Engagement and retention in digital mental health interventions: a narrative review

Abstract Background While many digital mental health interventions (DMHIs) have been shown to be effective, such interventions also have been criticized for poor engagement and retention rates. However, several questions remain about how users engage with DMHIs, how to define engagement, and what factors might help improve DMHI engagement. Main abstract In this narrative review, we show that although DMHIs are criticized for poor engagement, research suggests engagement rates are quite variable across studies and DMHIs. In some instances, engagement rates are high, even in real-world settings where there is evidence of a subset of users who could be considered ‘superusers’. We then review research on the…