Do attitudes towards technology mediate engagement with digital mental health interventions?

Background: Digital Mental Health Interventions (DMHIs), including mHealth apps and serious games, promise to improve mental health outcomes, particularly among vulnerable populations, who have logistic, time and economic difficulties to reach health services or hospitals. However, high dropout rates remain a critical barrier to DMHIs’ success. Previous scientific studies suggest that users’ characteristics and predispositions significantly impact their engagement with DMHIs. Investigating implicit and explicit attitudes towards these technologies could reveal crucial insights into factors influencing user retention and motivation, opening the way for more effective and sustainable mental health solutions. Methods: The present research will focus on mediators of engagement with DMHIs. This work adopts a novel approach, comparing users’ explicit and implicit attitudes towards mental health interventions before and after their use. Implicit attitudes, measured through techniques such as Implicit Association Tests (IAT), will be correlated with explicit self-reports (e.g. the TWente Engagement with eHealth Technologies Scale, TWEETS) and objective engagement data collected pre-, during and post-intervention usage. Objective metrics, including app usage frequency and task completion rates, will be paired with subjective feedback to understand user engagement and attitude towards technological tools for mental health comprehensively. Future Findings: The study will identify key motivational and attitudinal factors influencing engagement with DMHIs. Preliminary analyses of the literature suggest that implicit attitudes could serve as significant predictors of user retention, critically complementing explicit measures of motivation and satisfaction with DMHIs for mental health. These findings will offer valuable insights into tailoring DMHIs to better align with users’ needs and expectations, ultimately reducing dropout rates and enhancing the effectiveness of digital mental health technologies. Discussion: Understanding the mediators of engagement with DMHIs is crucial for their successful implementation. This study aims to test these assumptions, thereby aiding future research in addressing outcomes for populations with unique vulnerabilities and stressors. This research aims to address the current knowledge gap surrounding implicit attitudes' role in predicting user engagement with DMHIs. By examining how biases and preconceptions affect interaction, this approach may reveal how initial attitudes influence long-term commitment to these tools. The outcomes are expected to advance the field of digital mental health by providing actionable insights into improving user retention and optimizing interventions design for general and specific vulnerable populations, they will also underscore the importance of integrating psychological principles into the development of health technologies, contributing to their broader adoption and impact.