ArticlePLOS digital health2025
Measuring the influence of depressive symptoms on engagement, adherence, and weight loss in an eHealth intervention.
Article in PLOS digital health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Considering depression as a risk factor for early disengagement in a 12-month eHealth weight loss intervention.Journal of health psychology · 2026Trial
- Engagement and Weight Change in an Online Weight Management Program in Clinical Settings: An Implementation Project.Journal of general internal medicine · 2026Article
- Examining latent trajectories of participant engagement in a 12-month eHealth weight management intervention.Digital healthArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundDigital behavior change interventions (eHealth, mHealth) are known to be capable of promoting clinically significant weight loss among some participants. However, these programs can struggle with declining engagement and adherence over time, which can hamper their effectiveness. This analysis examines the extent that depression symptoms may negatively influence engagement, adherence, and 6 month weight change in an eHealth intervention.
methodsStructural equation modeling is applied to test the effects of baseline depression symptoms on weight change outcomes, mediated through latent constructs of engagement and adherence, respectively. These constructs were highly correlated within this dataset and necessitated two separate models to be tested. Engagement was indicated by 6 month sums of website logins, user-created goals, visiting various webpages, and posts on the online discussion boards. Adherence was indicated by 6 month sums of weeks exercise goals met, days weight logged, and days of complete dietary tracking.
resultsDepression symptoms showed no direct association with weight change (p's ≥ 0.6), but were negatively associated with both constructs of engagement and adherence (p's < 0.001), which in turn were negatively associated with weight change in both models (p's < 0.001). It was determined depression symptoms had a positive indirect association with weight change fully mediated through these variables, meaning less weight loss or possible weight gain (p < 0.001). DISCUSSION: This analysis shows that depression symptoms had a significant, undesirable effect on weight loss outcomes within this eHealth intervention, fully mediated through measured participant engagement and adherence. Further research is needed to test these constructs within a longitudinal model to better understand their dynamic interrelationships, and consider means to address depression in future digital interventions.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.