Healthcare Professionals' Engagement with Digital Mental Health Interventions in the UK and China: Engagement Factors and Design Implications (Preprint)

BACKGROUND Mental health issues like occupational stress and burnout have long affected healthcare professionals (HCPs) around the world. The impact of COVID-19 has further burdened HCPs, making them one of the most vulnerable groups to stress and burnout. Digital mental health interventions (DMHIs) can be accessible and effective to support well-being among HCPs. However, low engagement rates of DMHIs are frequently reported, limiting the potential effectiveness. More evidence is needed to reveal the factors that impact HCPs’ decision to adopt and engage with DMHIs. OBJECTIVE This study aims to explore HCPs’ motivation to engage with DMHIs and identify key factors affecting their engagement. We also aim to investigate the cultural impact in DMHI perception and engagement among HCPs. METHODS We used a mixed-method approach, with a cross-sectional survey (N=439) and semi-structured interviews (N=25) with HCPs from the UK and China. Participants were recruited from one major public hospital in each country. RESULTS Our results demonstrated a generally low engagement rate with DMHIs among HCPs from the two countries. Several key factors that affect DMHI engagement were identified, including belonging to underrepresented cultural and ethnic groups, limited mental health knowledge, low perceived need, lack of time and space, negative perceptions of DMHIs, and cultural elements like self-stigma. The results support recommendations that DMHIs for healthcare staff to: 1) provide psychoeducational content and meaningful rationale during early user engagement, or even before engagement when possible; 2) provide tailored content and design that are specific and relevant to HCPs; 3) maximise flexibility and facilitate potential integration of the intervention into HCPs’ work routines; 4) use non-judgemental languages and activities, and position the platform as self-care or wellness support for users with strong stigma; 5) incorporate human-based support while ensuring privacy and anonymity; 6) facilitate community support without fostering comparison and prejudice. CONCLUSIONS Although DMHIs can be an ideal alternative mental health support for HCPs, engagement rates among HCPs in China and the UK are still low due to multiple factors and barriers. More research is needed to develop and evaluate tailored DMHIs with unique design and content that can be engaged by HCPs from various cultural backgrounds.