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Abstract. Chronic illnesses cause considerable burden in quality of life, often leading to physical, psychological, and social dysfunctioning of the sufferers and their family. There is a growing need for flexible provision of home-based psychological services to increase reach even for traditionally underserved chronic illness sufferer populations. Digital interventions can fulfill this role and provide a range of psychological services to improve functioning. Despite the potential of digital interventions, concerns remain regarding users' engagement, as low engagement is associated with low adherence rates, high attrition, and suboptimal exposure to the intervention. Human–computer interaction (e.g., theoretical models of persuasive system design, gamification, tailoring, and supportive accountability) and user characteristics (e.g., gender, age, computer literacy) are the main identified culprits contributing to engagement and adherence difficulties. To date, there have not been any clear and concise recommendations for improved utilization and engagement in digital interventions. This paper provides an overview of user engagement factors and proposes research informed recommendations for engagement and adherence planning in digital intervention development. The recommendations were derived from the literature and consensualized by expert members of the European Federation of Psychology Associations, Psychology and Health Standing Committee, and e-Health Task Force. These recommendations serve as a starting point for researchers and clinicians interested in the digitalized health field and promote effective planning for engagement when developing digital interventions with the potential to maximize adherence and optimal exposure in the treatment of chronic health conditions.

Introduction: The COVID-19 pandemic has impacted individuals, communities, and whole populations. Experts across many different fields contributed their time and efforts in different ways to respond to the pandemic. Psychologists working in healthcare provided support and led many initiatives, both regionally and nationally. However, it is unknown how this has differed across Europe and its full range of activities and contributions. Aim: The current study is a survey of European member associations of EFPA, carried out to understand the current contributions and the impact those psychology contributions have had on the COVID-19 pandemic response, to share lessons learned, and to propose a roadmap for the future. Results: Overall, our study highlights how psychological expertise was integrated into many countries' policy/decision-making, action-planning, caregiving, and the promotion of health and well-being to health professionals and the general public. Even in places where psychologists were not directly integrated into governmental systems, they played an important role in responding to this pandemic by providing their services and empirical knowledge. Discussion: Many psychologists possess the skills and tools to adapt their practice to the digital provision of services and to provide a continuity of care during the pandemic. Research carried out by psychologists has contributed important and new knowledge on pandemic effects, consequences, and interventions; yet, more research financial support is needed. We make recommendations for augmenting psychologists' contributions in the future. In a global health crisis, where the main possible treatment is a preventive approach concentrated on sustainable behavior change, psychologists should be included every step of the way - they can make a difference.

Introduction: The COVID-19 pandemic has impacted individuals, communities, and whole populations. Experts across many different fields contributed their time and efforts in different ways to respond to the pandemic. Psychologists working in healthcare provided support and led many initiatives, both regionally and nationally. However, it is unknown how this has differed across Europe and its full range of activities and contributions. Aim: The current study is a survey of European member associations of EFPA, carried out to understand the current contributions and the impact those psychology contributions have had on the COVID-19 pandemic response, to share lessons learned, and to propose a roadmap for the future. Results: Overall, our study highlights how psychological expertise was integrated into many countries' policy/decision-making, action-planning, caregiving, and the promotion of health and well-being to health professionals and the general public. Even in places where psychologists were not directly integrated into governmental systems, they played an important role in responding to this pandemic by providing their services and empirical knowledge. Discussion: Many psychologists possess the skills and tools to adapt their practice to the digital provision of services and to provide a continuity of care during the pandemic. Research carried out by psychologists has contributed important and new knowledge on pandemic effects, consequences, and interventions; yet, more research financial support is needed. We make recommendations for augmenting psychologists' contributions in the future. In a global health crisis, where the main possible treatment is a preventive approach concentrated on sustainable behavior change, psychologists should be included every step of the way – they can make a difference.

Introduction: The COVID-19 pandemic has impacted individuals, communities, and whole populations. Experts across many different fields contributed their time and efforts in different ways to respond to the pandemic. Psychologists working in healthcare provided support and led many initiatives, both regionally and nationally. However, it is unknown how this has differed across Europe and its full range of activities and contributions. Aim: The current study is a survey of European member associations of EFPA, carried out to understand the current contributions and the impact those psychology contributions have had on the COVID-19 pandemic response, to share lessons learned, and to propose a roadmap for the future. Results: Overall, our study highlights how psychological expertise was integrated into many countries' policy/decision-making, action-planning, caregiving, and the promotion of health and well-being to health professionals and the general public. Even in places where psychologists were not directly integrated into governmental systems, they played an important role in responding to this pandemic by providing their services and empirical knowledge. Discussion: Many psychologists possess the skills and tools to adapt their practice to the digital provision of services and to provide a continuity of care during the pandemic. Research carried out by psychologists has contributed important and new knowledge on pandemic effects, consequences, and interventions; yet, more research financial support is needed. We make recommendations for augmenting psychologists' contributions in the future. In a global health crisis, where the main possible treatment is a preventive approach concentrated on sustainable behavior change, psychologists should be included every step of the way – they can make a difference.

Introduction: The COVID-19 pandemic has impacted individuals, communities, and whole populations. Experts across many different fields contributed their time and efforts in different ways to respond to the pandemic. Psychologists working in healthcare provided support and led many initiatives, both regionally and nationally. However, it is unknown how this has differed across Europe and its full range of activities and contributions. Aim: The current study is a survey of European member associations of EFPA, carried out to understand the current contributions and the impact those psychology contributions have had on the COVID-19 pandemic response, to share lessons learned, and to propose a roadmap for the future. Results: Overall, our study highlights how psychological expertise was integrated into many countries' policy/decision-making, action-planning, caregiving, and the promotion of health and well-being to health professionals and the general public. Even in places where psychologists were not directly integrated into governmental systems, they played an important role in responding to this pandemic by providing their services and empirical knowledge. Discussion: Many psychologists possess the skills and tools to adapt their practice to the digital provision of services and to provide a continuity of care during the pandemic. Research carried out by psychologists has contributed important and new knowledge on pandemic effects, consequences, and interventions; yet, more research financial support is needed. We make recommendations for augmenting psychologists' contributions in the future. In a global health crisis, where the main possible treatment is a preventive approach concentrated on sustainable behavior change, psychologists should be included every step of the way – they can make a difference. ; info:eu-repo/semantics/acceptedVersion

Background The COVID-19 pandemic triggered vast governmental lockdowns. The impact of these lockdowns on mental health is inadequately understood. On the one hand such drastic changes in daily routines could be detrimental to mental health. On the other hand, it might not be experienced negatively, especially because the entire population was affected. Methods The aim of this study was to determine mental health outcomes during pandemic induced lockdowns and to examine known predictors of mental health outcomes. We therefore surveyed n = 9,565 people from 78 countries and 18 languages. Outcomes assessed were stress, depression, affect, and wellbeing. Predictors included country, sociodemographic factors, lockdown characteristics, social factors, and psychological factors. Results Results indicated that on average about 10% of the sample was languishing from low levels of mental health and about 50% had only moderate mental health. Importantly, three consistent predictors of mental health emerged: social support, education level, and psychologically flexible (vs. rigid) responding. Poorer outcomes were most strongly predicted by a worsening of finances and not having access to basic supplies. Conclusions These results suggest that on whole, respondents were moderately mentally healthy at the time of a population-wide lockdown. The highest level of mental health difficulties were found in approximately 10% of the population. Findings suggest that public health initiatives should target people without social support and those whose finances worsen as a result of the lockdown. Interventions that promote psychological flexibility may mitigate the impact of the pandemic. ; peerReviewed

Background The COVID-19 pandemic triggered vast governmental lockdowns. The impact of these lockdowns on mental health is inadequately understood. On the one hand such drastic changes in daily routines could be detrimental to mental health. On the other hand, it might not be experienced negatively, especially because the entire population was affected. Methods The aim of this study was to determine mental health outcomes during pandemic induced lockdowns and to examine known predictors of mental health outcomes. We therefore surveyed n = 9,565 people from 78 countries and 18 languages. Outcomes assessed were stress, depression, affect, and wellbeing. Predictors included country, sociodemographic factors, lockdown characteristics, social factors, and psychological factors. Results Results indicated that on average about 10% of the sample was languishing from low levels of mental health and about 50% had only moderate mental health. Importantly, three consistent predictors of mental health emerged: social support, education level, and psychologically flexible (vs. rigid) responding. Poorer outcomes were most strongly predicted by a worsening of finances and not having access to basic supplies. Conclusions These results suggest that on whole, respondents were moderately mentally healthy at the time of a population-wide lockdown. The highest level of mental health difficulties were found in approximately 10% of the population. Findings suggest that public health initiatives should target people without social support and those whose finances worsen as a result of the lockdown. Interventions that promote psychological flexibility may mitigate the impact of the pandemic.