Future Engagement Research Articles

Mild traumatic brain injury increases engagement in criminal behaviour 10 years later: a case-control study.

Sustaining a mild traumatic brain injury (mTBI) has been linked to increased criminal behaviour in later life. However, previous studies have not controlled for the number of injuries, gender, social deprivation, impact of past behaviour, or link to offence type. This study aims to determine if people who experienced a single or multiple mTBI have increased risk of criminal behaviour 10 years post-injury than matched orthopaedic controls. This was a case control study of adults (aged >16 years) who experienced a medically diagnosed mTBI and controls who experienced a lower limb fracture (with no TBI) over a 12-month period (01/01/2003-31/12/2003). Participants were identified within Stats New Zealand's Integrated Data Infrastructure (national database including health and justice records). Participants who experienced a subsequent TBI (post-2003), who were not resident in New Zealand, and who died by 2013 were excluded. Case and controls were matched by age, sex, ethnicity, deprivation index and pre-injury criminal history. The study included N = 6,606 mTBI cases and N = 15,771 matched trauma controls. In the 10 years after injury, people experiencing a single mTBI had significantly higher numbers of violent charges (0.26 versus 0.21, p < 0.01) and violent convictions (0.16 versus 0.13, p < 0.05) but not for all court charges and convictions. Analysis of those with a history of prior mTBIs yielded larger effects, with significantly higher numbers of violent charges (0.57 versus 0.24, p < 0.05) and violent convictions (0.34 versus 0.14, p < 0.05). For males, the single mTBI case group had a significantly higher number of violent charges (0.40 versus 0.31, p < 0.05) and violent convictions (0.24 versus 0.20, p < 0.05) but this was not observed for females or all offence types. Experiencing multiple mTBIs over the lifetime increases the number of subsequent violence-related charges and convictions but not for all offence types in males but not for females. These findings highlight the need for improved recognition and treatment of mTBI to prevent future engagement in antisocial behaviour.

Early Child Adversity and Delinquent Behavior in Foster Care Youth: Do Future Expectations and Sexual Identity Moderate the Mediating Role of Posttraumatic Stress?

Delinquency in youth is a significant public health concern for individuals who experienced adversity and complex trauma as children. The present study explored the longitudinal associations between adverse child experiences and future engagement in delinquent behavior. Using a sample of 1,245 foster youth who are aging out of the child welfare system, mediation, moderation, and moderated mediation analysis was used to test the mechanistic role of post-traumatic stress symptoms and the moderating role of sexual identity and positive future expectations on engagement in delinquent behavior. Results showed a positive and significant association between adverse child experiences and engagement in delinquent behavior. Post-traumatic stress symptoms partially mediated the ACEs-delinquency relationship. In addition, sexual minority youth and youth who were less optimistic about the future, but who experienced more ACEs, were at risk for heightened levels of post-traumatic stress. Interventions that promote positive future outlooks may minimize the psychological sequelae of early child adversity and delinquent behavior particularly when tailored to the needs of sexual minority youth.

Japan’s new national security strategy: a reconsideration of regional and global security context

This article is devoted to the analysis and description of Japan’s new vision of its national security in a deteriorating international environment, as well as consequences of such shifts for the regional and global security infrastructure. The authors have highlighted the prerequisites of these changes, taken a look at reactions from key international actors and described Japan’s plans for future engagement with its allies and adversaries.

Engaging families after Covid: reconnecting in the classroom

PurposePrior to Covid, family involvement was on a forward movement of becoming a more involved, collaborative relationship between teachers and families of students. Just as family involvement was beginning to gain momentum with student-led conferences, in and out of school volunteer opportunities and families being seen as a valued perspective regarding student learning, Covid happened. This one event changed how families were seen within the school system. Through reflection with clinical candidates experiencing the effects of Covid and engagement experiences with families in the classroom, two different themes emerged regarding how schools have moved forward since Covid. Some schools found families to be a valued partner in student learning where other districts chose to use Covid as a reason for shutting the doors to family involvement. This article aims to address the family engagement timeline beginning prior to Covid, the perceptions of clinical candidates based on their experiences in classrooms, and innovative strategies for supporting future engagement with families.Design/methodology/approachThe work provides a summary of family involvement pre-existent to Covid, during the pandemic and post-Covid through a review of the literature and emerging from teacher candidate experiences in the school setting.FindingsAfter a careful review of literature and reflection of current teacher candidate experiences in the school system, two clear movements have emerged as Covid restrictions have been lowered. Where some districts are relieved by a lowering of visitor restrictions with the increased involvement of families in the building, other schools have tightened restrictions on families, causing increased tension on parent-teacher relationships. These schools are left caught in the pandemic, unaware or unsure of how to proceed in a post-pandemic world. This article provides key aspects to include in creating a plan for engaging with families and creating strong reciprocal relationships.Originality/valueValuing families in the school setting is crucial for developing strong relationships among teachers, students, student supports and the families who are raising these children. With increased social emotional needs in students, post-Covid, allowing families to contribute to discussion and planning regarding their children is mutually beneficial. Including families in school learning, planning and opportunities leads to positive family engagement and overall increased success in students, extending to the value educators place on involving these families. In addition, modeling how to postively engage families in school learning supports clinical partnerships with area universities. Where schools and classrooms are developing intergrated plans to include families in school learning experiences, future educators are able to better see and value the role of the family in education. When clinical candidates are not able to observe positive interactions between schools and families, there is a disconnect between school learning and home life that may never be explored.

Emotion Dysregulation and Substance Use Risk and Protective Factors among Veterans in Residential Treatment

Background: Substance use disorders (SUDs) are frequent concerns among healthcare providers serving military personnel and Veterans, and SUDs are also associated with high healthcare utilization. Problematic substance use is consistently associated with deficits in emotion regulation, and changes in emotional regulatory processes may be important factors during treatment and recovery. Methods: The present study examined emotion regulation and substance use risk and protective factors among Veterans seeking residential treatment for SUD within the Veterans Health Administration (VHA). Data were collected from 138 Veterans at pre-treatment and post-treatment to examine if changes in emotion regulation were associated with post-treatment outcomes. Results: Results indicated difficulties with emotion dysregulation at discharge predicted substance use risk factors, but not substance use protective factors, after controlling for scores at intake. Emotion regulation significantly improved throughout the course of treatment. Facets of emotion dysregulation at post-treatment, specifically difficulties engaging in goal-directed behavior, lower emotional clarity, lower emotional awareness, and more impulse control difficulties, predicted future admission to withdrawal management services, but not future mental health engagement, mortality, or resumed use (positive urine drug screen). Conclusions: Emotion regulation skills may be valuable treatment components, as they are related to reduced substance use risk factors; however, the results of improved emotion regulation were mixed for other measures of treatment outcome.

Locating the Belt and Road Initiative's spatial trilectics

AbstractIn this paper, we survey the expanding body of literature on the Belt and Road Initiative (BRI) in Chinese and Anglophone geography, and locate the main lines of development. The emerging scholarship approaches the BRI as a spatial discourse and examines the production of geographical reasoning in statecraft. It also links up with studies of the BRI as both a material project and an everyday experience. We argue that it is in this combined understanding of BRI's multiple registers, as discourse, project, and experience, that a trilectical approach for future geographical engagement can be identified as the BRI edges to its second decade.

"I'm Hooked on e-cycling, I Can Finally Be Active Again": Perceptions of e-cycling as a Physical Activity Intervention during Breast Cancer Treatment.

Electrically-assisted bicycles (e-bikes) are a means through which to increase individual physical activity (PA) and overcome some commonly reported barriers to engaging in conventional cycling. Fatigue is a common side effect to breast cancer treatment, and the rate of PA engagement drops significantly following a breast cancer diagnosis. The aim of this qualitative study was to examine perceptions of e-cycling as a means of increasing PA in this population. Twenty-four participants (mean age = 57.88 (standard deviation 10.8), 100% female) who have had a breast cancer diagnosis, completed two semi-structured interviews via Zoom. One interview was conducted prior to an e-bike taster session and a second, after the session. Taster sessions were conducted by certified cycling instructors in the community. Interviews were conducted between December 2021 and May 2022. Data were transcribed verbatim and analyzed thematically using NVivo 12 software. An inductive and deductive approach to analysis was adopted. Five themes were generated: (1) Perceived role of e-bikes during treatment, (2) The relationship between e-bikes and fatigue, (3) Cancer-specific considerations, (4) Is e-cycling 'enough'?, and (5) Optimizing the intervention. Negative perceptions of e-bikes noted before the taster session were altered following riding an e-bike. The multiple levels of assistance made cycling manageable and less impacted by fatigue, thereby enabling individuals to re-establish previous cycling habits. E-cycling may be a suitable option to increase PA behavior amongst individuals being treated for breast cancer, with the potential to overcome many of the barriers of conventional cycling. Enabling this population to trial an e-bike elicits positive physical and psychological responses that may help to promote future engagement.

In the shadow of nuclear dependency: Competing pathways and the social acceptance of offshore wind energy in France

Opposition to offshore wind energy can cause major delays in the deployment of this technology, possibly compromising ambitious national strategies for increasing the generation of electricity to meet the net zero emissions target. However, shifting the perspective to the technology in full – from manufacturing to siting – can shed light on competing pathways where opposition coexists with acceptance, and provides a fuller understanding of place-based dependency dynamics. To apply this research agenda, this article presents a case study of France, where the first offshore wind farm is yet to be launched in 2025, in the midst of a growing controversy over the local impacts of the technology. However, France has also become a major manufacturing site for turbine and nacelle manufacturing, accounting for one-third of European industrial capacity.We use insights from social acceptance studies to offer an explanation for these contradictory paths. We study the role of scale in the social conflicts over offshore wind, showing the influence of wider place-based dependencies in the incentives hindrances to legitimacy for this technology. On the one side, local opponents to offshore wind farms deny their legitimacy on the grounds of their inadequacy within the inherited and centralized French energy system dominated by nuclear energy. Meanwhile, the development of manufacturing of offshore wind components is not questioned, and even benefits from a large support from local stakeholders. We then question the limits of current and future public engagement schemes in the context of a national energy system dominated by nuclear power.

Perceptions of travel-related health risks and pre-travel health-seeking behaviour among students: A qualitative analysis.

The impact of the COVID-19 pandemic on travel risk perceptions and pre-travel healthcare attendance is unknown. We aimed to explore barriers and enablers to engagement in and uptake of pre-travel advice (PTA) among university students, a recognised at-risk group for travel-related morbidity and poor PTA uptake. Additionally, we aimed to explore whether the COVID-19 pandemic has influenced attitudes towards future PTA. Semi-structured interviews were conducted with university students (October-December 2021). Thematic analysis of the data was conducted using the Health Belief Model (HBM) framework. We interviewed 18 students (11 male, median age 24). Students' risk perceptions relating to travel-related illnesses were influenced by past experiences, travel destination, vaccination status and knowledge. Barriers to seeking PTA included a lack of perceived need and concerns about accessibility/availability, whereas potential benefits included reduced health risks, vaccine-induced protection, and knowledge gain. Cues to seeking future PTA were perceived risks of travel-related illness, perceived high-risk destination, itinerary-related vaccine requirements, perceived benefits of advice and concerns about COVID-19 infection. COVID-19 risk perceptions did not consistently align with those of other travel-related illness. We used findings to inform recommendations. The current COVID-19 pandemic offers an opportunity to increase students' risk awareness and promote preventive travel health behaviours. Recommendations to improve students' future engagement in PTA include: 1) increasing awareness of risks associated with travel, 2) emphasising PTA benefits, and 3) ensuring PTA is convenient, accessible and affordable.

Predictors of Scientific Civic Engagement (PSCE) Survey: A Multidimensional Instrument to Measure Undergraduates' Attitudes, Knowledge, and Intention to Engage with the Community Using Their Science Skills.

Civic engagement is an individual's active participation that is intended to improve a community's socioeconomic status or help shape its future. Undergraduates who engage with a community during formal course work are more likely to participate civically later in life. This outcome is important for science, technology, engineering and math (STEM) students since they use STEM knowledge to make informed decisions about public health, national security and the environment. STEM courses that incorporate this idea actively engage students in helping communities, and yet, assessment of the civic outcomes in these courses, such as measuring important predictors of future civic engagement, has been inconsistent and challenging. To address this need, we designed and assessed a new survey by adapting and testing items from previously existing civic engagement measures. The result was a 14-item survey comprising the following scientific civic constructs, that predict future scientific civic engagement: value, self-efficacy, action, and knowledge. This survey has potential to provide insight into the development of scientific civic engagement for STEM disciplines among undergraduate populations and can be used with additional scales of interest, allowing for researchers to assess relationships between predictors of scientific civic engagement and other constructs.

How much is a “feedback” worth? User engagement and interaction for computer-supported adaptive quizzing

ABSTRACT The digital transformation of education is greatly accelerating in various computer-supported applications. As a particularly prominent application of the human-machine interactive system, intelligent learning systems aim to capture users’ current intentions and provide recommendations through real-time feedback. However, we have a limited understanding on what is the reality of user feedback for computer-supported adaptive quizzing. This present study proposes formalization for user feedback including engagement and interactions to understand and improve intelligent adaptive quizzing. This work starts by taking individual system’s action transition patterns as a temporally evolving action graph and derives patterns in terms of informing future user engagement. Furthermore, considering the student knowledge preference for a certain moment is closely related to personal experience of past learning,a novel framework EICQ (Engagement and Interaction-based Computer-Supported Adaptive Quizzing) is proposed for learning and adapting to students’ current preference based on engagement trends and interaction by collecting feedback data in real-time during a learning session. This established framework captures question characters, student dynamic interactions and engagement trends, which yield a better learning experience with adaptive practice question (PQ) recommendations. Finally, much more endeavors have been made to integrate the proposed EICQ into XXXU intelligent learning systems that are co-developed with the YYY Company.

Management of orofacial clefts in Africa, insufficient management centers, and workforce.

Management of orofacial clefts in Africa, insufficient management centers, and workforce.

Development of the Community Impact Feedback Questionnaire for Service-Learning: A Delphi Study

Community impacts of service-learning have gone largely unexamined by researchers, partly because of the absence of a well-established feedback tool. This study is a step toward filling this research gap by developing and validating the Community Impact Feedback Questionnaire (CIFQ) as a means for collecting feedback from partner organization representatives (PORs) on the impacts of particular service-learning projects on community partner organizations (CPOs) and, where applicable, end-beneficiaries. The CIFQ contains items about three categories of impact on CPOs, corresponding to a conceptual model developed by Snell &amp; Lau (2022). These are: a) achieving project goals to further the CPO’s mission; b) augmenting resources of the CPO; and c) acquiring knowledge, insights, ideas, and techniques.There are also items on impacts for end-beneficiaries, overall impact evaluations, and future engagement. The CIFQ was validated with the Delphi method by inviting 16 practitioner panelists, mainly from CPOs, with prior involvement in service-learning. Three Delphi survey rounds helped refine the CIFQ as a tool for capturing the community impacts on CPOs and end beneficiaries arising from service-learning. Possible reasons for controversy and non-retention are discussed.

Evaluation of rural general practice experiences for pre-vocational medical graduates.

Despite substantial investment in rural workforce support, sustaining the necessary recruitment and retention of general practitioners (GPs) in rural areas remains a challenge. Insufficient medical graduates are choosing a general/rural practice career. Medical training at postgraduate level, particularly for those 'between' undergraduate medical education and specialty training, remains strongly reliant on hospital experience in larger hospitals, potentially diverting interest away from general/rural practice. The Rural Junior Doctor Training Innovation Fund (RJDTIF) program offered junior hospital doctors (interns) an experience of 10 weeks in a rural general practice, aiming to increase their consideration of general/rural practice careers This study aimed to evaluate the educational and potential workforce impact of the RJDTIF program. Up to 110 places were established during 2019-2020 for Queensland's interns to undertake an 8-12-week rotation (depending on individual hospital rosters) out of regional hospitals to work in a rural general practice. Participants were surveyed before and after the placement, although only 86 were invited due to the disruption caused by the COVID-19 pandemic. Descriptive quantitative statistics were applied to the survey data. Four semi-structured interviews were conducted to further explore the experiences post-placement, with audio-recordings transcribed verbatim. Semi-structured interview data were analysed using inductive, reflexive thematic analysis. In total, 60 interns completed either survey, although only 25 were matched as completing both surveys. About half (48%) indicated they had preferenced the rural GP term and 48% indicated strong enthusiasm for the experience. General practice was indicated as the most likely career option for 50%, other general specialty 28% and subspecialty 22%. Likelihood to be working in a regional/rural location in 10 years was indicated as 'likely' or 'very likely' for 40%, 'unlikely' for 24% and 'unsure' for 36%. The two most common reasons for preferencing a rural GP term were experiencing training in a primary care setting (50%) and gaining more clinical skills through increased patient exposure (22%). The overall impact on pursuing a primary care career was self-assessed as much more likely by 41%, but much less by 15%. Interest in a rural location was less influenced. Those rating the term poor or average had low pre-placement enthusiasm for the term. The qualitative analysis of interview data produced two themes: importance of the rural GP term for interns (hands-on learning, skills improvement, influence on future career choice and engagement with the local community), and potential improvements to rural intern GP rotations. Most participants reported a positive experience from their rural GP rotation, which was recognised as a sound learning experience at an important time with respect to choosing a specialty. Despite the challenges posed by the pandemic, this evidence supports the investment in programs that provide opportunities for junior doctors to experience rural general practice in these formative postgraduate years to stimulate interest in this much-needed career pathway. Focusing resources on those who have at least some interest and enthusiasm may improve its workforce impact.

Patient priority setting in HIV ageing research: exploring the feasibility of community engagement and involvement in Tanzania

ObjectiveThe chronic complications of ageing with HIV are not well studied in sub-Saharan Africa (SSA) where general healthcare resources are limited. We aimed to collaborate with individuals living with HIV aged ≥ 50 years, and community elders (aged ≥ 60 years) living with non-communicable diseases in the Kilimanjaro region of Tanzania in a health research priority-setting exercise.MethodsWe conducted structured workshops based on broad questions to aid discussion and group-based patient priority setting, alongside discussion of the feasibility of future community research engagement. Participant priorities were tallied and ranked to arrive at core priorities from consensus discussion.ResultsThirty older people living with HIV and 30 community elders attended separate priority setting workshops. Both groups reported motivation to participate in, conduct, and oversee future studies. In this resource-limited setting, basic needs such as healthcare access were prioritised much higher than specific HIV-complications or chronic disease. Stigma and social isolation were highly prioritised in those living with HIV.ConclusionsCommunity engagement and involvement in HIV and ageing research appears feasible in Tanzania. Ageing and non-communicable disease research should consider the wider context, and lack of basic needs in low-income settings. A greater impact may be achieved with community involvement.

Measuring a cross-sectional sample of students’ intentions to engage with science and modelling associations according to two theoretical perspectives

ABSTRACT Social cognitive career theory (SCCT) and the theories of reasoned action and planned behaviour (TRAPB) have both guided studies seeking to explain students’ intentions and decisions related to future science engagement. The purpose of this study was to simultaneously validate measures for these two social psychological models and closely examine these constructs and their associations. Students were sampled in two groups, across grades 5 through 10, from rural schools in the United States (N = 538). Each group was administered two sets of measures, and each set of measures was associated with a theoretical model, and included corresponding sub-scales suitable for self-report. Respondents also supplied information about a common set of predictor variables based on a review of the literature. Structural equation modelling was used to examine the constructs more closely. Results from confirmatory factor analysis were generally consistent with the theoretical structures. Multiple indicators multiple causes (MIMIC) models were generated to compare SCCT and TRAPB, including associations between factors and variables. Associations between common predictor variables like race and gender differed between the MIMIC models. Frequency of talk with family members, perceived science ability, gender, and race were all significantly associated with multiple factors in both the SCCT- and TRAPB-aligned models.

The Impact and Perception of England's Web-Based Heart Age Test of Cardiovascular Disease Risk: Mixed Methods Study.

It is well documented that individuals struggle to understand cardiovascular disease (CVD) percentage risk scores, which led to the development of heart age as a means of communicating risk. Developed for clinical use, its application in raising public awareness of heart health as part of a self-directed digital test has not been considered previously. This study aimed to understand who accesses England's heart age test (HAT) and its effect on user perception, knowledge, and understanding of CVD risk; future behavior intentions; and potential engagement with primary care services. There were 3 sources of data: routinely gathered data on all individuals accessing the HAT (February 2015 to June 2020); web-based survey, distributed between January 2021 and March 2021; and interviews with a subsample of survey respondents (February 2021 to March 2021). Data were used to describe the test user population and explore knowledge and understanding of CVD risk, confidence in interpreting and controlling CVD risk, and effect on future behavior intentions and potential engagement with primary care. Interviews were analyzed using reflexive thematic analysis. Between February 2015 and June 2020, the HAT was completed approximately 5 million times, with more completions by men (2,682,544/4,898,532, 54.76%), those aged between 50 to 59 years (1,334,195/4,898,532, 27.24%), those from White ethnic background (3,972,293/4,898,532, 81.09%), and those living in the least deprived 20% of areas (707,747/4,898,532, 14.45%). The study concluded with 819 survey responses and 33 semistructured interviews. Participants stated that they understood the meaning of high estimated heart age and self-reported at least some improvement in the understanding and confidence in understanding and controlling CVD risk. Negative emotional responses were provoked among users when estimated heart age did not equate to their previous risk perceptions. The limited information needed to complete it or the production of a result when physiological risk factor information was missing (ie, blood pressure and cholesterol level) led some users to question the credibility of the test. However, most participants who were interviewed mentioned that they would recommend or had already recommended the test to others, would use it again in the future, and would be more likely to take up the offer of a National Health Service Health Check and self-reported that they had made or intended to make changes to their health behavior or felt encouraged to continue to make changes to their health behavior. England's web-based HAT has engaged large number of people in their heart health. Improvements to England's HAT, noted in this paper, may enhance user satisfaction and prevent confusion. Future studies to understand the long-term benefit of the test on behavioral outcomes are warranted.

Effect of Daily Life Reward Loop Functioning on the Course of Depression

Engagement in activities increases positive affect (Reward Path 1), which subsequently reinforces motivation (Reward Path 2), and hence future engagement in activities (Reward Path 3). Strong connections between these three reward loop components are considered adaptive, and might be disturbed in depression. Although some ecological nomentary assessment (EMA) studies have investigated the cross-sectional association between separate reward paths and individuals’ level of depression, no EMA study has looked into the association between individuals’ reward loop strength and depressive symptom course. The present EMA study assessed reward loop functioning (5x/day, 28 days) of 46 outpatients starting depression treatment at secondary mental health services and monitored with the Inventory of Depressive Symptomatology—Self-Report (IDS-SR) during a 7-month period. Results of multilevel regression analyses showed significant within-person associations for Reward Path 1 (b = 0.21, p < .001), Reward Path 2 (b = 0.43, p < .001), and Reward Path 3 (b = 0.20, p < .001). Stronger average reward loops (i.e., within-person mean of all reward paths) did not relate to participants’ improvement in depressive symptoms over time. Path-specific results revealed that Reward Paths 1 and 2 may have partly opposite effects on depressive symptom course. Together, our findings suggest that reward processes in daily life might be best studied separately and that further investigation is warranted to explore under what circumstances strong paths are adaptive or not.

EVOLUTION OF INCELS: ONGOING SECURITY IMPLICATIONS OF INCEL IDEOLOGY

On November 23, 2022, Naama Kates, the writer, creator, and producer of the Incel podcast, presented Evolution of Incels: Ongoing Security Implications of Incel Ideology. The presentation was followed by a question-and-answer period with questions from the audience and CASIS Vancouver executives. The key points discussed were the definition, demographics, and rhetoric of the incel community, prominent attacks attributed to incels, and common misconceptions regarding the community and the impacts on future engagement. Received: 2022-12-21Revised: 2023-01-08

Understanding the Subjective Experience of Long-term Remote Measurement Technology Use for Symptom Tracking in People With Depression: Multisite Longitudinal Qualitative Analysis

Remote measurement technologies (RMTs) have the potential to revolutionize major depressive disorder (MDD) disease management by offering the ability to assess, monitor, and predict symptom changes. However, the promise of RMT data depends heavily on sustained user engagement over extended periods. In this paper, we report a longitudinal qualitative study of the subjective experience of people with MDD engaging with RMTs to provide insight into system usability and user experience and to provide the basis for future promotion of RMT use in research and clinical practice. We aimed to understand the subjective experience of long-term engagement with RMTs using qualitative data collected in a longitudinal study of RMTs for monitoring MDD. The objectives were to explore the key themes associated with long-term RMT use and to identify recommendations for future system engagement. In this multisite, longitudinal qualitative research study, 124 semistructured interviews were conducted with 99 participants across the United Kingdom, Spain, and the Netherlands at 3-month, 12-month, and 24-month time points during a study exploring RMT use (the Remote Assessment of Disease and Relapse-Major Depressive Disorder study). Data were analyzed using thematic analysis, and interviews were audio recorded, transcribed, and coded in the native language, with the resulting quotes translated into English. There were 5 main themes regarding the subjective experience of long-term RMT use: research-related factors, the utility of RMTs for self-management, technology-related factors, clinical factors, and system amendments and additions. The subjective experience of long-term RMT use can be considered from 2 main perspectives: experiential factors (how participants construct their experience of engaging with RMTs) and system-related factors (direct engagement with the technologies). A set of recommendations based on these strands are proposed for both future research and the real-world implementation of RMTs into clinical practice. Future exploration of experiential engagement with RMTs will be key to the successful use of RMTs in clinical care.