Pub Date : 2024-12-28DOI: 10.1016/j.invent.2024.100799
Anna Messina, Anna Maria Annoni, Rebecca Amati, Beatrice Bano, Giovanni Franscella, Emiliano Albanese, Maddalena Fiordelli
Aims
The growing use of technology in healthcare has contributed to the development of digital interventions for informal caregivers of people living with dementia. However, the marked heterogeneity of interventions poses challenges in evaluating their effectiveness. We conducted a review to delineate the distinctive features and development of the interventions, with focus on participatory methods.
Methods
We searched the following databases: Cochrane; Cinahl; Pubmed; Psychinfo; Scopus; Web of Knowledge, and IEEE, and screened and selected studies based on titles, abstracts and full texts. We used standardized procedure to abstract and synthetize relevant data of primary studies, and the Mixed Methods Appraisal Tool to assess their quality.
Results
Of 3136 records, 20 studies met the inclusion criteria. Most of the studies were web-based interventions, with multiple components and interactive features. The design and development of eight interventions employed participatory methods with large variations in the underlying framework and application.
Conclusions
This review sheds light on the design and development of digital interventions for dementia caregivers. The limited and heterogeneous use of participatory methods, along with inadequate reporting, hinders a clear understanding of intervention efficacy and implementation. Formal standardization of participatory action research methods is necessary to improve the design, development, and evaluation of digital interventions for caregivers of people with dementia.
{"title":"Participatory methods in designing digital health interventions for informal caregivers of people with dementia. A systematic review","authors":"Anna Messina, Anna Maria Annoni, Rebecca Amati, Beatrice Bano, Giovanni Franscella, Emiliano Albanese, Maddalena Fiordelli","doi":"10.1016/j.invent.2024.100799","DOIUrl":"10.1016/j.invent.2024.100799","url":null,"abstract":"<div><h3>Aims</h3><div>The growing use of technology in healthcare has contributed to the development of digital interventions for informal caregivers of people living with dementia. However, the marked heterogeneity of interventions poses challenges in evaluating their effectiveness. We conducted a review to delineate the distinctive features and development of the interventions, with focus on participatory methods.</div></div><div><h3>Methods</h3><div>We searched the following databases: Cochrane; Cinahl; Pubmed; Psychinfo; Scopus; Web of Knowledge, and IEEE, and screened and selected studies based on titles, abstracts and full texts. We used standardized procedure to abstract and synthetize relevant data of primary studies, and the Mixed Methods Appraisal Tool to assess their quality.</div></div><div><h3>Results</h3><div>Of 3136 records, 20 studies met the inclusion criteria. Most of the studies were web-based interventions, with multiple components and interactive features. The design and development of eight interventions employed participatory methods with large variations in the underlying framework and application.</div></div><div><h3>Conclusions</h3><div>This review sheds light on the design and development of digital interventions for dementia caregivers. The limited and heterogeneous use of participatory methods, along with inadequate reporting, hinders a clear understanding of intervention efficacy and implementation. Formal standardization of participatory action research methods is necessary to improve the design, development, and evaluation of digital interventions for caregivers of people with dementia.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100799"},"PeriodicalIF":3.6,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-12DOI: 10.1016/j.invent.2024.100797
Camilla S. Øverup , Daniel B. Johnsen , Martin Skriver , Søren Sander , Theis Lange , Gert Martin Hald
Parental relationship dissolution is among the most prevalent life crises for youths and is associated with both short- and long-term intra- and interpersonal struggles. Extant support programs tend to be in-person and in a group format. However, the structure and personnel needed for these programs make them costly to implement, less accessible, and difficult to scale. Digital interventions may present a suitable alternative. The current study examines the effectiveness of an online psycho-social intervention for children who have experienced parental relationship dissolution in Denmark, using a two-arm, parallel-group, randomized controlled trial study design. Families are recruited through Danish municipalities and the Danish Agency of Family Law and randomly assigned to the intervention group or wait-list control group. Individuals are assessed at baseline, 4 weeks, and 12 weeks post-baseline; parents complete questionnaires on behalf of their children aged 3–10, while youth aged 11–17 complete the questionnaires themselves. The primary study outcomes are 1) emotional problems symptoms, as measured by the Strength and Difficulty Questionnaire (SDQ), 2) mental well-being related difficulties, represented by the SDQ-Total scale score, and 3) impact of problems on daily life, as assessed by the SDQ-Impact scale score, at 12-weeks post-baseline. The data will be analyzed using a generalized estimating equation, accounting for non-independence of data (nesting of children within a family). The present study will contribute to the extant knowledge about the effectiveness of digital interventions for youths experiencing parental relationship dissolution and contribute to a cost-effective evidence-based scalable psychological help for a population who needs it.
{"title":"The “SES NXT” digital intervention for children of relationship dissolution: Study protocol for a randomized controlled trial study","authors":"Camilla S. Øverup , Daniel B. Johnsen , Martin Skriver , Søren Sander , Theis Lange , Gert Martin Hald","doi":"10.1016/j.invent.2024.100797","DOIUrl":"10.1016/j.invent.2024.100797","url":null,"abstract":"<div><div>Parental relationship dissolution is among the most prevalent life crises for youths and is associated with both short- and long-term intra- and interpersonal struggles. Extant support programs tend to be in-person and in a group format. However, the structure and personnel needed for these programs make them costly to implement, less accessible, and difficult to scale. Digital interventions may present a suitable alternative. The current study examines the effectiveness of an online psycho-social intervention for children who have experienced parental relationship dissolution in Denmark, using a two-arm, parallel-group, randomized controlled trial study design. Families are recruited through Danish municipalities and the Danish Agency of Family Law and randomly assigned to the intervention group or wait-list control group. Individuals are assessed at baseline, 4 weeks, and 12 weeks post-baseline; parents complete questionnaires on behalf of their children aged 3–10, while youth aged 11–17 complete the questionnaires themselves. The primary study outcomes are 1) emotional problems symptoms, as measured by the Strength and Difficulty Questionnaire (SDQ), 2) mental well-being related difficulties, represented by the SDQ-Total scale score, and 3) impact of problems on daily life, as assessed by the SDQ-Impact scale score, at 12-weeks post-baseline. The data will be analyzed using a generalized estimating equation, accounting for non-independence of data (nesting of children within a family). The present study will contribute to the extant knowledge about the effectiveness of digital interventions for youths experiencing parental relationship dissolution and contribute to a cost-effective evidence-based scalable psychological help for a population who needs it.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100797"},"PeriodicalIF":3.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-07DOI: 10.1016/j.invent.2024.100794
E.C.A. Mertens , J.-L. Van Gelder
The opportunities technology offers for improving mental health have led to a surge in digital interventions. A pivotal step in the development of such interventions involves translating theoretical intervention techniques into specific technological features. However, practical guidelines on how to approach this translation are currently underdeveloped. To support efforts to develop digital mental health interventions, from theoretical inception to an actual digital intervention, we present the Digital Intervention Development Guide (DID-Guide). The DID-Guide is structured into two distinct phases. Phase 1 establishes the intervention's theoretical foundation, outlining the steps for developing a theoretical intervention framework. Phase 2 translates this theoretical framework into actionable technological features, that make up the intervention. We break down the DID-Guide's two phases into a series of actionable steps, accompanied by concrete examples from a recent intervention that can be delivered through both a smartphone app and Virtual Reality. The DID-Guide serves as a comprehensive resource for creating impactful digital mental health interventions, while also facilitating collaboration and communication among a diverse range of stakeholders, including researchers, clinicians, and software developers.
{"title":"The DID-guide: A guide to developing digital mental health interventions","authors":"E.C.A. Mertens , J.-L. Van Gelder","doi":"10.1016/j.invent.2024.100794","DOIUrl":"10.1016/j.invent.2024.100794","url":null,"abstract":"<div><div>The opportunities technology offers for improving mental health have led to a surge in digital interventions. A pivotal step in the development of such interventions involves translating theoretical intervention techniques into specific technological features. However, practical guidelines on how to approach this translation are currently underdeveloped. To support efforts to develop digital mental health interventions, from theoretical inception to an actual digital intervention, we present the Digital Intervention Development Guide (DID-Guide). The DID-Guide is structured into two distinct phases. Phase 1 establishes the intervention's theoretical foundation, outlining the steps for developing a theoretical intervention framework. Phase 2 translates this theoretical framework into actionable technological features, that make up the intervention. We break down the DID-Guide's two phases into a series of actionable steps, accompanied by concrete examples from a recent intervention that can be delivered through both a smartphone app and Virtual Reality. The DID-Guide serves as a comprehensive resource for creating impactful digital mental health interventions, while also facilitating collaboration and communication among a diverse range of stakeholders, including researchers, clinicians, and software developers.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100794"},"PeriodicalIF":3.6,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-06DOI: 10.1016/j.invent.2024.100796
V. Peynenburg , R.P. Sapkota , N. Titov , B.F. Dear , H.D. Hadjistavropoulos
Background
Internet-delivered cognitive behaviour therapy (ICBT) is an accessible and effective treatment option for post-secondary students, but engagement and completion rates are less favourable than in non-student populations in routine care. Studies on students' treatment preferences suggest that a range of options should be offered. Examining students' engagement and outcomes associated with ICBT course options of varying durations can help inform how to optimally deliver ICBT to university students in routine care.
Methods
University students (N = 72) were offered a choice of a transdiagnostic ICBT course of three different durations (i.e., ultra-brief with no time locks, brief, or standard-length). The trial examined course preferences, predictors of preferences, treatment outcomes (depression, anxiety, and perceived academic functioning) at post-treatment and 4-month follow-up, as well as treatment engagement and satisfaction across course options.
Results
Of the 72 students who started treatment, 32 (44.4 %) chose the brief course, 36 (50.0 %) chose standard-length, and 4 (5.6 %) chose the ultra-brief course. Between-group comparisons focused on the brief and standard-length courses, as uptake was too low for the ultra-brief course. From pre-treatment to post-treatment, clients in both groups experienced large reductions in depression (brief: d = 1.26, 95 % CI [0.84, 1.69]; standard: d = 1.43, 95 % CI [0.88, 1.98]) and anxiety (brief: d = 1.40, 95 % CI [0.96, 1.84]; standard: d = 1.59, 95 % CI [1.03, 2.15]), and small but not significant improvements in perceived academic functioning (brief: d = 0.27, 95 % CI [−0.12, 0.67]; standard: d = 0.44, 95 % CI [−0.07, 0.95]). At 4-month follow-up, improvements in depression and anxiety were maintained and improvements in perceived academic functioning reached significance in both groups, with medium effects found. There were no pre-treatment between-group differences in demographic or clinical characteristics and treatment satisfaction was comparable between the groups. The percentage of clients who accessed all lessons was similar in the brief (59.4 %) and standard (55.6 %) courses.
Conclusions
As the brief and standard-length course options had similar uptake, outcomes, completion rates, and client satisfaction and similar costs in terms of therapist resources, clinics can confidently offer these options and accommodate student preferences. The low interest in an ultra-brief course prevented evaluation of the outcomes of this course but implies allocating time and resources to offering this option when offered alongside other options is not worthwhile in this particular clinic. Further research could explore whether offering ultra-brief ICBT under different circumstances is of interest and benefit to students.
{"title":"Internet-delivered cognitive behaviour therapy for university students: Preference trial for various course durations","authors":"V. Peynenburg , R.P. Sapkota , N. Titov , B.F. Dear , H.D. Hadjistavropoulos","doi":"10.1016/j.invent.2024.100796","DOIUrl":"10.1016/j.invent.2024.100796","url":null,"abstract":"<div><h3>Background</h3><div>Internet-delivered cognitive behaviour therapy (ICBT) is an accessible and effective treatment option for post-secondary students, but engagement and completion rates are less favourable than in non-student populations in routine care. Studies on students' treatment preferences suggest that a range of options should be offered. Examining students' engagement and outcomes associated with ICBT course options of varying durations can help inform how to optimally deliver ICBT to university students in routine care.</div></div><div><h3>Methods</h3><div>University students (<em>N</em> = 72) were offered a choice of a transdiagnostic ICBT course of three different durations (i.e., ultra-brief with no time locks, brief, or standard-length). The trial examined course preferences, predictors of preferences, treatment outcomes (depression, anxiety, and perceived academic functioning) at post-treatment and 4-month follow-up, as well as treatment engagement and satisfaction across course options.</div></div><div><h3>Results</h3><div>Of the 72 students who started treatment, 32 (44.4 %) chose the brief course, 36 (50.0 %) chose standard-length, and 4 (5.6 %) chose the ultra-brief course. Between-group comparisons focused on the brief and standard-length courses, as uptake was too low for the ultra-brief course. From pre-treatment to post-treatment, clients in both groups experienced large reductions in depression (brief: <em>d</em> = 1.26, 95 % CI [0.84, 1.69]; standard: <em>d</em> = 1.43, 95 % CI [0.88, 1.98]) and anxiety (brief: <em>d</em> = 1.40, 95 % CI [0.96, 1.84]; standard: <em>d</em> = 1.59, 95 % CI [1.03, 2.15]), and small but not significant improvements in perceived academic functioning (brief: <em>d</em> = 0.27, 95 % CI [−0.12, 0.67]; standard: <em>d</em> = 0.44, 95 % CI [−0.07, 0.95]). At 4-month follow-up, improvements in depression and anxiety were maintained and improvements in perceived academic functioning reached significance in both groups, with medium effects found. There were no pre-treatment between-group differences in demographic or clinical characteristics and treatment satisfaction was comparable between the groups. The percentage of clients who accessed all lessons was similar in the brief (59.4 %) and standard (55.6 %) courses.</div></div><div><h3>Conclusions</h3><div>As the brief and standard-length course options had similar uptake, outcomes, completion rates, and client satisfaction and similar costs in terms of therapist resources, clinics can confidently offer these options and accommodate student preferences. The low interest in an ultra-brief course prevented evaluation of the outcomes of this course but implies allocating time and resources to offering this option when offered alongside other options is not worthwhile in this particular clinic. Further research could explore whether offering ultra-brief ICBT under different circumstances is of interest and benefit to students.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100796"},"PeriodicalIF":3.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.invent.2024.100795
Catherine Johnson , Sarah J. Egan , Per Carlbring , Roz Shafran , Tracey D. Wade
Background
We examined the feasibility and outcomes of Artificial Intelligence (AI) as a virtual coach in guided self-help (GSH-AI) compared to pure self-help (PSH).
Method
Participants (N = 85 undergraduate university students; M age = 20.65 years [SD = 2.38]; 84 % female) were randomised to PSH (N = 42) or GSH-AI (N = 43). The intervention was a brief 11-module online cognitive behaviour therapy for perfectionism intervention completed over 4-weeks. GSH-AI participants were given suggested questions to ask AI for guidance in completing the intervention. Data were collected at baseline, 4- and 8-weeks post-randomisation.
Results
Engagement was good, only one person in each group did not use any modules; module completion was equivalent across conditions (6.67, SD = 3.22 and 6.18, SD = 3.42 respectively). Between baseline and post-intervention people in the GSH-AI condition showed an almost 3.5 times increase in preferring support to be received from AI versus other modes of support. Only 52 % and 22 % of participants completed 4- and 8-week post-randomisation surveys, with no differences in psychological outcomes between the PSH and GSH-AI groups. Main effects of time indicated moderate to large within-group effect size improvements for disordered eating, stress, anxiety, and perfectionism.
Conclusions
Qualitative feedback indicated that AI was initially acceptable as a guide and became even more acceptable after it had been experienced. Fully powered trials are required to determine the impact of AI guidance on outcomes, and whether type of AI platform (customised versus generic) and type of mental health disorder interact with its effects.
{"title":"Artificial intelligence as a virtual coach in a cognitive behavioural intervention for perfectionism in young people: A randomised feasibility trial","authors":"Catherine Johnson , Sarah J. Egan , Per Carlbring , Roz Shafran , Tracey D. Wade","doi":"10.1016/j.invent.2024.100795","DOIUrl":"10.1016/j.invent.2024.100795","url":null,"abstract":"<div><h3>Background</h3><div>We examined the feasibility and outcomes of Artificial Intelligence (AI) as a virtual coach in guided self-help (GSH-AI) compared to pure self-help (PSH).</div></div><div><h3>Method</h3><div>Participants (<em>N</em> = 85 undergraduate university students; M age = 20.65 years [<em>SD</em> = 2.38]; 84 % female) were randomised to PSH (<em>N</em> = 42) or GSH-AI (<em>N</em> = 43). The intervention was a brief 11-module online cognitive behaviour therapy for perfectionism intervention completed over 4-weeks. GSH-AI participants were given suggested questions to ask AI for guidance in completing the intervention. Data were collected at baseline, 4- and 8-weeks post-randomisation.</div></div><div><h3>Results</h3><div>Engagement was good, only one person in each group did not use any modules; module completion was equivalent across conditions (6.67, <em>SD</em> = 3.22 and 6.18, <em>SD</em> = 3.42 respectively). Between baseline and post-intervention people in the GSH-AI condition showed an almost 3.5 times increase in preferring support to be received from AI versus other modes of support. Only 52 % and 22 % of participants completed 4- and 8-week post-randomisation surveys, with no differences in psychological outcomes between the PSH and GSH-AI groups. Main effects of time indicated moderate to large within-group effect size improvements for disordered eating, stress, anxiety, and perfectionism.</div></div><div><h3>Conclusions</h3><div>Qualitative feedback indicated that AI was initially acceptable as a guide and became even more acceptable after it had been experienced. Fully powered trials are required to determine the impact of AI guidance on outcomes, and whether type of AI platform (customised versus generic) and type of mental health disorder interact with its effects.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100795"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-23DOI: 10.1016/j.invent.2024.100793
Hasan Arslan, A. Esin Yilmaz
The rate of exposure to traumatic events is high globally, and post-traumatic stress disorder (PTSD) is one of the most serious consequences. It was reported that approximately 14 million people were affected by earthquakes in Turkey in February 2023. Cognitive Behavioral Therapy (CBT) is a therapeutic approach to treating PTSD and has a proven efficacy. However, access to face-to-face therapies such as CBT is limited and there is a high dropout rate. Technology-based interventions can offer new solutions to make CBT more accessible and integrated into daily life. In this study, we will develop an application called TraumaRelief, which aims to relieve PTSD symptoms. We will test the feasibility, acceptability, and efficacy of this application through a pilot randomized controlled study conducted in Turkey, with 105 participants aged between 18 and 65 years who have experienced a traumatic event. Participants will be randomly assigned to the Application Plus Online Therapist Support Group (AT + OT Group), Application Only Group (Group A), and Waitlist Control Group (WLC Group). This study aims to evaluate symptoms of PTSD, depression, and anxiety, as well as their effects on quality of life. In addition, the feasibility and acceptability of the study; the attrition, consent, recruitment, and adherence rate to the application; fidelity of intervention delivery; system usability score; preferred and least preferred module components; app utilization frequency; and likelihood to recommend the application will be examined. Application efficacy will be monitored with follow-ups at one and three months. The results could provide important information on the integration of technology-based treatments with psychotherapy. In addition, it could allow the evaluation of potential mobile applications in the field of psychotherapy and represents an important step in the development and evaluation of a customized mobile application for a society with unique cultural and social dynamics, such as Turkey. It could also be an important resource for increasing the capacity to cope with the effects of traumatic events that have occurred in Turkey or future events.
{"title":"Assessing the feasibility, acceptability, and preliminary efficacy of the ‘TraumaRelief’ app for PTSD symptom management in Turkey: Study protocol for a pilot randomized controlled trial","authors":"Hasan Arslan, A. Esin Yilmaz","doi":"10.1016/j.invent.2024.100793","DOIUrl":"10.1016/j.invent.2024.100793","url":null,"abstract":"<div><div>The rate of exposure to traumatic events is high globally, and post-traumatic stress disorder (PTSD) is one of the most serious consequences. It was reported that approximately 14 million people were affected by earthquakes in Turkey in February 2023. Cognitive Behavioral Therapy (CBT) is a therapeutic approach to treating PTSD and has a proven efficacy. However, access to face-to-face therapies such as CBT is limited and there is a high dropout rate. Technology-based interventions can offer new solutions to make CBT more accessible and integrated into daily life. In this study, we will develop an application called TraumaRelief, which aims to relieve PTSD symptoms. We will test the feasibility, acceptability, and efficacy of this application through a pilot randomized controlled study conducted in Turkey, with 105 participants aged between 18 and 65 years who have experienced a traumatic event. Participants will be randomly assigned to the Application Plus Online Therapist Support Group (AT + OT Group), Application Only Group (Group A), and Waitlist Control Group (WLC Group). This study aims to evaluate symptoms of PTSD, depression, and anxiety, as well as their effects on quality of life. In addition, the feasibility and acceptability of the study; the attrition, consent, recruitment, and adherence rate to the application; fidelity of intervention delivery; system usability score; preferred and least preferred module components; app utilization frequency; and likelihood to recommend the application will be examined. Application efficacy will be monitored with follow-ups at one and three months. The results could provide important information on the integration of technology-based treatments with psychotherapy. In addition, it could allow the evaluation of potential mobile applications in the field of psychotherapy and represents an important step in the development and evaluation of a customized mobile application for a society with unique cultural and social dynamics, such as Turkey. It could also be an important resource for increasing the capacity to cope with the effects of traumatic events that have occurred in Turkey or future events.</div></div><div><h3>Clinical Trial Registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> Identifier <span><span>NCT06288594</span><svg><path></path></svg></span>. Unique Protocol ID: DEU-PSI-HA-001.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100793"},"PeriodicalIF":3.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-21DOI: 10.1016/j.invent.2024.100789
Blake F. Dear , Andreea I. Heriseanu , Bareena Johnson , Letitia Norton , Helen Nguyen , Ali Richards , Sheldon Pace , Nickolai Titov
Background
University students report high levels of psychological distress, which is a contributor to poorer academic, social and health outcomes. There is increasing interest in the use of internet-delivered psychological treatments in student counselling services as a strategy improving access to psychological care at scale. However, to date, few large-scale prospective effectiveness trials of internet-delivered psychological treatment have been conducted in “real world” settings with university student populations.
Aim
To investigate the effectiveness and acceptability of a brief transdiagnostic internet-delivered cognitive behavioural therapy (iCBT) intervention for anxiety and depression when delivered as part of routine care by the counselling service of an Australian university.
Design
A large, prospective, single-group Phase IV clinical trial.
Method
Students engaging with the university counselling service between 2018 and 2023 (N = 845; 8.5% of those presenting to the service) were given the option to receive the intervention based on their clinical needs and preferences. Students completed standardised measures of depression and anxiety severity at pre-treatment, each week of the intervention, and post-treatment. A subsample (n = 426) also completed the measures at 3-month follow-up.
Results
Over a 5-year period, 700 students participated in the intervention and 489 provided data at post-treatment. Significant reductions in depression symptoms (% reduction = 27%, Hedges' g = 0.35) and anxiety (% reduction = 37%, Hedges' g = 0.61) were observed, alongside high levels of satisfaction (>70%) and adherence (68%). Over 50% of students had clinically significant improvements in symptom severity, and symptom deterioration was observed in <15% of students.
Conclusion
The results of the current trial provide support for the effectiveness and acceptability of internet-delivered psychological interventions provided as part of routine care to university students with symptoms of anxiety and depression.
背景大学生的心理困扰程度很高，这也是学业、社交和健康状况较差的一个原因。越来越多的人开始关注在学生咨询服务中使用互联网提供的心理治疗方法，并将其作为一种改善心理治疗可及性的策略。目的 研究澳大利亚一所大学的心理咨询服务机构在常规治疗中使用简短的跨诊断网络认知行为疗法（iCBT）干预焦虑和抑郁的有效性和可接受性。设计一项大型、前瞻性、单组IV期临床试验。方法2018年至2023年期间参与大学咨询服务的学生（N = 845；占服务对象的8.5%）可根据其临床需求和偏好选择接受干预。学生们在治疗前、干预期间的每周和治疗后完成了抑郁和焦虑严重程度的标准化测量。结果在 5 年的时间里，共有 700 名学生参与了干预，其中 489 人提供了治疗后的数据。抑郁症状（减少率 = 27%，赫奇斯 g = 0.35）和焦虑症状（减少率 = 37%，赫奇斯 g = 0.61）显著减少，同时满意度（70%）和坚持率（68%）也很高。50%以上的学生症状严重程度有了明显改善，15%的学生症状恶化。
{"title":"Implementation trial II: Clinical outcomes and acceptability of an internet-delivered intervention for anxiety and depression delivered as part of routine care for university students in Australia","authors":"Blake F. Dear , Andreea I. Heriseanu , Bareena Johnson , Letitia Norton , Helen Nguyen , Ali Richards , Sheldon Pace , Nickolai Titov","doi":"10.1016/j.invent.2024.100789","DOIUrl":"10.1016/j.invent.2024.100789","url":null,"abstract":"<div><h3>Background</h3><div>University students report high levels of psychological distress, which is a contributor to poorer academic, social and health outcomes. There is increasing interest in the use of internet-delivered psychological treatments in student counselling services as a strategy improving access to psychological care at scale. However, to date, few large-scale prospective effectiveness trials of internet-delivered psychological treatment have been conducted in “real world” settings with university student populations.</div></div><div><h3>Aim</h3><div>To investigate the effectiveness and acceptability of a brief transdiagnostic internet-delivered cognitive behavioural therapy (iCBT) intervention for anxiety and depression when delivered as part of routine care by the counselling service of an Australian university.</div></div><div><h3>Design</h3><div>A large, prospective, single-group Phase IV clinical trial.</div></div><div><h3>Method</h3><div>Students engaging with the university counselling service between 2018 and 2023 (<em>N</em> = 845; 8.5% of those presenting to the service) were given the option to receive the intervention based on their clinical needs and preferences. Students completed standardised measures of depression and anxiety severity at pre-treatment, each week of the intervention, and post-treatment. A subsample (<em>n</em> = 426) also completed the measures at 3-month follow-up.</div></div><div><h3>Results</h3><div>Over a 5-year period, 700 students participated in the intervention and 489 provided data at post-treatment. Significant reductions in depression symptoms (% reduction = 27%, Hedges' <em>g</em> = 0.35) and anxiety (% reduction = 37%, Hedges' <em>g</em> = 0.61) were observed, alongside high levels of satisfaction (>70%) and adherence (68%). Over 50% of students had clinically significant improvements in symptom severity, and symptom deterioration was observed in <15% of students.</div></div><div><h3>Conclusion</h3><div>The results of the current trial provide support for the effectiveness and acceptability of internet-delivered psychological interventions provided as part of routine care to university students with symptoms of anxiety and depression.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100789"},"PeriodicalIF":3.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-21DOI: 10.1016/j.invent.2024.100791
Blake F. Dear , Andreea I. Heriseanu , Bareena Johnson , David Sander , Kimberly Farmer , Nickolai Titov
Background
Psychological distress is highly prevalent among university students and can contribute to poor academic performance and drop-out. Help-seeking has increased in recent years, contributing to growing interest in employing internet-delivered psychological treatments to support the mental health of university students. However, few large-scale “real-world” effectiveness trials have been conducted in routine care settings for this population.
Aim
The aim of the current study was to examine the acceptability and effectiveness of a brief, five-week internet-delivered cognitive behavioural therapy (iCBT) intervention for anxiety and depression when delivered as part of routine care by a university counselling service in New Zealand.
Design
A large, prospective, single-group Phase IV clinical trial.
Method
Students (N = 1044) engaging with the university counselling service between 2018 and 2023 were provided the option to receive the intervention based on their needs and preferences. Students completed standardised measures of depression and anxiety severity at pre-treatment, each week of the intervention, and post-treatment. A subsample (n = 405) also completed these at 3-month follow-up.
Results
Over a 5-year period, 839 students participated in the intervention. Significant reductions in symptoms of depression (% reduction = 35%, Hedges' g = 0.56) and anxiety (% reduction = 36%, Hedges' g = 0.73) were observed, alongside high levels of satisfaction (> 60%). Symptom deterioration was observed in <10% of students.
Conclusion
The current results provide further support for the provision of internet-delivered psychological interventions as routine care to university students with symptoms of anxiety and depression.
背景心理困扰在大学生中非常普遍，可导致学习成绩差和辍学。近年来，大学生寻求帮助的人数不断增加，这促使人们越来越关注采用互联网提供的心理治疗方法来帮助大学生获得心理健康。本研究的目的是考察新西兰一所大学的咨询服务机构在提供常规服务时，采用为期五周的简短网络认知行为疗法（iCBT）干预焦虑症和抑郁症的可接受性和有效性。方法在2018年至2023年期间接受大学咨询服务的学生（N = 1044）可根据自己的需求和偏好选择接受干预。学生在治疗前、干预期间的每周和治疗后完成了抑郁和焦虑严重程度的标准化测量。结果在 5 年的时间里，共有 839 名学生参与了干预。抑郁症状明显减轻（减轻率 = 35%，赫奇斯 g = 0.56），焦虑症状明显减轻（减轻率 = 36%，赫奇斯 g = 0.73），满意度也很高（60%）。结论目前的研究结果进一步支持将互联网提供的心理干预作为对有焦虑和抑郁症状的大学生的常规护理。
{"title":"Implementation trial I: Clinical outcomes and acceptability of an internet-delivered intervention for anxiety and depression delivered as part of routine care for university students in New Zealand","authors":"Blake F. Dear , Andreea I. Heriseanu , Bareena Johnson , David Sander , Kimberly Farmer , Nickolai Titov","doi":"10.1016/j.invent.2024.100791","DOIUrl":"10.1016/j.invent.2024.100791","url":null,"abstract":"<div><h3>Background</h3><div>Psychological distress is highly prevalent among university students and can contribute to poor academic performance and drop-out. Help-seeking has increased in recent years, contributing to growing interest in employing internet-delivered psychological treatments to support the mental health of university students. However, few large-scale “real-world” effectiveness trials have been conducted in routine care settings for this population.</div></div><div><h3>Aim</h3><div>The aim of the current study was to examine the acceptability and effectiveness of a brief, five-week internet-delivered cognitive behavioural therapy (iCBT) intervention for anxiety and depression when delivered as part of routine care by a university counselling service in New Zealand.</div></div><div><h3>Design</h3><div>A large, prospective, single-group Phase IV clinical trial.</div></div><div><h3>Method</h3><div>Students (<em>N</em> = 1044) engaging with the university counselling service between 2018 and 2023 were provided the option to receive the intervention based on their needs and preferences. Students completed standardised measures of depression and anxiety severity at pre-treatment, each week of the intervention, and post-treatment. A subsample (<em>n</em> = 405) also completed these at 3-month follow-up.</div></div><div><h3>Results</h3><div>Over a 5-year period, 839 students participated in the intervention. Significant reductions in symptoms of depression (% reduction = 35%, Hedges' <em>g</em> = 0.56) and anxiety (% reduction = 36%, Hedges' <em>g</em> = 0.73) were observed, alongside high levels of satisfaction (> 60%). Symptom deterioration was observed in <10% of students.</div></div><div><h3>Conclusion</h3><div>The current results provide further support for the provision of internet-delivered psychological interventions as routine care to university students with symptoms of anxiety and depression.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100791"},"PeriodicalIF":3.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/j.invent.2024.100790
Reece Bush-Evans , Emily Arden-Close , Sarah Thomas , John McAlaney , Ruijie Wang , Elvira Bolat , Sarah Hodge , Abigail Hamson-Ford , Keith Phalp
Gambling, though a popular social activity, can lead to addiction and cause significant harm. This study aimed to explore the experiences of 36 low-to-moderate risk gamblers (PGSI score 0–7; 31 male, 5 female; 10 per each intervention arm, 6 per control group) in the ‘EROGamb 2.0’ feasibility trial (n = 168). The trial used social norm messages and goal setting feedback to promote safer gambling behaviour. Participants took part in semi-structured interviews via telephone or audio calls using Zoom or Wire, a secure messaging app. The interviews were analysed using Framework Analysis. Most participants found the interventions interesting and useful, though some reported no change in their gambling behaviour. Motivations for joining the trial included interest in the topic, altruism, and financial incentives. Participants appreciated the study's clear information, efficient processes, and helpful notifications, despite some technical issues. Reactions to social norm messages were mixed, with some expressing scepticism about the statistics. However, the goal setting intervention was well-received, with participants valuing the clarity and usefulness of the information. External factors, such as promotional offers from gambling companies, influenced gambling behaviour. The findings support the feasibility and acceptability of social norm and goal setting interventions to reduce gambling behaviour, highlighting the need for personalised approaches in future research.
{"title":"Promoting safer gambling through social norms and goal setting: A qualitative process analysis of participants' experiences in the EROGamb 2.0 feasibility trial","authors":"Reece Bush-Evans , Emily Arden-Close , Sarah Thomas , John McAlaney , Ruijie Wang , Elvira Bolat , Sarah Hodge , Abigail Hamson-Ford , Keith Phalp","doi":"10.1016/j.invent.2024.100790","DOIUrl":"10.1016/j.invent.2024.100790","url":null,"abstract":"<div><div>Gambling, though a popular social activity, can lead to addiction and cause significant harm. This study aimed to explore the experiences of 36 low-to-moderate risk gamblers (PGSI score 0–7; 31 male, 5 female; 10 per each intervention arm, 6 per control group) in the ‘EROGamb 2.0’ feasibility trial (<em>n</em> = 168). The trial used social norm messages and goal setting feedback to promote safer gambling behaviour. Participants took part in semi-structured interviews via telephone or audio calls using Zoom or Wire, a secure messaging app. The interviews were analysed using Framework Analysis. Most participants found the interventions interesting and useful, though some reported no change in their gambling behaviour. Motivations for joining the trial included interest in the topic, altruism, and financial incentives. Participants appreciated the study's clear information, efficient processes, and helpful notifications, despite some technical issues. Reactions to social norm messages were mixed, with some expressing scepticism about the statistics. However, the goal setting intervention was well-received, with participants valuing the clarity and usefulness of the information. External factors, such as promotional offers from gambling companies, influenced gambling behaviour. The findings support the feasibility and acceptability of social norm and goal setting interventions to reduce gambling behaviour, highlighting the need for personalised approaches in future research.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100790"},"PeriodicalIF":3.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-17DOI: 10.1016/j.invent.2024.100792
Lara Baez , Jaime Hamil , Elaine McBride , Katherine A. Czech , Bayley J. Taple , Adriana Santillano , Mingjing Huang , Alinne Z. Barrera , S. Darius Tandon
Background
Depression that occurs in pregnancy or postpartum (perinatal depression) impacts 1 in 5 mothers, yet access to effective and high-quality preventative interventions remains elusive for most. Digital interventions are a promising solution to this treatment gap because of the ubiquity of mobile devices and internet access. The Mothers and Babies Online Course (eMB) is an online adaptation of Mothers and Babies, an evidence-based preventative program for postpartum depression. Preliminary studies of eMB point to its potential efficacy, but low engagement with eMB was a major limitation. Leveraging home visitors as coaches to guide clients through eMB may be a way to increase uptake and engagement, and ultimately improve outcomes when implemented in home visiting programs.
Objective
The aim of this study was to implement user-centered design methods to develop a coaching manual for home visitors to implement eMB.
Methods
10 parents and 10 home visitors were interviewed individually. Measures included a “think aloud” activity and a semi-structured interview focused on gaining insight into parent and home visitor needs and preferences regarding eMB coaching in the context of home visiting. Thematic analysis was used to derive themes and sub-themes from interview transcripts.
Results
Parents were enthusiastic about eMB, but noted barriers including limited time and forgetfulness. Parents also thought that their home visitor would be the ideal eMB coach because of the existing close relationship. Home visitors shared that eMB would fit seamlessly into their home visiting workflow. They also thought that home visitors could address challenges that parents encounter in using eMB and leverage their relationship with parents to crystalize learning. Home visitors also noted that a coaching manual would be a key part of successful eMB implementation. Thus, valuable insights from parents and home visitors were used to create a coaching manual.
Conclusions
Parents and home visitors were both enthusiastic about eMB with adjunctive coaching, and home visitors agreed that a coaching manual would be vital in guiding them to help parents through eMB. Results highlight the importance of engaging end-users in all aspects of online intervention design, including the coaching manual. The effectiveness of the intervention and utility of the coaching protocol will be evaluated in a future pilot trial.
{"title":"Developing a coaching manual to provide human support for the Mothers and Babies Online (eMB) perinatal mental health intervention","authors":"Lara Baez , Jaime Hamil , Elaine McBride , Katherine A. Czech , Bayley J. Taple , Adriana Santillano , Mingjing Huang , Alinne Z. Barrera , S. Darius Tandon","doi":"10.1016/j.invent.2024.100792","DOIUrl":"10.1016/j.invent.2024.100792","url":null,"abstract":"<div><h3>Background</h3><div>Depression that occurs in pregnancy or postpartum (perinatal depression) impacts 1 in 5 mothers, yet access to effective and high-quality preventative interventions remains elusive for most. Digital interventions are a promising solution to this treatment gap because of the ubiquity of mobile devices and internet access. The Mothers and Babies Online Course (eMB) is an online adaptation of Mothers and Babies, an evidence-based preventative program for postpartum depression. Preliminary studies of eMB point to its potential efficacy, but low engagement with eMB was a major limitation. Leveraging home visitors as coaches to guide clients through eMB may be a way to increase uptake and engagement, and ultimately improve outcomes when implemented in home visiting programs.</div></div><div><h3>Objective</h3><div>The aim of this study was to implement user-centered design methods to develop a coaching manual for home visitors to implement eMB.</div></div><div><h3>Methods</h3><div>10 parents and 10 home visitors were interviewed individually. Measures included a “think aloud” activity and a semi-structured interview focused on gaining insight into parent and home visitor needs and preferences regarding eMB coaching in the context of home visiting. Thematic analysis was used to derive themes and sub-themes from interview transcripts.</div></div><div><h3>Results</h3><div>Parents were enthusiastic about eMB, but noted barriers including limited time and forgetfulness. Parents also thought that their home visitor would be the ideal eMB coach because of the existing close relationship. Home visitors shared that eMB would fit seamlessly into their home visiting workflow. They also thought that home visitors could address challenges that parents encounter in using eMB and leverage their relationship with parents to crystalize learning. Home visitors also noted that a coaching manual would be a key part of successful eMB implementation. Thus, valuable insights from parents and home visitors were used to create a coaching manual.</div></div><div><h3>Conclusions</h3><div>Parents and home visitors were both enthusiastic about eMB with adjunctive coaching, and home visitors agreed that a coaching manual would be vital in guiding them to help parents through eMB. Results highlight the importance of engaging end-users in all aspects of online intervention design, including the coaching manual. The effectiveness of the intervention and utility of the coaching protocol will be evaluated in a future pilot trial.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100792"},"PeriodicalIF":3.6,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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