Exploring behaviour-intention gaps to explain low retention in a community-based video-conferencing intervention for depression: Lessons for researchers using technology as interventions

This paper reflects on the outcomes of a community-based video-conferencing intervention for depression, predating the COVID-19 pandemic. The study investigates the potential implications of its findings for enhancing adherence to digital mental health interventions. The primary objective is to present considerations for researchers aimed at minimising the intention-behaviour gap frequently encountered in digital mental health interventions. A randomised control feasibility trial design was employed to implement a telehealth model adapted from an established face-to-face community-based intervention for individuals clinically diagnosed with depression. 60 participants were initially recruited in association with a local mental health charity offering traditional talking-based therapies with only eight opting to continue through all phases of the project. Modifications aligning with technological advancements were introduced. However, the study faced challenges, with low uptake observed after an initial surge in recruitment interest. The behaviour-intention gap highlighted technology as a barrier to service accessibility, exacerbated by participant age. Furthermore, the clinical diagnosis of depression, characterised by low mood and reduced interest in activities, emerged as a potential influencing factor. The limitations of the research include its pre-pandemic execution, during a nascent stage of technological mental health interventions when participants were less familiar with online developments. Despite these limitations, this study's reflections offer valuable insights for researchers aiming to design and implement telehealth services. Addressing the intention-behaviour gap necessitates a nuanced understanding of participant demographics, diagnosis, and technological familiarity. The study's relevance extends to post-pandemic society, urging researchers to reassess assumptions about technology availability to ensure engagement. This paper contributes to the mental health research landscape by raising awareness of critical considerations in the design and implementation of digital mental health interventions.