Who Gets Included? Equity in Digital and Decentralised Mental Health and Neurodevelopmental Trials: A Systematic Review

  1. Sophie S Hall
  2. Charlotte L Hall
  3. Christopher Partlett
  4. Alexia Jeayes
  5. Nikita Rattu
  6. Helen Henshaw
  7. Jennifer Martin
  8. Emily Shoesmith
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Abstract

Decentralised clinical trials (DCTs) may improve access to digital mental health interventions, but equity remains limited. This review of 60 papers (58 DCTs) found key PROGRESS-Plus variables—race/ethnicity, socioeconomic status, occupation, and residence—were underreported. Underserved groups were consistently underrepresented. Barriers included digital exclusion and cognitive or sensory challenges, while therapist support and simplified onboarding facilitated participation. Standardised reporting and inclusive DCT design are needed.

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  1. Version published to 10.21203/rs.3.rs-7565290/v1 on Research Square