Dynamic Indicators of Adherence and Retention in Adults Using a Digital Mental Health App: Longitudinal Observational Analysis From the Brighten Study

作者：Dylan Hamitouche, Youcef Barkat, Deven Parekh, Eva Hammer, David Benrimoh · 发表于：JMIR Human Factors · 年份：2025 · DOI：10.2196/69464 · 被引用次数：1 · 研究领域：Digital Mental Health Interventions、Mental Health via Writing、Mobile Health and mHealth Applications

Background: Making optimal use of mobile health technologies requires the validation of digital biomarkers, which in turn demands high levels of participant adherence and retention. However, current remote digital health studies have high attrition rates and low participant adherence, which may introduce bias and limit the generalizability of their findings. Objective: This study aimed to identify longitudinal indicators of participant retention and adherence, which may serve to develop strategies to improve data collection in digital health studies and improve understanding of how study cohorts are shaped by participant withdrawal and nonadherence. Methods: We performed secondary analyses on the Brighten study, which consisted of 2 remote, smartphone-based randomized controlled trials evaluating mobile apps for depression treatment, enrolling 2193 participants in total. Participants were asked, after baseline assessment, to complete 7 digital questionnaires regularly. We assessed adherence to digital questionnaires, engagement (postbaseline participation), and retention rates (the proportion of participants who continued completing questionnaires over time) as outcomes. We investigated the relationship between these outcomes and both static measures (eg, demographics and average questionnaire scores) and dynamic measures (eg, changes in questionnaire scores over time). Results: The study included 2201 participants, of whom 1093 completed at least 1 nonbaseline questionnaire,...