Engagement with Digital Behaviour Change Interventions (DBCIs) for Anxiety and Depression: A Systematic Review

  • Tsakanikos, Elias (PI)

Project Details


Rationale: High participant attrition in research investigating the efficacy of digital behaviour change interventions (DBCIs) for anxiety and depression is a very challenging issue, largely due to the nature of the symptoms. Although multidimensional conceptualisations of engagement with DBCIs have been previously proposed, further work is needed to address the specific challenges in DBCIs designed for anxiety and depression.

Aims: We aimed to systematically review studies that investigated DBCIs for depression and anxiety in order to (a) identify predictors of engagement and (b) evaluate these features in terms of their contribution to clinical change.

Methods: A systematic review according to PROSPERO and preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) guidelines was conducted. Decision making endpoints included adherence and attrition rates; effect sizes (Cohens d) and validated depression and anxiety scales.

Key findings

Results: 19 studies (total N = 7,380) met the inclusion criteria and examined to identify the features that are most likely to promote engagement. Conclusion: A number of specific and non-specific factors predicting digital engagement were identified supporting the need for specific models of engagement with DBCIs designed for anxiety and depression. These factors should be considered carefully in future apps aimed at preventing and supporting health and wellbeing. Technical implications and proposed R & D areas are discussed.
Short titleDigital engagement
Effective start/end date17/03/1917/06/19