ArticleNPJ digital medicine2025
A meta-analysis of persuasive design, engagement, and efficacy in 92 RCTs of mental health apps.
Article in NPJ digital medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed.
- Efficacy of a smartphone app to improve mental health among emergency service workers: A randomised controlled trial.PloS one · 2026Trial
- Supporting mental well-being of healthcare workers using a mobile app: A mixed-methods feasibility study.PloS one · 2026Trial
- Moderated Online Social Therapy (MOST) in Help-Seeking Young People: Pilot Randomized Controlled Study.Journal of medical Internet research · 2025Trial
- Efficacy of a Self-Guided Transdiagnostic Intervention for Adults With Anxiety and Depression: Randomized Controlled Trial.JMIR mHealth and uHealth · 2025Trial
- Impacts of digital third-wave interventions for adults on wellbeing and mental health outcomes: A systematic review and meta-analysis of randomized controlled trials.PLOS digital health · 2026Article
- Personal Health Large Language Models and the Negotiation of Medical Authority in Clinical Care: Opportunities, Risks, and Governance.Journal of medical Internet research · 2026Article
- Article
- Safety Envelopes and Continuous Assurance for Updates and Postmarket Surveillance in Digital Mental Health Technologies.Journal of medical systems · 2026Article
- Sustained engagement with a digital youth mental health platform: A mixed-methods study.Internet interventions · 2026Article
- Reducing the 'Silence Between Sessions': A Qualitative Study on Youth and Professionals' Perspectives on Digital Tools for Suicide Prevention.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Digital mental health needs a purpose-driven approach.Nature human behaviour · 2026Review
- Increasing Truck Drivers' Compliance, Retention, and Long-Term Engagement with e-Health & Mobile Applications: A PRISMA Systematic Review.Healthcare (Basel, Switzerland) · 2026Review
- A user centered evaluation framework for mobile health applications using Fuzzy AHP and TOPSIS: evidence from expert reviews and user experience data.Frontiers in public health · 2026Article
- Insights from fifteen years of real-world development, testing and implementation of youth digital mental health interventions.Internet interventions · 2025Review
- Development of a supportive mHealth device for persons with schizophrenia spectrum disorders (KisoLightFrontiers in psychology · 2025Article
- Article
- Participatory development and proof-of-concept of a dyadic-based, AI-driven, just-in-time adaptive intervention mechanism for preventing anxiety and depressive disorders via app: study protocol for a feasibility study.Frontiers in public health · 2025Article
- Review
Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This systematic review and meta-analysis examined the efficacy of digital mental health apps and the impact of persuasive design principles on intervention engagement and outcomes. Ninety-two RCTs and 16,728 participants were included in the meta-analyses. Findings indicate that apps significantly improved clinical outcomes compared to controls (g = 0.43). Persuasive design principles ranged from 1 to 12 per app (mode = 5). Engagement data were reported in 76% of studies, with 25 distinct engagement metrics identified, the most common being the percentage of users who completed the intervention and the average percentage of modules completed. No significant association was found between persuasive principles and either efficacy or engagement. With 25 distinct engagement metrics and 24% of studies not reporting engagement data, establishing overall engagement with mental health apps remains unfeasible. Standardising the definition of engagement and implementing a structured framework for reporting engagement metrics and persuasive design elements are essential steps toward advancing effective, engaging interventions in real-world settings.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.