Understanding the dose‒response relationship between patient engagement in cognitive behavioral therapy (CBT) and health outcomes is critical for developing and implementing effective CBT programs. In studies of CBT interventions, patient engagement is measured only at a single time point, and outcomes are typically assessed before and after the intervention. Examination of the dose‒response relationship between patient engagement in CBT and outcomes is limited. It is unclear whether a dose‒response relationship exists between patient engagement in on-site CBT intervention and anxiety and depression in people living with HIV (PLWH). If present, does this dose‒response relationship occur early or later in the intervention? This study aimed to address this gap by examining the dose‒response relationships between patient engagement and anxiety and depression in CBT interventions among PLWH. Utilizing data from a pilot randomized trial (10 participants) and a clinical controlled trial (70 participants), our secondary analysis spans baseline, 3-month, and 6-month assessments. Both trials implemented the nurse-led CBT intervention. Cluster analysis identified two groups based on on-site attendance and WeChat activity. Patients with good adherence (6–10 times) of on-site attendance exhibited significantly lower anxiety and depression scores at 3 months (β = 1.220, P = 0.047; β = 1.270, P = 0.019), with no significant differences observed at 6 months. WeChat activity did not significantly influence anxiety or depression scores. The findings highlight a significant short-term dose‒response relationship, endorsing nurse-led CBT interventions for mental health in PLWH. Organizational strategies should focus on incentivizing and facilitating patient engagement, particularly through enhancing WeChat features.

了解患者参与认知行为治疗 (CBT) 与健康结果之间的剂量反应关系对于制定和实施有效的 CBT 计划至关重要。在 CBT 干预研究中，仅在单个时间点测量患者参与度，并且通常在干预前后评估结果。对患者参与 CBT 与结果之间剂量反应关系的检查是有限的。目前尚不清楚患者参与现场 CBT 干预与艾滋病毒感染者 (PLWH) 的焦虑和抑郁之间是否存在剂量反应关系。如果存在，这种剂量反应关系是在干预的早期还是后期发生？本研究旨在通过检查 PLWH 的 CBT 干预中患者参与度与焦虑和抑郁之间的剂量反应关系来解决这一差距。利用试点随机试验（10 名受试者）和临床对照试验（70 名受试者）的数据，我们的二次分析涵盖基线、3 个月和 6 个月的评估。两项试验均实施了护士主导的 CBT 干预。聚类分析根据现场出席情况和微信活动识别出两组。现场出诊依从性良好（6-10 次）的患者在 3 个月时表现出显着较低的焦虑和抑郁评分（β = 1.220，P = 0.047；β = 1.270，P = 0.019），而在 6 个月时没有观察到显着差异。几个月。微信活动没有显着影响焦虑或抑郁分数。研究结果强调了显着的短期剂量反应关系，支持护士主导的 CBT 干预措施对感染者心理健康的影响。组织策略应侧重于激励和促进患者参与，特别是通过增强微信功能。