Browsing by Author "Vesterinen, Maria"

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The qualities of patients interested in using a game-based digital mental health intervention for depression: a sequential mixed methods study
(2023-09-07) Lukka, Lauri; Salonen, Antti; Vesterinen, Maria; Karhulahti, Veli Matti; Palva, Satu; Palva, J. Matias
A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä
Background Digital interventions are typically evaluated by their effectiveness and engagement, while the characteristics of patients who perceive them to be attractive have remained poorly understood. This challenges user-centered intervention development but also presents an avenue to improve intervention efficacy and engagement. Our objective was to characterize people to whom game-based interventions appeal to with a focus on their mental health backgrounds and prior digital game experiences. Methods We performed a sequential mixed methods study with adults suffering from major depressive disorder (MDD) who participated in a randomized controlled clinical trial studying the effectiveness of a game-based digital intervention for depression. First, randomly chosen participants were interviewed (N = 22), and the transcribed data were analyzed inductively. Then, focusing on the themes established through the interview data, we triangulated the findings using complementary questionnaire data (N = 445). Results The interview data yielded four themes that we illuminated with quantified questionnaire data. (T1) The participants had enduring and diverse psychiatric symptomology: 73% had been diagnosed with a comorbid disorder in addition to depression. (T2) Participants had received at least some treatments that had not led to full remission of depression. 92% currently received therapeutic support, psychiatric medication, or both. (T3) Many participants had close relationships with digital gaming and played actively: on average, for 13 h a week on various gaming platforms and in various genres. (T4) Some participants used gaming to manage their psychiatric symptoms, and 76% found that playing helped them feel better. Conclusions Identifying and characterizing people attracted to game-based therapeutic interventions can catalyze intervention development and improve their efficacy. We found that game-based interventions have appealing potential across diverse psychiatric symptoms and for people with prior or existing treatments. Game-based interventions may appeal particularly to active players and offer a promising alternative to the self-treatment usage of entertainment games.
User journey method : a case study for improving digital intervention use measurement
(2025-12) Lukka, Lauri; Vesterinen, Maria; Salonen, Antti; Bergman, Vilma Reetta; Torkki, Paulus; Palva, Satu; Palva, J. Matias
A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä
Background: Many digital mental health interventions meet low levels of use. However, current use measurement methods do not necessarily help identify which intervention elements are associated with dropout, despite this information potentially facilitating iterative intervention development. Here, we suggest improving the comprehensiveness of intervention use measurement with the user journey method, which evaluates every intervention element to identify intervention-specific use barriers. Methods: We applied user journey method in a clinical trial that investigated the efficacy of a novel game-based intervention, Meliora, for adult Major Depressive Disorder. We modelled the intervention for its four technological (Recruitment, Website, Questionnaires, Intervention Software) and two interpersonal elements (Assessment, Support). We then applied the user journey method to measure how many users proceeded from one element to the next combining social media analytics, website use data, signup data, clinical subject coordinator interview data, symptom questionnaire data, and behavioral intervention use data. These measurements were complemented with the qualitative analysis of the study discovery sources and email support contacts. Results: Recruitment: The intervention recruitment reached at least 145,000 Finns, with social media, word-of-mouth, and news and web sources being the most effective recruitment channels. Website: The study website received 16,243 visitors, which led to 1,007 sign-ups. Assessment: 895 participants were assessed and 735 were accepted. Intervention Software: 498 participants were assigned to the active intervention or comparator, of whom 457 used them at least once: on average, for 17.3 h (SD = 20.4 h) on 19.7 days (SD = 20.7 d) over a period of 38.9 days (SD = 31.2 d). The 28 intervention levels were associated with an average dropout rate of 2.6%, with two sections exhibiting an increase against this baseline. 150 participants met the minimum adherence goal of 24 h use. Questionnaires: 116 participants completed the post-intervention questionnaire. Support: 313 signed-up participants contacted the researchers via email. Conclusion: The user journey method allowed for the comprehensive evaluation of the six intervention elements, and enabled identifying use barriers expediting iterative intervention development and implementation. Trial registration: ClinicalTrials.gov, NCT05426265. Registered 28 June 2022, https://clinicaltrials.gov/ct2/show/NCT05426265.