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Investigating the Role of Situational Disruptors in Engagement with Digital Mental Health Tools

Ananya Bhattacharjee, Joseph Jay Williams, Miranda Beltzer, Jonah Meyerhoff, Harsh Kumar, Haochen Song, David C. Mohr, Alex Mariakakis, Rachel Kornfield

TL;DR

This paper reframes engagement with digital mental health (DMH) tools as a function of users' social context rather than solely tool design. Through an eight-week SMS intervention with 20 participants, it identifies situational engagement disruptors (SEDs) arising from academic/work, family, and other life events that derail sustained use. A follow-up series of five design workshops with 25 participants yields actionable design strategies—structured goal-setting to encourage self-care, flexible engagement to accommodate varying availability, and leveraging external resources—to mitigate SEDs. The findings advance HCI/CSCW understanding by foregrounding social-context variables, offering practical design guidelines, and suggesting socio-technical approaches to enhance DMH tool resilience and real-world impact.

Abstract

Challenges in engagement with digital mental health (DMH) tools are commonly addressed through technical enhancements and algorithmic interventions. This paper shifts the focus towards the role of users' broader social context as a significant factor in engagement. Through an eight-week text messaging program aimed at enhancing psychological wellbeing, we recruited 20 participants to help us identify situational engagement disruptors (SEDs), including personal responsibilities, professional obligations, and unexpected health issues. In follow-up design workshops with 25 participants, we explored potential solutions that address such SEDs: prioritizing self-care through structured goal-setting, alternative framings for disengagement, and utilization of external resources. Our findings challenge conventional perspectives on engagement and offer actionable design implications for future DMH tools.

Investigating the Role of Situational Disruptors in Engagement with Digital Mental Health Tools

TL;DR

This paper reframes engagement with digital mental health (DMH) tools as a function of users' social context rather than solely tool design. Through an eight-week SMS intervention with 20 participants, it identifies situational engagement disruptors (SEDs) arising from academic/work, family, and other life events that derail sustained use. A follow-up series of five design workshops with 25 participants yields actionable design strategies—structured goal-setting to encourage self-care, flexible engagement to accommodate varying availability, and leveraging external resources—to mitigate SEDs. The findings advance HCI/CSCW understanding by foregrounding social-context variables, offering practical design guidelines, and suggesting socio-technical approaches to enhance DMH tool resilience and real-world impact.

Abstract

Challenges in engagement with digital mental health (DMH) tools are commonly addressed through technical enhancements and algorithmic interventions. This paper shifts the focus towards the role of users' broader social context as a significant factor in engagement. Through an eight-week text messaging program aimed at enhancing psychological wellbeing, we recruited 20 participants to help us identify situational engagement disruptors (SEDs), including personal responsibilities, professional obligations, and unexpected health issues. In follow-up design workshops with 25 participants, we explored potential solutions that address such SEDs: prioritizing self-care through structured goal-setting, alternative framings for disengagement, and utilization of external resources. Our findings challenge conventional perspectives on engagement and offer actionable design implications for future DMH tools.

Paper Structure

This paper contains 39 sections, 2 figures, 3 tables.

Table of Contents

  1. Introduction
  2. Related Work
  3. Social Context and Individual Challenges as Determinants of Psychological Wellbeing
  4. Text Messaging as a DMH Platform for Promoting Behavior Change and Psychological Wellbeing
  5. Challenges of Sustaining Engagement with DMH Tools
  6. Procedure of Study 1
  7. Participants
  8. Overview of the Text Messaging Program
  9. Data Collection and Procedures
  10. Data Analysis
  11. Ethical Considerations
  12. Findings from Study 1
  13. Disengagement Due to Habituation and Personal Preferences
  14. Broader Social Contexts Underlying Disengagement
  15. Academic and Workplace Responsibilities
  16. ...and 24 more sections

Figures (2)

  • Figure 1: Examples of message dialogues seen by participants in the Small Steps SMS Program: (a) A dialogue showcasing specific psychological strategies and skill-building exercises, (b) illustrative accounts of individuals successfully employing strategies to overcome challenges, and (c) messages designed to prompt self-reflection.
  • Figure 2: Excerpts of text message dialogue flow