had over 70% of users attempting to have ad-hoc chats with practitioners in the pre-COVID cohort, compared to one out of four clusters in the COVID cohort. Overall, engagement change patterns during the COVID-19 pandemic were not equal across clusters. Sensitivity analysis revealed varying strength of these defined clusters. Discussion: Our study identified changes in user activity and engagement behavior within a digital mental healthcare service during the COVID-19 pandemic. These findings suggest that usage patterns within digital mental health services may be susceptible to change in response to external events such as a pandemic. Continuous monitoring of engagement patterns is important for informed design and personalized interventions.</abstract><type>Journal Article</type><journal>Frontiers in Psychiatry</journal><volume>14</volume><journalNumber/><paginationStart/><paginationEnd/><publisher>Frontiers Media SA</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1664-0640</issnElectronic><keywords>COVID-19, pandemic, engagement, digital mental health, mental health, children and young people, machine learning, clustering</keywords><publishedDay>27</publishedDay><publishedMonth>7</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-07-27</publishedDate><doi>10.3389/fpsyt.2023.1143272</doi><url>http://dx.doi.org/10.3389/fpsyt.2023.1143272</url><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>AB, SDOG, and LS are employed and receive honorarium by Kooth plc. 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AJ and MDPB were also funded by UKRI – Medical Research Council through the DATAMIND Hub (MRC reference: MR/W014386/1).</funders><projectreference/><lastEdited>2024-01-08T13:48:39.4647942</lastEdited><Created>2023-07-05T15:01:29.2246895</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Aynsley</firstname><surname>Bernard</surname><order>1</order></author><author><firstname>Santiago de Ossorno</firstname><surname>Garcia</surname><order>2</order></author><author><firstname>Louisa</firstname><surname>Salhi</surname><order>3</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>4</order></author><author><firstname>Marcos</firstname><surname>del Pozo Banos</surname><orcid>0000-0003-1502-389X</orcid><order>5</order></author></authors><documents><document><filename>63779__28280__9c250e7118704d689964d0867fe6b2b7.pdf</filename><originalFilename>63779.VOR.pdf</originalFilename><uploaded>2023-08-09T11:15:49.7181580</uploaded><type>Output</type><contentLength>1097116</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© 2023 Bernard, de Ossorno Garcia, Salhi, John and DelPozo-Banos. 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spelling v2 63779 2023-07-05 Patterns of engagement in a digital mental health service during COVID-19: a cohort study for children and young people ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false f141785b1c0ab9efe45665d35c081b84 0000-0003-1502-389X Marcos del Pozo Banos Marcos del Pozo Banos true false 2023-07-05 HDAT Introduction: The COVID-19 pandemic increased public use of digital mental health technologies. However, little is known about changes in user engagement with these platforms during the pandemic. This study aims to assess engagement changes with a digital mental healthcare service during COVID-19. Methods: A cohort study based on routinely collected service usage data from a digital mental health support service in the United Kingdom. Returning users aged 14-25 years that interacted for a maximum of two months were included. The study population was divided into pre-COVID and COVID cohorts. Demographic and usage information between cohorts were compared and usage clusters were identified within each cohort. Differences were tested using Chi-squared, two-sample Kolmogorov-Smirnov tests and logit regressions. Results: Of the 624,103 users who joined the service between May 1, 2019, and October 1, 2021, 18,889 (32.81%) met the inclusion criteria: 5,048 in the pre-COVID cohort and 13,841 in the COVID cohort. The COVID cohort wrote more journals; maintained the same focus on messaging practitioners, posting discussions, commenting on posts, and having booked chats; and engaged less in writing journals, setting personal goals, posting articles, and having ad-hoc chats. Four usage profiles were identified in both cohorts: one relatively disengaged, one focused on contacting practitioners through chats/messages, and two broadly interested in writing discussions and comments within the digital community. Despite their broad similarities, usage patterns also exhibited differences between cohorts. For example, all four clusters had over 70% of users attempting to have ad-hoc chats with practitioners in the pre-COVID cohort, compared to one out of four clusters in the COVID cohort. Overall, engagement change patterns during the COVID-19 pandemic were not equal across clusters. Sensitivity analysis revealed varying strength of these defined clusters. Discussion: Our study identified changes in user activity and engagement behavior within a digital mental healthcare service during the COVID-19 pandemic. These findings suggest that usage patterns within digital mental health services may be susceptible to change in response to external events such as a pandemic. Continuous monitoring of engagement patterns is important for informed design and personalized interventions. Journal Article Frontiers in Psychiatry 14 Frontiers Media SA 1664-0640 COVID-19, pandemic, engagement, digital mental health, mental health, children and young people, machine learning, clustering 27 7 2023 2023-07-27 10.3389/fpsyt.2023.1143272 http://dx.doi.org/10.3389/fpsyt.2023.1143272 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University Another institution paid the OA fee AB, SDOG, and LS are employed and receive honorarium by Kooth plc. MDPB was funded by Kooth plc. AJ and MDPB were also funded by UKRI – Medical Research Council through the DATAMIND Hub (MRC reference: MR/W014386/1). 2024-01-08T13:48:39.4647942 2023-07-05T15:01:29.2246895 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Aynsley Bernard 1 Santiago de Ossorno Garcia 2 Louisa Salhi 3 Ann John 0000-0002-5657-6995 4 Marcos del Pozo Banos 0000-0003-1502-389X 5 63779__28280__9c250e7118704d689964d0867fe6b2b7.pdf 63779.VOR.pdf 2023-08-09T11:15:49.7181580 Output 1097116 application/pdf Version of Record true © 2023 Bernard, de Ossorno Garcia, Salhi, John and DelPozo-Banos. Distributed under the terms of a Creative Commons Attribution 4.0 License (CC BY 4.0). true eng https://creativecommons.org/licenses/by/4.0/
title Patterns of engagement in a digital mental health service during COVID-19: a cohort study for children and young people
spellingShingle Patterns of engagement in a digital mental health service during COVID-19: a cohort study for children and young people
Ann John
Marcos del Pozo Banos
title_short Patterns of engagement in a digital mental health service during COVID-19: a cohort study for children and young people
title_full Patterns of engagement in a digital mental health service during COVID-19: a cohort study for children and young people
title_fullStr Patterns of engagement in a digital mental health service during COVID-19: a cohort study for children and young people
title_full_unstemmed Patterns of engagement in a digital mental health service during COVID-19: a cohort study for children and young people
title_sort Patterns of engagement in a digital mental health service during COVID-19: a cohort study for children and young people
author_id_str_mv ed8a9c37bd7b7235b762d941ef18ee55
f141785b1c0ab9efe45665d35c081b84
author_id_fullname_str_mv ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
f141785b1c0ab9efe45665d35c081b84_***_Marcos del Pozo Banos
author Ann John
Marcos del Pozo Banos
author2 Aynsley Bernard
Santiago de Ossorno Garcia
Louisa Salhi
Ann John
Marcos del Pozo Banos
format Journal article
container_title Frontiers in Psychiatry
container_volume 14
publishDate 2023
institution Swansea University
issn 1664-0640
doi_str_mv 10.3389/fpsyt.2023.1143272
publisher Frontiers Media SA
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
url http://dx.doi.org/10.3389/fpsyt.2023.1143272
document_store_str 1
active_str 0
description Introduction: The COVID-19 pandemic increased public use of digital mental health technologies. However, little is known about changes in user engagement with these platforms during the pandemic. This study aims to assess engagement changes with a digital mental healthcare service during COVID-19. Methods: A cohort study based on routinely collected service usage data from a digital mental health support service in the United Kingdom. Returning users aged 14-25 years that interacted for a maximum of two months were included. The study population was divided into pre-COVID and COVID cohorts. Demographic and usage information between cohorts were compared and usage clusters were identified within each cohort. Differences were tested using Chi-squared, two-sample Kolmogorov-Smirnov tests and logit regressions. Results: Of the 624,103 users who joined the service between May 1, 2019, and October 1, 2021, 18,889 (32.81%) met the inclusion criteria: 5,048 in the pre-COVID cohort and 13,841 in the COVID cohort. The COVID cohort wrote more journals; maintained the same focus on messaging practitioners, posting discussions, commenting on posts, and having booked chats; and engaged less in writing journals, setting personal goals, posting articles, and having ad-hoc chats. Four usage profiles were identified in both cohorts: one relatively disengaged, one focused on contacting practitioners through chats/messages, and two broadly interested in writing discussions and comments within the digital community. Despite their broad similarities, usage patterns also exhibited differences between cohorts. For example, all four clusters had over 70% of users attempting to have ad-hoc chats with practitioners in the pre-COVID cohort, compared to one out of four clusters in the COVID cohort. Overall, engagement change patterns during the COVID-19 pandemic were not equal across clusters. Sensitivity analysis revealed varying strength of these defined clusters. Discussion: Our study identified changes in user activity and engagement behavior within a digital mental healthcare service during the COVID-19 pandemic. These findings suggest that usage patterns within digital mental health services may be susceptible to change in response to external events such as a pandemic. Continuous monitoring of engagement patterns is important for informed design and personalized interventions.
published_date 2023-07-27T13:48:41Z
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