Background: Digital mental health interventions (DMHI) hold promise for addressing mental health needs on a large scale. Among these interventions, Internet-based Cognitive Behavioral Therapy (iCBT) has proven effective in tackling various mental health issues. However, the effectiveness of these interventions is hindered by a lack of sustained user engagement. A lack of knowledge on what specific iCBT content is the most engaging and the absence of a standardized approach to measure engagement hampers progress in this area. Aim: To conduct an evaluation of engagement based on usage data to learn which and what kind of iCBT content from a self-tailored blended iCBT application is the most engaging in order to inform strategies and enhance efforts to improve the overall effectiveness of the intervention. Methods: An observational, quantitative study of real-world usage data was conducted to evaluate engagement levels across various iCBT modules available in the app. Four engagement metrics were obtained from the users´ usage data: Adherence Rate, Rate of Max. Progress, Return Rate, and Average Time Spent to create rank and compare engagement levels across the iCBT modules. Results: The results included data from the 1st of January to the 30th of April of 2023 for 138 iCBT modules. The mean engagement score for all iCBT modules was 56.41±9.85, with a median of 57.30 and a range of 67.97. The most engaging iCBT modules were “Thought traps and questioning thoughts” (81.4), “A model for social anxiety” (80.5), and “Safety Behaviors” (78.1). The most engaging iCBT module classifications were “Social phobia” (92.10), “Depressive disorder” (80.70), and “Post-traumatic stress disorder” (80.40). Conclusions: Based on real-world usage data of patients, it was possible to determine the extent to which users engaged with different iCBT modules comprehensively. The findings shed light on the strengths and weaknesses of the iCBT modules regarding engagement levels. The quantitative evaluation of “in the wild” patient usage data proved useful for assessing engagement levels of specific content within the app.

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13571号 / 論医博第2297号 / 新制||医||1069(附属図書館) / (主査)教授 川上 浩司, 教授 渡邉 大, 教授 村井 俊哉 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

This study uses data from HopeWorks, a Christian, faith-based vocational program inside the Shelby County Division of Corrections in Memphis, Tennessee, to examine factors affecting reentry success. Specifically, this research examines how spirituality - using measures that assess both spirituality (measured at the end of the program) and change in spirituality (measured as the difference between pre- and post-program measures of spirituality) - affects released offenders' reengagement with the program, ability to obtain employment, and ability to refrain from reoffending.

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Childhood anxiety disorders are often considered gateway disorders: having an anxiety disorder in youth is associated with a higher likelihood of developing a related psychological disorder in adulthood. Successfully treating youth with anxiety disorders may reduce the likelihood of subsequent anxiety, depressive, and substance use disorders later in life. This study evaluates follow-up outcomes associated with treatment for childhood anxiety by comparing successfully and unsuccessfully treated participants 16 years after the completion of treatment. A sample of 66 youth (ages 7 to 14 at time of initial study treatment, ages 18 to 32 at present follow-up) who had been diagnosed with an anxiety disorder and randomized to treatment in a randomized clinical trial on average 16.24 (SD = 3.56) years prior participated in the present follow-up evaluation that included self-report measures and a diagnostic interview conducted to assess anxiety, depression, and substance misuse. Results indicate that, relative to those who respond successfully to CBT intervention for an anxiety disorder in childhood, those who were less responsive to CBT for childhood anxiety had higher rates of panic disorder, alcohol dependence, and drug abuse in adulthood. The present study is the first to assess the 16-year follow-up effects of CBT treatment for an anxiety disorder in youth on anxiety, depression, and substance abuse through the period of young adulthood when these disorders are often seen. / Psychology