Human factors shaping engagement with a digital treatment platform among individuals with lived experience of addiction

IntroductionSubstance use disorders (SUDs) are highly prevalent, yet access to care remains limited. Digital interventions have been investigated as a means to expand treatment access, but individuals routinely disengage from them. We evaluated the acceptability, appropriateness, feasibility, and usability of a digital platform being tested as part of a collaborative care management-based intervention for SUD treatment in under-resourced areas to identify human factors influencing feasibility, usability, and accessibility.MethodsParticipants were adults with lived experience of addiction and related treatment. They engaged with the digital treatment platform for one week, then completed semi-structured interviews exploring their experience, followed by the Acceptability of Intervention Measure, Intervention Appropriateness Measure, Feasibility of Intervention Measure, and System Usability Scale. Template-based rapid analysis identified themes.Results18 individuals (n = 12 females) completed all assessments. Heavy text, lack of customization, and inconsistent notifications hindered usability. Participants felt assigned goals should match an individual's circumstances and resources available to them to support utilization. Participants desired personalization, integration with existing recovery supports, and features that encouraged routine use. Acceptability, appropriateness, and feasibility had respective means of 3.4 (95%CI = 3.0-3.9), 3.3 (95%CI = 2.8-3.9), and 3.4 (95%CI = 2.8-4.0) on 5-point scales with a neutral midpoint of 3. Usability scores approached the commonly used benchmark of 68 (mean=67.6, SD = 15.0).DiscussionDigital interventions suffer from heavy disengagement. These findings suggest that digital interventions should fit the end-user's needs and surrounding environment and be both person- and context-specific. Attention to these human factors may improve usability and accessibility, while also limiting additional barriers in under-resourced areas.