Increasing Engagement in eHealth Interventions Using Personalization and Implementation Intentions

Approximately one in five adults in the United States have been diagnosed with some form of mental illness, but less than half received treatment in this past year [1]. An interdisciplinary team at the University of Virginia aims to reduce this gap in mental health coverage through its freely accessible online research platform, the MindTrails Project. The MindTrails Calm Thinking study evaluates cognitive bias modification for interpretation (CBM-I), an intervention that aims to reframe the thinking patterns of highly anxious individuals when they respond to ambiguous situations that they might interpret as stressful. MindTrails is experiencing a high attrition (dropout) rate, which is common to eHealth interventions. In response to this, our project utilized two novel approaches to online anxiety interventions to improve engagement and retention: (1) personalization of training content and (2) implementation intentions and goal setting. We designed a prototype for a new mobile interface that engages users with a journal to record implementation intentions and goals. Users also have the ability to choose the domain of anxiety (e.g., relationships, health) that they would like to work on. To further incorporate these psychological principles into the MindTrails program, suggestions for future work are also discussed. We hypothesize that, with its new user-centered mobile interface, the Calm Thinking mobile application will further connect users with an evidence-based mental health intervention and increase the efficacy of the program.