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. 2023 Sep 6:7:e49384.
doi: 10.2196/49384.

Satisfaction, Perceived Usefulness, and Therapeutic Alliance as Correlates of Participant Engagement in a Pediatric Digital Mental Health Intervention: Cross-Sectional Questionnaire Study

Landry Huffman  1 , Darian Lawrence-Sidebottom  1 , Jennifer Huberty  1   2 , Clare Beatty  2 , Monika Roots  1 , Kurt Roots  1 , Amit Parikh  1 , Rachael Guerra  1
Affiliations

Satisfaction, Perceived Usefulness, and Therapeutic Alliance as Correlates of Participant Engagement in a Pediatric Digital Mental Health Intervention: Cross-Sectional Questionnaire Study

Landry Huffman et al. JMIR Form Res. .

Abstract

Background: Although evidence suggests that digital mental health interventions (DMHIs) are effective alternatives to traditional mental health care, participant engagement continues to be an issue, especially for pediatric DMHIs. Extant studies of DMHIs among adults suggest that participants' satisfaction, perceived usefulness, and therapeutic alliance are closely tied to engagement. However, these associations have not been investigated among children and adolescents involved in DMHIs.

Objective: To address these gaps in extant DMHI research, the purpose of this study was to (1) develop and implement a measure to assess satisfaction, perceived usefulness, and therapeutic alliance among children and adolescents participating in a DMHI and (2) investigate satisfaction, perceived usefulness, and therapeutic alliance as correlates of children's and adolescents' engagement in the DMHI.

Methods: Members (children and adolescents) of a pediatric DMHI who had completed at least one session with a care provider (eg, coach or therapist) were eligible for inclusion in the study. Adolescent members and caregivers of children completed a survey assessing satisfaction with service, perceived usefulness of care, and therapeutic alliance with care team members.

Results: This study provides evidence for the reliability and validity of an adolescent- and caregiver-reported user experience assessment in a pediatric DMHI. Moreover, our findings suggest that adolescents' and caregivers' satisfaction and perceived usefulness are salient correlates of youths' engagement with a DMHI.

Conclusions: This study provides valuable preliminary evidence that caregivers' satisfaction and perceived usefulness are salient correlates of youths' engagement with a DMHI. Although further research is required, these findings offer preliminary evidence that caregivers play a critical role in effectively increasing engagement among children and adolescents involved in DMHIs.

Keywords: adolescent; child; children; coach; coaching; collaborative care; digital mental health intervention; engagement; internet-based coaching; internet-based therapy; mental health; patient-provider; perceived usefulness; satisfaction; service satisfaction; youth.

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Conflict of interest statement

Conflicts of Interest: All authors are employed or contracted with Bend Health, Inc, which delivered the treatment used in this retrospective study. However, authors’ employment status and salary are not dependent upon the results of their research.

Figures

Figure 1
Figure 1
Satisfaction latent factor model (model parameters=14). Model fit is satisfactory (χ214=42.7; P<.001; comparative fit index [CFI]=0.936; Tucker-Lewis index [TLI]=0.904; standardized root mean square residual [SRMR]=0.039). ***P<.001. Of note, items are abbreviated in the figure, and when necessary, include only the adolescent version. Table S1 in Multimedia Appendix 1 presents the full items.
Figure 2
Figure 2
Perceived usefulness latent factor model (model parameters=16). Model fit is satisfactory (χ220=25.1; P=.19; comparative fit index [CFI]=0.990; Tucker-Lewis index [TLI]=0.987; standardized root mean square residual [SRMR]=0.026). ***P<.001. Of note, items are abbreviated in the figure, and when necessary, include only the adolescent version. Table S1 in Multimedia Appendix 1 presents the full items.
Figure 3
Figure 3
Alliance latent factor model (model parameters=8). Model fit is satisfactory (χ22=1.6; P=.44; comparative fit index [CFI]=1.000; Tucker-Lewis index [TLI]=1.004; standardized root mean square residual [SRMR]=0.010). ***P<.001. Of note, items are abbreviated in the figure, and when necessary, include only the adolescent version. Table S1 in Multimedia Appendix 1 presents the full items.
Figure 4
Figure 4
Correlation between satisfaction and total coaching and therapy sessions.
Figure 5
Figure 5
Correlation between perceived usefulness and total coaching and therapy sessions.
See this image and copyright information in PMC

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