Table 2.
Description of human support by meta-analysis.
| Study | Description of human support | Description of no human support |
| Carolan et al [57], 2017 | Studies varied in who provided support: 70% of the studies described the support as coming from a therapist or coach, 20% had a coordinator or member of staff providing support, and 10% described support as a clinical psychologist | Self-guided DMHIa |
| Cheng et al [47], 2020 | Professional support | Self-guided DMHI |
| Conley et al [58], 2016 | Participants received prompts, reminders, feedback, or guidance through emails, and some personal monitoring of the intervention | Self-administered DMHIs, in which assistance was provided only for assessment purposes or to offer a brief introduction to the technology |
| Cowpertwait and Clarke [59], 2013 | Human-supported | Self-guided DMHI |
| Domhardt et al [4], 2019 | Continuous therapeutic support | Self-help DMHI, with therapist contact for assessment (if at all) |
| Firth et al [60], 2017 | Involved “in-person” (ie, human) feedback | No in-person feedback |
| Fu et al [61], 2020 | Presence of guidance | Absence of guidance |
| Grist et al [62], 2019 | Supported: minimal contact therapy (“active involvement of therapist, help in applying specific therapeutic techniques, >90 min of time”); some support: predominantly unguided defined as predominantly self-administered (“giving initial therapeutic rationale, direction on how to use the program and periodic check-ins, <90 min of time”) | Purely unguided defined as purely self-administered (“therapist contact for assessment at most”) |
| Harrer et al [63], 2018 | Individual feedback | Unguided DMHI |
| Heber et al [5], 2017 | Guided with regular written feedback | Unguided with no support or only technical support |
| Kampmann et al [64], 2016 | Guided internet-delivered cognitive behavioral therapy | Unguided internet-delivered cognitive behavioral therapy |
| Kuester et al [65], 2016 | Therapeutic support from a therapist (“in remote contact with the client and provided therapeutic feedback messages”) | No therapeutic support (“programs that were either fully automated, provided only nontherapeutic moderation such as the supervision of forum posts or solely technical assistance”) |
| Leung et al [52], 2022 | Nonclinician (eg, peers, research assistants, or other lay persons) or clinician (ie, psychiatrists, psychologists, therapists, social workers, graduate students in a mental health–related field, or students completing clinical practicum training) | Unguided |
| Li et al [66], 2014 | Therapist involved (minimal contact therapy and therapy administrated) | No therapist involved (self-administered and predominately self-help) |
| Linardon et al [7], 2019 | Studies that offered professional guidance (eg, regular supportive text messages, phone calls, or personalized feedback from therapists or research staff) | Studies that did not offer professional guidance |
| Mehta et al [46], 2019 | Therapist-guided (“usually involve weekly contact with a web-based therapist or guide, either through asynchronous web-based messaging or by telephone”) | Self-guided DMHI (“participants do not have regular contact with a therapist”) |
| Pang et al [41], 2021 | Therapist guidance group (“group communicating with the therapist”); virtual health indicator guidance group (“group communicating with the virtual health care provider”) | No therapist guidance group (“group not communicating with the therapist”) |
| Păsărelu et al [38], 2017 | Experienced clinical psychologists and supervised students | Self-guided DMHI |
| Phillips et al [44], 2019 | Studies with guidance provided different types of human support (eg, regular calls by a clinical study officer, feedback from a clinical psychologist on home assignments, regular guidance from trained e-coaches, peer group discussions, and virtual class meetings) | Without guidance |
| Richards and Richardson [40], 2012 | Therapist-supported studies included a clinician who offered postsession feedback and support or a clinician-delivered intervention | Completely self-administered |
| Sherifali et al [45], 2018 | Internet-based information or education plus professional psychosocial support | Internet-based information or education only |
| Sijbrandij et al [67], 2016 | Therapist-assisted (email, telephone calls, in-person support) | Self-help |
| Simmonds-Buckley et al [68], 2020 | Predominantly therapist delivered | Self-administered DMHI |
| Spijkerman et al [69], 2016 | Therapist guidance | Without therapist guidance |
| Stratton et al [70], 2017 | Feedback provided, rather than just technical support | Self-help |
| Sztein et al [6], 2018 | Clinician was in some way involved in the dissemination of information to the study participants, whether through discussion forums, email, telephone, etc | Self-guided |
| Thompson et al [42], 2021 | Therapist-guided (included phone calls, personalized written messages and feedback, tailored emails, face-to-face meetings, and automated text messages or emails) | Not guided (although may have included automated text messages or emails) |
| Twomey et al [71], 2020 | Clinician or technician guidance | Without guidance |
| Versluis et al [72], 2016 | DMHI was included in a “treatment package” and was supported by a mental health professional; the “treatment package” could include the DMHI and therapy or DMHI and continued feedback (on homework assignments or messages to improve adherence) | Stand-alone DMHI |
| Victorson et al [73], 2020 | Human-supported | Without human support |
| Wright et al [43], 2019 | Clinician assisted or technician assisted | Unsupported DMHI |
aDMHI: digital mental health intervention.