Accepted for/Published in: JMIR Mental Health
Date Submitted: Feb 15, 2024
Date Accepted: Jun 21, 2024
Evaluation of Digital Mental Health Technologies in the United States: A Systematic Literature Review and Framework Synthesis
ABSTRACT
Background:
Digital mental health technologies (DMHT) have the potential to enhance mental healthcare delivery. However, there is little information on how DMHT are evaluated and what factors influence their use.
Objective:
A systematic literature review was conducted to understand how DMHT are valued in the United States (US) from user, payer, and employer perspectives.
Methods:
Articles published after 2017 were identified from MEDLINE, Embase, PsycInfo, Cochrane Library, the Health Technology Assessment Database, and digital and mental health congresses. Each article was evaluated by two independent reviewers to identify US studies reporting on factors considered in the evaluation of DMHT targeting mental health, Alzheimer’s, epilepsy, autism spectrum disorder, or attention deficit hyperactive disorder. Study quality was assessed using the Critical Appraisal Skills Program Qualitative and Cohort Studies checklists. Studies were coded and indexed using the American Psychiatric Association’s Mental Health App Evaluation Framework to extract and synthesize relevant information.
Results:
Of 4,353 articles screened, data from 26 unique studies from patient, caregiver, and healthcare provider perspectives were included. Engagement style was the most reported theme (n=23 studies), with users valuing DMHT usability, particularly alignment with therapeutic goals through features including anxiety management tools. Key barriers to DMHT use included limited internet access, poor technical literacy, and privacy concerns. Novel findings included discreetness of DMHT to avoid stigma.
Conclusions:
Usability, cost, accessibility, technical considerations, and alignment with therapeutic goals are important to users, although DMHT valuation varies across individuals. DMHT apps should be developed and selected with specific user needs in mind.
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