Evidence map›Paper›PMID 41551033›Full record

ArticleInternet interventions2026

Improving adherence to an online intervention for low mood by a virtual coach or personalized motivational feedback messages: A three-arm pilot randomized controlled trial.

Khadicha Amarti, Marketa Ciharova, Simon Provoost, Mieke H J Schulte, Annet Kleiboer, Ali El Hassouni, Gonçalo Gonçalves, Heleen Riper

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In one paragraph

Article in Internet interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Khadicha AmartiDepartment of Clinical, Neuro- and Developmental Psychology, Clinical Psychology Section, VU University, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Marketa CiharovaDepartment of Clinical, Neuro- and Developmental Psychology, Clinical Psychology Section, VU University, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Simon ProvoostDepartment of Clinical, Neuro- and Developmental Psychology, Clinical Psychology Section, VU University, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Mieke H J SchulteDepartment of Clinical, Neuro- and Developmental Psychology, Clinical Psychology Section, VU University, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Annet KleiboerDepartment of Clinical, Neuro- and Developmental Psychology, Clinical Psychology Section, VU University, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Ali El HassouniDepartment of Computer Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Gonçalo GonçalvesInstitute for Systems and Computer Engineering, Technology and Science, Porto, Portugal.
Heleen RiperDepartment of Clinical, Neuro- and Developmental Psychology, Clinical Psychology Section, VU University, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Online psychological interventions like behavioural activation (BA) can be provided with or without human support. Unguided online interventions require no human contact and are therefore easier to implement on a large scale than guided interventions. However, effectiveness and adherence rates to these interventions are generally lower. One way to increase adherence to unguided online interventions is to offer automated motivational support. Objective: This pilot randomized controlled trial (RCT) examined whether adherence to unguided online BA for low mood could be improved by adding automated support in the form of smartphone-delivered personalized motivational messages or a motivational virtual coach. Methods: A three-arm pilot RCT ( Results: Adherence was moderate overall, with participants visiting on average 23 pages of 55 webpages and completing on average 50 of 84 requested mood ratings. No evidence for differences in adherence rates were observed between the intervention conditions and the control condition. Satisfaction with the intervention was moderate to high. Usability scores were below the desirable threshold of 68. Depression symptoms did not change significantly across all participants ( Conclusions: Adding automated support to unguided online BA for depression did not improve overall adherence. The limited effectiveness may reflect a misalignment between the motivational strategies and the needs of the target population, who reported mild symptoms and high intrinsic motivation. The findings highlight the need to further improve both the quality of automated support and the usability of online platforms. Future research should explore additional adherence-related factors and investigate how personalization can better address different symptom severities in unguided mental health interventions. Trial registration: International Clinical Trials Registry Platform: trialsearch.who.int/Trial2.aspx?TrialID=NL8110.

Indexed as

AdherenceBehavioural activationLow moodMotivational supportPersonalizationVirtual coach

Identifiers

PMID41551033
PMCPMC12811679

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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.