Impact of guidance on intervention adherence in computerised interventions for mental health problems: a meta-analysis

2021 ◽  
pp. 1-12
Author(s):  
Peter Musiat ◽  
Catherine Johnson ◽  
Melissa Atkinson ◽  
Simon Wilksch ◽  
Tracey Wade
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Health Interventions ◽  
Web Based ◽  
Symptoms Of Depression ◽  
Mental Health Interventions ◽  
Intervention Content ◽  
Intervention Adherence ◽  
The Impact

Abstract Web-based interventions are increasingly used for the prevention, treatment and aftercare of mental disorders. A crucial factor to the efficacy of such online programmes is adherence to the intervention content and procedure. It has been frequently suggested that adherence in web-based interventions is low and little is known about which factors influence adherence. To increase intervention uptake and completion, studies increasingly include interventions with some form of guidance. Guided interventions have been shown to have higher efficacy, however, evidence for the impact on adherence is limited and mixed. This meta-analysis explored the impact of human guidance on intervention completion in web-based mental health interventions. A total of 22 studies were included with interventions primarily targeting symptoms of depression and anxiety disorders. Results showed that guidance significantly increases the average amount of intervention completion [g = 0.29, 95% confidence interval (CI) 0.18–0.40] and the proportion of intervention completers [log odds ratio (OR) = 0.50, 95% CI 0.34–0.66] with small effects. On average, full completion rates were 12% higher in guided intervention groups. This meta-analysis demonstrated that guidance in web-based mental health interventions does increase adherence, but more research is required to better understand the specific mechanisms between guidance, adherence and outcomes.

scholarly journals The need for accessible mental health interventions for young adults in the COVID-19 pandemic: A student psychologists’ perspective and rapid systematic review

2021 ◽  
Author(s):  
Dilan Hulaj ◽  
Sophie Antesberger ◽  
Tabea Blum ◽  
Raffaela Böswald ◽  
Hannah M. Brandl ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Young Adults ◽  
General Population ◽  
Mental Health Problems ◽  
Severe Disease ◽  
Health Interventions ◽  
Medium Effect ◽  
Web Based ◽  
Mental Health Interventions

Importance: Although young adults are on average less affected by the physical consequences of COVID-19 infections, showing less severe disease progression and lower mortality risk, they suffer strongly from the mental health impact of the pandemic.Objective: We, a group of psychology students experiencing these impacts, aim to provide an overview of the existing literature on prevention and intervention efforts to effectively reduce the development of, or suffering from, mental health problems in young adults (18-35) during the COVID-19 pandemic.Evidence Review: A rapid systematic review was conducted to identify studies focusing on the implementation of mental health interventions for young adults of the general population during the COVID-19 pandemic. Literature was searched with Pubmed and Web of Science on June 17, 2021. The quality of each study was assessed by two reviewers with the Standard Quality Assessment Criteria for Evaluating Primary Research Papers.Findings: Of N = 76 records initially screened, eight studies met the inclusion criteria. Six applied web-based interventions, of which four were randomized controlled trials. Interventions were based on Cognitive Behavioral Therapy approaches (n = 5), mindfulness practices, logo-autobiography, and synergistic thinking methods. The interventions varied in length from single sessions to multiple sessions over a period of up to 10 weeks. All interventions were effective in reducing depression and anxiety symptoms, as well as stress with small to medium effect sizes and a symptom reduction up to 78.9%. With only three studies being of high quality, the overall quality was low.Conclusions and Relevance: Research on mental health interventions for young adults in the general population during the pandemic is sparse. However, all interventions resulted in symptoms reductions and thus have been shown to be effective ways of counteracting the potential development of mental disorders during times of uncertainty, with high levels of stress, such as during a pandemic. Therefore, we propose a concept for an innovative and cost-effective web-based platform to structure and raise awareness for existing measures.

The impact of a Stress Control course delivered in partnership with a sports organisation on mental health outcomes in a general population

2020 ◽  
Vol 13 ◽  
Author(s):  
Jennifer Hayes ◽  
Rosarie Crowley ◽  
Yvonne O’Brien ◽  
Geraldine Hannon ◽  
Emma Hennessey ◽  
...  
Keyword(s):  
Mental Health ◽  
General Population ◽  
Focus Group ◽  
Health Outcomes ◽  
Large Scale ◽  
Mental Health Problems ◽  
Health Interventions ◽  
Stress Control ◽  
Mental Health Interventions ◽  
The Impact

Abstract Mental health problems have a significant impact globally in terms of social and economic costs. Increasing access to and uptake of mental health interventions (particularly by men) remains a challenge for service providers. The current study sought to examine the efficacy of a delivering a Stress Control intervention in partnership with a community sporting organisation (the Gaelic Athletic Assocaition, GAA) in ameliorating mental health difficulties in a general population. Measures of anxiety, depression and quality of life were administered before and after the delivery of the 6-week programme. A focus group was conducted afterwards to gather qualitative data on participants’ experiences of the intervention. Statistically significant decreases in depression scores were found following attendance at the course: t (94) = 3.14, p = .002, with a large effect size (0.5) (n = 95). There was an increase in the number of male attendees compared with clinic-based courses. Thematic analysis of the focus group data revealed a number of key themes including increased accessibility in terms of the scale and context of the delivery of the course. Delivering large-scale psychoeducational courses like Stress Control in partnership with the GAA represents a promising avenue for increasing access (for males in particular) to an effective intervention for improving mental health outcomes Key learning aims (1) To gain an understanding of the impact of delivering a large-scale psychological intervention in partnership with a community sports organisation on accessibility and stigma reduction for participants. (2) To become aware of the potential benefits of considering non-clinic-based locations in running public mental health interventions. (3) To understand the key role of the normalisation of the experience of common mental health problems and the impact on intervention uptake.

scholarly journals The impact of technology systems and professional support in digital mental health interventions: a secondary meta-analysis

2021 ◽  
Author(s):  
Maxime Sasseville ◽  
Annie LeBlanc ◽  
Jack Tchuente ◽  
Mylene Boucher ◽  
Michele Dugas ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Reviews ◽  
Outcome Measurement ◽  
Meta Analysis ◽  
Health Interventions ◽  
Rapid Review ◽  
Anxiety And Depression ◽  
Inclusion Criteria ◽  
Mental Health Interventions ◽  
The Impact

Background: A rapid review of systematic reviews was conducted to assess the effectiveness of digital mental health interventions for people with a chronic disease. Although it provided an overview of the evidence, it offered limited understanding of ethe types of interventions that were the most effective. The aim of this study was to perform a meta-analysis of primary studies identified in this rapid review of systematic reviews by focusing on the needs of knowledge users. Methods: This secondary meta-analysis follows a rapid review of systematic reviews, a virtual workshop with knowledge users to identify research questions and a modified Delphi study to guide research methods. We conducted a secondary analysis of the primary studies identified in the rapid review. Two reviewers independently screened the titles and abstracts and applied inclusion criteria: RCT design using a digital mental health intervention in a population of adults with another chronic condition, published after 2010 in French or English, and including an outcome measurement of anxiety or depression. Results: 708 primary studies were extracted from the systematic reviews and 84 primary studies met the inclusion criteria Digital mental health interventions were significantly more effective than in-person care for both anxiety and depression outcomes. Online messaging was the most effective technology to improve anxiety and depression scores; however, all technology types were effective. Interventions partially supported by healthcare professionals were more effective than self-administered. Conclusions: While our meta-analysis identifies digital interventions characteristics that are more effective, all technologies and levels of support can be used considering implementation context and population. Review registration: The protocol for this review is registered in the National Collaborating Centre for Methods and Tools (NCCMT) COVID-19 Rapid Evidence Service (ID 75).

scholarly journals “Smartphone Apps Are Cool, but Do They Help Me?”: A Qualitative Interview Study of Adolescents’ Perspectives on Using Smartphone Interventions to Manage Nonsuicidal Self-Injury

2021 ◽  
Vol 18 (6) ◽  
pp. 3289
Author(s):  
Anja Čuš ◽  
Julian Edbrooke-Childs ◽  
Susanne Ohmann ◽  
Paul L. Plener ◽  
Türkan Akkaya-Kalayci
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Health Problems ◽  
Health Interventions ◽  
Structured Interviews ◽  
Related Factors ◽  
Self Injury ◽  
Qualitative Interview Study ◽  
Mental Health Interventions ◽  
Nonsuicidal Self Injury

Nonsuicidal self-injury (NSSI) is a major mental health problem associated with negative psychosocial outcomes and it most often starts in early adolescence. Despite this, adolescents are rarely involved in informing the development of interventions designed to address their mental health problems. This study aimed to (1) assess adolescents’ needs and preferences about future interventions that are delivered through smartphones and (2) develop a framework with implications for designing engaging digital mental health interventions. Fifteen adolescent girls, aged 12–18 years, who met diagnostic criteria for a current NSSI disorder and were in contact with mental health services, participated in semi-structured interviews. Following a reflexive thematic analysis approach, this study identified two main themes: (1) Experiences of NSSI (depicts the needs of young people related to their everyday experiences of managing NSSI) and (2) App in Context (portrays preferences of young people about smartphone interventions and reflects adolescents’ views on how technology itself can improve or hinder engaging with these interventions). Adolescent patients expressed interest in using smartphone mental health interventions if they recognize them as helpful, relevant for their life situation and easy to use. The developed framework suggests that digital mental health interventions are embedded in three contexts (i.e., person using the intervention, mental health condition, and technology-related factors) which together need to inform the development of engaging digital resources. To achieve this, the cooperation among people with lived experience, mental health experts, and human computer interaction professionals is vital.

scholarly journals Usability guidelines for developing and evaluating web-based mental health interventions: Establishing a practical framework

2019 ◽  
Author(s):  
Gustav Petersen ◽  
Jakob Hyldig Nielsen ◽  
Johannes Verner Olsen ◽  
Robin Niels Kok
Keyword(s):  
Mental Health ◽  
Evaluation Method ◽  
Health Anxiety ◽  
Health Interventions ◽  
Heuristic Evaluation ◽  
Web Based ◽  
Usability Assessment ◽  
E Learning ◽  
Mental Health Interventions ◽  
The Relationship

Background: Even though problems with usability constitute a major challenge to the implementation of new eHealth technology, the field web-based interventions is lacking usability guidelines for development and evaluation of web-based intervention platforms. Objective: The aim of present study is to create a set of eHealth-specific usability guidelines for the development and evaluation of web-based mental health interventions. Methods: Knowledge about usability was gathered from peripheral fields of e-learning, emotional design, and human-computer interaction in a top-down approach. This knowledge was synthesized into usability guidelines for web-based interventions, which were then case-tested on an existing web-based intervention for patients with health anxiety, using the heuristic evaluation method. Results: Nine broad guidelines were developed. The subsequent case-test of the web-based intervention showed that application of the guidelines was feasible and was able to identify several important usability issues with the intervention. Conclusions: Health professionals should be included in intervention design. Future usability assessment should focus on the different usability attributes. The relationship between usability and adherence needs further investigation.

scholarly journals Online Indicated Preventive Mental Health Interventions for Youth: A Scoping Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Marilon van Doorn ◽  
Laurens A. Nijhuis ◽  
Mees D. Egeler ◽  
Joost G. Daams ◽  
Arne Popma ◽  
...  
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Mental Health Problems ◽  
Well Being ◽  
Health Interventions ◽  
Health Complaints ◽  
Preventive Interventions ◽  
Online Interventions ◽  
Preventive Mental Health ◽  
Mental Health Interventions

Objective: Between the ages of 12 and 25 the onset of mental disorders typically occurs, and the burden of mental health problems is greatest for this group. Indicated preventive interventions to target individuals with subclinical symptoms to prevent the transition to clinical levels of disorders have gained considerable traction. However, the threshold to seek help appears to be high even when help is needed. Online interventions could offer a solution, especially during the COVID-19 pandemic. This scoping review will present an overview of the recent research of indicated online preventive interventions for youth (12–25 years) experiencing the early stages of mental health complaints with the aim of identifying the nature and extent of the research evidence.Methods: The 5-stage framework by Arksey and O'Malley was used. Academic literature published from 2013 onwards in printed or electronic format was included from Scopus, PsychINFO, and Ovid MEDLINE(R) ALL.Results: The search yielded 11,122 results, with the final selection resulting in inclusion of 30 articles for this review. In total, the articles included 4,950 participants. 26.7% of the selected articles focused on youth between 12 and 25 years. Of the articles 60% did not screen for, nor exclude participants with clinical levels of symptoms. Most studies used a common evidence-based therapy for the disorder-category targeted. More than half of the online interventions included some form of human support. Adherence levels ranged between 27.9 and 98%. The results indicate general effectiveness, usability and acceptability of online indicated preventive interventions. The most commonly used approach was CBT (n = 12 studies). Studies varied in their size, rigor of study, effectiveness and outcome measures. Online interventions with a combination of clinical and peer moderation (n = 3 studies) appear to result in the most stable and highest effect sizes.Conclusion: Online indicated preventive mental health interventions for youth with emerging mental health issues show promise in reducing various mental health complaints, and increasing positive mental health indicators such as well-being and resilience. Additionally, high levels of usability and acceptability were found. However, the included studies show important methodological shortcomings. Also, the research has mainly focused on specific diagnostic categories, meaning there is a lack of transdiagnostic approaches. Finally, clear definitions of- as well as instruments to measure- emerging or subclinical mental health symptoms in youth remain are missing.

The effects of non-clinician guidance on effectiveness and process outcomes of digital mental health interventions: A systematic review and meta-analysis. (Preprint)

2021 ◽  
Author(s):  
Calista Leung ◽  
Julia Pei ◽  
Kristen Hudec ◽  
Farhud Shams ◽  
Richard Munthali ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Psychosocial Support ◽  
Meta Analysis ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Health Interventions ◽  
Cochrane Central Register ◽  
Process Outcomes ◽  
Mental Health Interventions

BACKGROUND Digital mental health interventions are increasingly prevalent in the current context of rapidly evolving technology, and research indicates that they yield effectiveness outcomes comparable to in-person treatment. Integrating professionals (i.e. psychologists, physicians) into digital mental health interventions has been common, and the inclusion of guidance within programs can increase adherence to interventions. However, employing professionals to enhance mental health programs may undermine the scalability of digital interventions. Therefore, delegating guidance tasks to paraprofessionals (peer supporters, technicians, lay counsellors, or other non-clinicians) can help reduce costs and increase accessibility. OBJECTIVE This systematic review and meta-analysis evaluates the effectiveness, adherence, and other process outcomes of non-clinician guided digital mental health interventions. METHODS Four databases (MEDLINE, EMBASE, CINAHL, and PSYCInfo) were searched for randomized controlled trials published between 2010 and 2020 examining digital mental health interventions. Three journals focused on digital intervention were also hand searched and grey literature was searched using ProQuest and the Cochrane Central Register of Control Trials (CENTRAL). Two researchers independently assessed risk of bias using the Cochrane Risk of Bias Tool 2. Data were collected on effectiveness, adherence, and other process outcomes, and meta-analyses were conducted for effectiveness and adherence outcomes. Non-clinician guided interventions were compared with treatment as usual, clinician-guided interventions, and unguided interventions. RESULTS Thirteen studies qualified for inclusion. Results indicate that non-clinician guided interventions yielded higher post-treatment effectiveness outcomes when compared to conditions involving control programs (e.g. online psychoeducation, monitored attention control) or waitlist controls (k=7, Hedges g=-0.73 (95% CI -1.08 to -0.38)). There are significant differences between non-clinician guided interventions and unguided interventions as well (k=6, Hedges g=-0.17 (95% CI -0.23 to -0.11)). In addition, non-clinician guided interventions did not differ in effectiveness from clinician-guided interventions (k=3, Hedges g=0.08 (95% CI -0.01 to 0.17)). These results suggest that guided digital mental health interventions are helpful to improve mental health outcomes regardless of the qualification, and that the presence of a non-clinician guide improves effectiveness outcomes more than no guidance. Non-clinician guided interventions did not yield significantly different effects on adherence outcomes when compared with unguided interventions (k=3, OR 1.58 (95% CI 0.51 to 4.92)), although a general trend of improved adherence was observed within non-clinician guided interventions. CONCLUSIONS Integrating paraprofessionals and non-clinicians appear to improve outcomes of digital mental health interventions, and may also enhance adherence outcomes (though the trend was nonsignificant). Further research should focus on the specific types of tasks these paraprofessionals can successfully provide (i.e. psychosocial support, therapeutic alliance, technical augmentation) and their associated outcomes. CLINICALTRIAL The protocol is preregistered on PROSPERO (CRD42020191226).

scholarly journals Using generic preference-based measures in mental health: psychometric validity of the EQ-5D and SF-6D

2014 ◽  
Vol 205 (3) ◽  
pp. 236-243 ◽  
Author(s):  
Brendan Mulhern ◽  
Clara Mukuria ◽  
Michael Barkham ◽  
Martin Knapp ◽  
Sarah Byford ◽  
...  
Keyword(s):  
Mental Health ◽  
Economic Evaluation ◽  
Construct Validity ◽  
Psychometric Properties ◽  
Mental Health Problems ◽  
Data Sets ◽  
Common Mental Health Problems ◽  
Euroqol 5D ◽  
Mental Health Interventions ◽  
The Impact

BackgroundGeneric preference-based measures (EuroQoL-5D (EQ-5D) and SF-6D) are used in the economic evaluation of mental health interventions. However, there are inconsistent findings regarding their psychometric properties.AimsTo investigate the psychometric properties of the EQ-5D and SF-6D in different mental health conditions, using seven existing data-sets.MethodThe construct validity and responsiveness of the measures were assessed in comparison with condition-specific indicators.ResultsEvidence for construct validity and responsiveness in common mental health and personality disorders was found (correlations 0.22–0.64; effect sizes 0.37–1.24; standardised response means 0.45–1.31). There was some evidence for validity in schizophrenia (correlations 0.05–0.43), but responsiveness was unclear.ConclusionsEQ-5D and SF-6D can be used in the economic evaluation of interventions for common mental health problems with some confidence. In schizophrenia, a preference-based measure focused on the impact of mental health should be considered.

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