Does human support add value to persuasive design-based digital mental health interventions? A propensity score matching study of a digital parenting program.

Background: While human support has been shown to increase user engagement with digital mental health interventions, it also increases managerial overhead, raises costs, and limits scalability. An alternative approach leverages persuasive design principles to potentially reduce the reliance on human support. Therapeutic persuasiveness (TP) is a concept for persuasive design that involves incorporating features that encourage users to make positive behavior changes in their lives. Prior research suggests that TP features can effectively improve both user engagement and intervention outcomes. Objective: This study aimed to evaluate the added value of human support in a TP-enhanced digital parent training program (DPT) by comparing engagement and clinical outcomes between human-supported and self-directed intervention formats. Methods: A propensity score matching approach was used to utilize data from two comparable studies, involving parents of children aged 3-7, all of whom received the same TP-enhanced DPT. One study included a self-directed condition ( Results: There were no significant differences between the self-directed and human-supported formats in program completion rates (89% vs. 92%, respectively; Conclusions: These findings suggest that well-designed, technology-enabled intervention features may effectively support program adherence and therapeutic outcomes without requiring additional human support. This study highlights the importance of further research into the relative impact of human-supported vs. self-directed DMHIs and investigating how intervention quality might influence this impact.