scholarly journals Gamification as an approach to improve resilience and reduce attrition in mobile mental health interventions: A randomized controlled trial

PLoS ONE ◽  
2020 ◽  
Vol 15 (9) ◽  
pp. e0237220 ◽  
Author(s):  
Silja Litvin ◽  
Rob Saunders ◽  
Markus A. Maier ◽  
Stefan Lüttke
2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Paul Bolton ◽  
Judith K Bass ◽  
Goran Abdulla Sabir Zangana ◽  
Talar Kamal ◽  
Sarah McIvor Murray ◽  
...  

2020 ◽  
Author(s):  
Esther Stalujanis ◽  
Joel Neufeld ◽  
Martina Glaus Stalder ◽  
Angelo Belardi ◽  
Gunther Meinlschmidt

BACKGROUND Smartphone-based mental health interventions provide new ways to treat mental disorders. There is certain evidence on the efficacy of such interventions. Placebo effects represent a substantial element of the mechanisms of action of face-to-face mental health interventions. OBJECTIVE We manipulated efficacy expectancies and investigated whether time trajectories of efficacy expectancies differed between conditions across a smartphone-based digital placebo mental health intervention. METHODS We conducted a randomized, controlled, single-blinded superiority trial with a multi-arm parallel design. Participants underwent a smartphone-based digital placebo mental health intervention for 20 consecutive days. We induced prospective efficacy expectancies by manipulating initial instructions on the purpose of the intervention and retrospective efficacy expectancies by manipulating feedback on the success of the intervention at days 1, 4, 7, 10, and 13. 132 healthy participants were randomized to four conditions: prospective expectancy only (n=33), retrospective expectancy only (n=33), combined expectancy (n=34), or control (n=32). Changes in efficacy expectancies were assessed with the Credibility Expectancy Questionnaire, at the introductory session and on intervention days 1, 7, 14, and 20. We performed our analyses for the intention-to-treat sample using a random effects model, with intervention day as time variable and condition as two factors: prospective expectancy (yes vs. no), and retrospective expectancy (yes vs.no), allowed to vary over participant and intervention day. RESULTS Credibility (b = -1.63, 95%confidence interval (CI) [-2.37, -0.89], P < 0.001) and expectancy (b = -0.77, 95%CI [-1.49, -0.05], P = 0.04) decreased across intervention days. For credibility and expectancy, we found significant three-way interactions intervention day*prospective expectancy*retrospective expectancy (b = 2.05, 95%CI [0.60, 3.50], P < 0.01 resp. b = 1.55, 95%CI [0.14, 2.95] P = 0.03). Efficacy expectancies decreased least in the combined expectancy and in the control condition, most in the prospective expectancy only and the retrospective expectancy only condition. CONCLUSIONS This is the first study investigating the induction of efficacy expectancies across a placebo smartphone-based mental health intervention. Efficacy expectancies decreased throughout intervention days and differed between conditions. Our findings may pave the way for diminishing and exploiting digital placebo effects and help to improve treatment efficacy of digital mental health interventions. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT02365220. Registered February 18, 2015.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saratu Umar Aliyu ◽  
Shmaila M. Hanif ◽  
Isa Usman Lawal

Abstract Background Post-fistula-repair incontinence (PFRI) is a common complication of vesicovaginal fistula (VVF) surgeries. It entails continuous leakage of urine after successful VVF closure. Pelvic Floor Muscle Training (PFMT) plays a vital role in the management of PFRI, however, an evolving exercise approach is the Paula Exercise Method (PEM) which has shown a promising effect in stopping urinary incontinence, but there is no data on its effect on PFRI. This study therefore, proposes to primarily investigate the effect of PEM on urine leakage and secondarily, pelvic floor strength (PFS), quality of life (QoL), sexual function (SF), and mental health (MH) in women with PFRI. Methods This is a study protocol for a randomized controlled trial. A total of 182 participants are expected to participate in the study after satisfying the inclusion criteria. The participants will be randomized into either PEM or PFMT study groups. The demographic data of all the participants will be recorded. Each participant will be assessed for urine leakage, PFS, QoL, SF, and MH at baseline and subsequently, at four, eight and 12 weeks of intervention. Demographic parameters will be summarized using descriptive statistics. Continuous data will be computed for differences using inferential statistic of Analysis of variance, t-test and Man Whitney U as appropriate. All analyses will be performed using SPSS version 22.0 with probability set at 0.05 alpha level. Discussion It is hoped that the outcome of this study will determine the effect of the Paula exercise method on urine leakage, pelvic floor strength, quality of life, sexual function, and mental health among women with post-fistula-repair incontinence and also provide evidence for the use of the Paula method in urinary incontinence. Trial registration: Pan African Clinical Trials Registry (www.pactr.org), identifier PACTR201906515532827.


2021 ◽  
pp. 088626052110041
Author(s):  
Roos Ruijne ◽  
Cornelis Mulder ◽  
Milan Zarchev ◽  
Kylee Trevillion ◽  
Roel van Est ◽  
...  

Despite increased prevalence of domestic violence and abuse (DVA), victimization through DVA often remains undetected in mental health care. To estimate the effectiveness of a system provider level training intervention by comparing the detection and referral rates of DVA of intervention community mental health (CMH) teams with rates in control CMH teams. We also aimed to determine whether improvements in knowledge, skills and attitudes to DVA were greater in clinicians working in intervention CMH teams than those working in control teams. We conducted a cluster randomized controlled trial in two urban areas of the Netherlands. Detection and referral rates were assessed at baseline and at 6 and 12 months after the start of the intervention. DVA knowledge, skills and attitudes were assessed using a survey at baseline and at 6 and 12 months after start of the intervention. Electronic patient files were used to identify detected and referred cases of DVA. Outcomes were compared between the intervention and control teams using a generalized linear mixed model. During the 12-month follow-up, detection and referral rates did not differ between the intervention and control teams. However, improvements in knowledge, skills and attitude during that follow-up period were greater in intervention teams than in control teams: β 3.21 (95% CI 1.18-4.60). Our trial showed that a training program on DVA knowledge and skills in CMH teams can increase knowledge and attitude towards DVA. However, our intervention does not appear to increase the detection or referral rates of DVA in patients with a severe mental illness. A low detection rate of DVA remains a major problem. Interventions with more obligatory elements and a focus on improving communication between CMH teams and DVA services are recommended.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacomijn Hofstra ◽  
Jorien van der Velde ◽  
Petra Jannette Havinga ◽  
Lies Korevaar

Abstract Background The onset of mental health problems generally occurs between the ages of 16 and 23 – the years in which young people follow post-secondary education, which is a major channel in our society to prepare for a career and enhance life goals. Several studies have shown that students with mental health problems have a higher chance of early school leaving. Supported Education services have been developed to support students with mental health problems to remain at school. The current project aims to study the effect of an individually tailored Supported Education intervention on remaining at school, study success, and satisfaction of students with mental health problems studying at an institute for intermediate vocational education and a university of applied sciences in the Netherlands. Methods/design The design combines quantitative research (Randomized Controlled Trial; RCT) with qualitative research (monitoring, interviews, focus groups). One hundred students with mental health problems recruited from the two educational institutes will be randomly allocated to either the intervention or control condition. The students in the intervention condition receive the Supported Education intervention given by a Supported Education specialist, the students in the active control condition receive support as usual plus advice from a trained staff member on potential supportive resources regarding studying with mental health problems. The primary outcome ‘remaining at school’, and the secondary outcome ‘study success’ will be determined using data from the school’s administration. The secondary outcome ‘student satisfaction’ and other variables that will be studied in a more exploratory way, such as self-efficacy and study skills, will be determined through online questionnaires at baseline, at 6 and at 12 months follow-up. Focus groups and interviews with the students and Supported Education specialists will be carried out to complement the trial. Discussion This RCT is the first to assess the effect of Supported Education on remaining at school, next to study success and student satisfaction among students with mental health problems. The use of a mixed-methods design will result in a thorough evaluation of the effect of the intervention. Issues regarding the influx and possible attrition of students in the follow-up are discussed. Trial registration The study was registered with Trialregister.nl, no. NL8349, date registered: February 4th 2020. Register name: Community participation through education. Effectiveness of Supported Education for youth with mental health problems, a mixed methods study – Study protocol for a Randomized Controlled Trial. Protocol Version: 3, date: May 28th, 2021.


2020 ◽  
Vol 42 (6_suppl) ◽  
pp. S39-S45
Author(s):  
Ram Pratap Beniwal ◽  
Priya Sreedaran ◽  
Uttara Chari ◽  
Ashok MV ◽  
Triptish Bhatia

Background: Persons with previous history of a suicide attempt are at increased future risk of death by suicide. These vulnerable individuals, however, do not seek receive or seek help from mental health services. Telephone-based psychosocial interventions are potential strategies in augmenting mental health care in such persons. Methods: We aim to compare the efficacy of telephone-based psychosocial interventions (TBPI) with routine telephone reminders in persons with recent suicide attempts using a multi-site, parallel group, rater-blind, two-arm randomized controlled trial design in 362 participants. In the first group, participants will receive three sessions of TBPI comprising of brief supportive interventions, problem-solving strategies, and reminders for adherence to prescribed mental health treatment at weekly intervals. In the second group, participants will receive three telephone reminders for adherence to prescribed mental health treatment at weekly intervals. We will follow up participants for 6 months. Primary outcomes are suicidal ideation scores on Beck’s Scale for Suicide Ideation and number of repeat suicide attempts. Secondary outcomes are scores on Beck’s Hopelessness Scale, Beck’s Depression Inventory, Connor–Davidson Resilience Scale and Visual Analogue Rating Scales for acceptability of interventions. Outcomes will be assessed at 1, 3, and 6 months after receiving telephone interventions or reminders. Results: The trial is currently underway after prospective registration under Clinical Trials Registry of India and has recruited 260 participants till August 15, 2020. Conclusion: This study has potential to generate evidence on additional strategies for use along with standard mental health treatments in management of high-risk suicide behaviors.


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