Barriers to the Use of Web-Based Mental Health Programs for Preventing Depression: Qualitative Study

Background Depression has a profound impact on population health. Although using web-based mental health programs to prevent depression has been found to be effective in decreasing depression incidence, there are obstacles preventing their use, as reflected by the low rates of use and adherence. Objective The aims of the study are to understand the barriers to using web-based mental health programs for the prevention of depression and the possible dangers or concerns regarding the use of such programs. Methods BroMatters and HardHat were two randomized controlled trials (RCTs) that evaluated the effectiveness of e–mental health programs for preventing workplace depression. In the BroMatters RCT, only working men who were at high risk of having a major depressive episode were included. The participants were assigned to either the control group or 1 of 2 intervention groups. The control participants had access to the general depression information on the BroMatters website. Intervention group 1 had access to BroMatters and BroHealth—the depression prevention program. Intervention group 2 had access to BroMatters and BroHealth along with weekly access to a qualified coach through telephone calls. The HardHat trial targeted both men and women at high risk of having a major depressive episode. The participants in the intervention group were given access to the HardHat depression prevention program (which included a web-based coach), whereas HardHat access was only granted to the control group once the study was completed. This qualitative study recruited male participants from the intervention groups of the two RCTs. A total of 2 groups of participants were recruited from the BroMatters study (after a baseline interview: n=41; 1 month after the RCT: n=20; 61/744, 8.2%), and 1 group was recruited from the HardHat RCT 1 month after the initial quantitative interview (9/103, 8.7%). Semistructured interviews were performed with the participants (70/847, 8.3%) and analyzed using content analysis. Results There were both personal and program-level barriers to program use. The three personal barriers included time, stress level, and the perception of depression prevention. Content, functionality, and dangers were the program-level barriers to the use of web-based mental health programs. Large amounts of text and functionality issues within the programs decreased participants’ engagement. The dangers associated with web-based mental health programs included privacy breaches and inadequate help for severe symptoms. Conclusions There are personal and program-level barriers to the use of web-based mental health programs. The stigmatization of help seeking for depression symptoms affects the time spent on the program, as does the public perception of depression. Certain barriers may be mitigated by program updates, whereas others may require a complete shift in the perception of depression prevention.

Download Full-text

Barriers to the Use of Web-Based Mental Health Programs for Preventing Depression: Qualitative Study (Preprint)

10.2196/preprints.16949 ◽

2019 ◽

Author(s):

Heidi Eccles ◽

Molly Nannarone ◽

Bonnie Lashewicz ◽

Mark Attridge ◽

Alain Marchand ◽

...

Keyword(s):

Mental Health ◽

High Risk ◽

Major Depressive Episode ◽

Intervention Group ◽

Health Programs ◽

Control Group ◽

Major Depressive ◽

Web Based ◽

Depression Prevention ◽

Mental Health Programs

BACKGROUND Depression has a profound impact on population health. Although using web-based mental health programs to prevent depression has been found to be effective in decreasing depression incidence, there are obstacles preventing their use, as reflected by the low rates of use and adherence. OBJECTIVE The aims of the study are to understand the barriers to using web-based mental health programs for the prevention of depression and the possible dangers or concerns regarding the use of such programs. METHODS BroMatters and HardHat were two randomized controlled trials (RCTs) that evaluated the effectiveness of e–mental health programs for preventing workplace depression. In the BroMatters RCT, only working men who were at high risk of having a major depressive episode were included. The participants were assigned to either the control group or 1 of 2 intervention groups. The control participants had access to the general depression information on the BroMatters website. Intervention group 1 had access to BroMatters and BroHealth—the depression prevention program. Intervention group 2 had access to BroMatters and BroHealth along with weekly access to a qualified coach through telephone calls. The HardHat trial targeted both men and women at high risk of having a major depressive episode. The participants in the intervention group were given access to the HardHat depression prevention program (which included a web-based coach), whereas HardHat access was only granted to the control group once the study was completed. This qualitative study recruited male participants from the intervention groups of the two RCTs. A total of 2 groups of participants were recruited from the BroMatters study (after a baseline interview: n=41; 1 month after the RCT: n=20; 61/744, 8.2%), and 1 group was recruited from the HardHat RCT 1 month after the initial quantitative interview (9/103, 8.7%). Semistructured interviews were performed with the participants (70/847, 8.3%) and analyzed using content analysis. RESULTS There were both personal and program-level barriers to program use. The three personal barriers included time, stress level, and the perception of depression prevention. Content, functionality, and dangers were the program-level barriers to the use of web-based mental health programs. Large amounts of text and functionality issues within the programs decreased participants’ engagement. The dangers associated with web-based mental health programs included privacy breaches and inadequate help for severe symptoms. CONCLUSIONS There are personal and program-level barriers to the use of web-based mental health programs. The stigmatization of help seeking for depression symptoms affects the time spent on the program, as does the public perception of depression. Certain barriers may be mitigated by program updates, whereas others may require a complete shift in the perception of depression prevention.

Download Full-text

Perceived Effectiveness and Motivations for the Use of Web-Based Mental Health Programs: Qualitative Study

Journal of Medical Internet Research ◽

10.2196/16961 ◽

2020 ◽

Vol 22 (7) ◽

pp. e16961

Author(s):

Heidi Eccles ◽

Molly Nannarone ◽

Bonnie Lashewicz ◽

Mark Attridge ◽

Alain Marchand ◽

...

Keyword(s):

Mental Health ◽

High Risk ◽

Health Program ◽

Intervention Group ◽

Mental Health Program ◽

Health Programs ◽

Perceived Effectiveness ◽

Web Based ◽

Mental Health Programs ◽

Risk For Depression

Background The prevalence of depression is high and has been stable despite increased treatment, research, and dissemination. People encounter barriers to seeking traditional mental health services, which could be mitigated by using web-based prevention methods. Objective This study aims to understand what people at high risk for depression perceive as effective aspects of web-based mental health programs and what motivates people at high risk for depression to use web-based mental health programs. Methods We conducted an inductive content analysis using telephone interview data from 77 participants at high risk for depression who were recruited from 2 randomized controlled trials (RCTs). Participants from the first RCT were working men who had been randomly assigned to 1 of the following 3 groups: control group, who had access to general depression information from a website called BroMatters; intervention group 1, who had access to the BroMatters website along with the associated BroHealth web-based mental health program; and intervention group 2, who had access to the BroMatters website, the BroHealth web-based mental health program, and telephone sessions with a life coach. Participants from the second RCT were men and women who had been assigned to the intervention group, who received access to the HardHat web-based mental health program, or the control group, who only received access to the HardHat web-based mental health program following completion of the RCT. Participants for this inductive content analysis study were recruited from the intervention groups in both RCTs. Two groups of participants (n=41 and n=20) were recruited from the BroHealth RCT, and a third group comprised 16 participants that were recruited from the HardHat RCT. Results We generated four categories regarding the perceived effectiveness of web-based programs and five categories related to what motivates the use of web-based programs. Participants identified awareness, program medium and functionality, program content, and coaches as categories related to the effectiveness of the programs. Categories of motivators to use web-based programs included providing reminders or incentives, promotion of the programs, providing appropriate medium and functionality, appropriate content, and perceived need. The final category related to motivators reflects perceptions of participants who were either unsure about what motivates them or believed that there is no way to motivate use. Conclusions Conflicting evidence was obtained regarding the perceived effectiveness of aspects of the content and functionality of web-based programs. In general, web-based mental health programs were perceived to help increase mental health awareness, especially when it includes live access to a coach. However, the results also revealed that it is difficult to motivate people to begin using web-based mental health programs. Strategies that may motivate the use of such programs include perceived personal need, effective promotion, providing incentives and reminders, and improving functionality.

Download Full-text

Perceived Effectiveness and Motivations for the Use of Web-Based Mental Health Programs: Qualitative Study (Preprint)

10.2196/preprints.16961 ◽

2019 ◽

Author(s):

Heidi Eccles ◽

Molly Nannarone ◽

Bonnie Lashewicz ◽

Mark Attridge ◽

Alain Marchand ◽

...

Keyword(s):

Mental Health ◽

High Risk ◽

Health Program ◽

Intervention Group ◽

Mental Health Program ◽

Health Programs ◽

Perceived Effectiveness ◽

Web Based ◽

Mental Health Programs ◽

Risk For Depression

BACKGROUND The prevalence of depression is high and has been stable despite increased treatment, research, and dissemination. People encounter barriers to seeking traditional mental health services, which could be mitigated by using web-based prevention methods. OBJECTIVE This study aims to understand what people at high risk for depression perceive as effective aspects of web-based mental health programs and what motivates people at high risk for depression to use web-based mental health programs. METHODS We conducted an inductive content analysis using telephone interview data from 77 participants at high risk for depression who were recruited from 2 randomized controlled trials (RCTs). Participants from the first RCT were working men who had been randomly assigned to 1 of the following 3 groups: control group, who had access to general depression information from a website called BroMatters; intervention group 1, who had access to the BroMatters website along with the associated BroHealth web-based mental health program; and intervention group 2, who had access to the BroMatters website, the BroHealth web-based mental health program, and telephone sessions with a life coach. Participants from the second RCT were men and women who had been assigned to the intervention group, who received access to the HardHat web-based mental health program, or the control group, who only received access to the HardHat web-based mental health program following completion of the RCT. Participants for this inductive content analysis study were recruited from the intervention groups in both RCTs. Two groups of participants (n=41 and n=20) were recruited from the BroHealth RCT, and a third group comprised 16 participants that were recruited from the HardHat RCT. RESULTS We generated four categories regarding the perceived effectiveness of web-based programs and five categories related to what motivates the use of web-based programs. Participants identified awareness, program medium and functionality, program content, and coaches as categories related to the effectiveness of the programs. Categories of motivators to use web-based programs included providing reminders or incentives, promotion of the programs, providing appropriate medium and functionality, appropriate content, and perceived need. The final category related to motivators reflects perceptions of participants who were either unsure about what motivates them or believed that there is no way to motivate use. CONCLUSIONS Conflicting evidence was obtained regarding the perceived effectiveness of aspects of the content and functionality of web-based programs. In general, web-based mental health programs were perceived to help increase mental health awareness, especially when it includes live access to a coach. However, the results also revealed that it is difficult to motivate people to begin using web-based mental health programs. Strategies that may motivate the use of such programs include perceived personal need, effective promotion, providing incentives and reminders, and improving functionality.

Download Full-text

Coach-Facilitated Web-Based Therapy Compared With Information About Web-Based Resources in Patients Referred to Secondary Mental Health Care for Depression: Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/15001 ◽

2020 ◽

Vol 22 (6) ◽

pp. e15001

Author(s):

Sarah MacLean ◽

Daniel J Corsi ◽

Sadie Litchfield ◽

Julia Kucharski ◽

Kira Genise ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Health Care ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Web Based ◽

Randomized Controlled

Background Depression is a common mental disorder with a high social burden and significant impact on suicidality and quality of life. Treatment is often limited to drug therapies because of long waiting times to see psychological therapists face to face, despite several guidelines recommending that psychological treatments should be first-line interventions for mild to moderate depression. Objective We aimed to evaluate, among patients on a waitlist to receive secondary mental health care services for depression, how effective coach-guided web-based therapy (The Journal) is, compared with an information-only waitlist control group, in reducing depression symptoms after 12 weeks. Methods We conducted a randomized controlled trial with 2 parallel arms and a process evaluation, which included interviews with study participants. Participants assigned to the intervention group received 12 weeks of web-based therapy guided by a coach who had a background in social work. Patients in the control group receive a leaflet of mental health resources they could access. The primary outcome measure was a change in depression scores, as measured by the Patient-Health Questionnaire (PHQ-9). Results A total of 95 participants were enrolled (intervention, n=47; control, n=48). The mean change in PHQ-9 scores from baseline to week 12 was −3.6 (SD 6.6) in the intervention group and −3.1 (SD 6.2) in the control group, which was not a statistically significant difference with a two-sided alpha of .05 (t91=−0.37; P=.72, 95% CI −3.1 to 2.2). At 12 weeks, participants in the intervention group reported higher health-related quality of life (mean EuroQol 5 dimensions visual analogue scale [EQ-5D-VAS] score 66.8, SD 18.0) compared with the control group (mean EQ-5D VAS score 55.9, SD 19.2; t84=−2.73; P=.01). There were no statistically significant differences between the two groups in health service use following their initial consultation with a psychiatrist. The process evaluation showed that participants in the intervention group completed a mean of 5.0 (SD 2.3) lessons in The Journal and 8.8 (SD 3.1) sessions with the coach. Most participants (29/47, 62%) in the intervention group who completed the full dose of the intervention, by finishing 6 or more lessons in The Journal, were more likely to have a clinically important reduction in depressive symptoms at 12 weeks compared with the control group (Χ21=6.3; P=.01, Φ=0.37). Participants who completed the interviews reported that the role played by the coach was a major factor in adherence to the study intervention. Conclusions The results demonstrate that the use of guided web-based therapy for the treatment of depression is not more effective than information-only waitlist control. However, it showed that the coach has the potential to increase adherence and engagement with web-based depression treatment protocols. Further research is needed on what makes the coach effective. Trial Registration ClinicalTrials.gov: NCT02423733; https://clinicaltrials.gov/ct2/show/NCT02423733

Download Full-text

Coach-Facilitated Web-Based Therapy Compared With Information About Web-Based Resources in Patients Referred to Secondary Mental Health Care for Depression: Randomized Controlled Trial (Preprint)

10.2196/preprints.15001 ◽

2019 ◽

Author(s):

Sarah MacLean ◽

Daniel J. Corsi ◽

Sadie Litchfield ◽

Julia Kucharski ◽

Kira Genise ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Health Care ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Web Based ◽

Randomized Controlled

BACKGROUND Depression is a common mental disorder with a high social burden and significant impact on suicidality and quality of life. Treatment is often limited to drug therapies because of long waiting times to see psychological therapists face to face, despite several guidelines recommending that psychological treatments should be first-line interventions for mild to moderate depression. OBJECTIVE We aimed to evaluate, among patients on a waitlist to receive secondary mental health care services for depression, how effective coach-guided web-based therapy (The Journal) is, compared with an information-only waitlist control group, in reducing depression symptoms after 12 weeks. METHODS We conducted a randomized controlled trial with 2 parallel arms and a process evaluation, which included interviews with study participants. Participants assigned to the intervention group received 12 weeks of web-based therapy guided by a coach who had a background in social work. Patients in the control group receive a leaflet of mental health resources they could access. The primary outcome measure was a change in depression scores, as measured by the Patient-Health Questionnaire (PHQ-9). RESULTS A total of 95 participants were enrolled (intervention, n=47; control, n=48). The mean change in PHQ-9 scores from baseline to week 12 was −3.6 (SD 6.6) in the intervention group and −3.1 (SD 6.2) in the control group, which was not a statistically significant difference with a two-sided alpha of .05 (t91=−0.37; P=.72, 95% CI −3.1 to 2.2). At 12 weeks, participants in the intervention group reported higher health-related quality of life (mean EuroQol 5 dimensions visual analogue scale [EQ-5D-VAS] score 66.8, SD 18.0) compared with the control group (mean EQ-5D VAS score 55.9, SD 19.2; t84=−2.73; P=.01). There were no statistically significant differences between the two groups in health service use following their initial consultation with a psychiatrist. The process evaluation showed that participants in the intervention group completed a mean of 5.0 (SD 2.3) lessons in The Journal and 8.8 (SD 3.1) sessions with the coach. Most participants (29/47, 62%) in the intervention group who completed the full dose of the intervention, by finishing 6 or more lessons in The Journal, were more likely to have a clinically important reduction in depressive symptoms at 12 weeks compared with the control group (Χ21=6.3; P=.01, Φ=0.37). Participants who completed the interviews reported that the role played by the coach was a major factor in adherence to the study intervention. CONCLUSIONS The results demonstrate that the use of guided web-based therapy for the treatment of depression is not more effective than information-only waitlist control. However, it showed that the coach has the potential to increase adherence and engagement with web-based depression treatment protocols. Further research is needed on what makes the coach effective. CLINICALTRIAL ClinicalTrials.gov: NCT02423733; https://clinicaltrials.gov/ct2/show/NCT02423733

Download Full-text

Reducing Alcohol Use Among High School Athletes: A Randomized Controlled Trial of a Brief, Web-Based Personalized Normative Feedback Intervention

The Sport Psychologist ◽

10.1123/tsp.2020-0022 ◽

2021 ◽

Vol 35 (1) ◽

pp. 55-63

Author(s):

Diana M. Doumas ◽

Nadine R. Mastroleo

Keyword(s):

High School ◽

High Risk ◽

Alcohol Use ◽

Intervention Group ◽

Control Group ◽

Normative Feedback ◽

High School Athletes ◽

Feedback Intervention ◽

Web Based ◽

Personalized Normative Feedback

High school athletes are at risk for heavy alcohol use, which is associated with consequences that may negatively impact performance and eligibility to participate in sports. This study evaluated the efficacy of a web-based personalized normative feedback intervention on reducing alcohol use among high school athletes in their senior year. Class periods were randomized to the intervention or an assessment-only control group. Athletes completed surveys at baseline and at a 6-week follow-up. They were classified as high-risk or low-risk drinkers based on baseline reports of binge drinking. Results indicated that for athletes classified as high-risk drinkers, those in the intervention group reported significantly greater reductions in quantity of weekly drinking and peak drinking quantity compared with those in the assessment-only control group. There were no significant intervention effects for frequency of alcohol use. Findings support the efficacy of web-based personalized normative feedback intervention for reducing alcohol use among high school senior athletes.

Download Full-text

Web-based Therapy Plus Support by a Coach in Depressed Patients Referred to Secondary Mental Health Care: Randomized Controlled Trial

JMIR Mental Health ◽

10.2196/mental.8510 ◽

2018 ◽

Vol 5 (1) ◽

pp. e5 ◽

Cited By ~ 5

Author(s):

Simon Hatcher ◽

Robyn Whittaker ◽

Murray Patton ◽

Wayne Sylvester Miles ◽

Nicola Ralph ◽

...

Keyword(s):

Mental Health ◽

Randomized Controlled Trial ◽

Usual Care ◽

Controlled Trial ◽

Qualitative Interviews ◽

Intervention Group ◽

Control Group ◽

Web Based ◽

Randomized Controlled

Background The evidence for the effectiveness of Web-based therapies comes mainly from nonclinical populations, with a few studies in primary care. There is little evidence from patients referred to secondary mental health care with depression. Adherence to Web-based therapies is often poor. One way to increase this is to create a new health service role of a coach to guide people through the therapy. Objective This study aimed to test in people referred to secondary care with depression if a Web-based therapy (The Journal) supported by a coach plus usual care would be more effective in reducing depression compared with usual care plus an information leaflet about Web-based resources after 12 weeks. Methods We conducted a randomized controlled trial with two parallel arms and a process evaluation that included structured qualitative interviews analyzed using thematic analysis. The coach had a background in occupational therapy. Participants were recruited face-to-face at community mental health centers. Results We recruited 63 people into the trial (intervention 35, control 28). There were no statistically significant differences in the change from baseline in Patient Health Questionnaire-9 (PHQ-9) scores at 12 weeks comparing The Journal with usual care (mean change in PHQ-9 score 9.4 in the intervention group and 7.1 in the control group, t41=1.05, P=.30; mean difference=2.3, 95% CI −2.1 to 6.7). People who were offered The Journal attended on average about one less outpatient appointment compared with usual care, although this difference was not statistically significant (intervention mean number of visits 2.8 (SD 5.5) compared with 4.1 (SD 6.7) in the control group, t45=−0.80, P=.43; mean difference=1.3, 95% CI −4.5 to 2.0). The process evaluation found that the mean number of lessons completed in the intervention group was 2.5 (SD=1.9; range=0-6) and the number of contacts with the coach was a mean of 8.1 (SD=4.4; range=0-17). The qualitative interviews highlighted the problem of engaging clinicians in research and their resistance to recruitment: technical difficulties with The Journal, which prevented people logging in easily; difficulty accessing The Journal as it was not available on mobile devices; participants finding some lessons difficult; and participants saying they were too busy to complete the sessions. Conclusions The study demonstrated that it is feasible to use a coach in this setting, that people found it helpful, and that it did not conflict with other care that participants were receiving. Future trials need to engage clinicians at an early stage to articulate where Web-based therapies fit into existing clinical pathways; Web-based therapies should be available on mobile devices, and logging in should be easy. The role of the coach should be explored in larger trials. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN): 12613000015741; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363351&isReview=true (Archived by WebCite at http://www.webcitation.org/6wEyCc6Ss).

Download Full-text

Consumer-Guided Development of an Engagement-Facilitation Intervention for Increasing Uptake and Adherence for Self-Guided Web-Based Mental Health Programs: Focus Groups and Online Evaluation Survey

JMIR Formative Research ◽

10.2196/22528 ◽

2020 ◽

Vol 4 (10) ◽

pp. e22528

Author(s):

Amelia Gulliver ◽

Alison L Calear ◽

Matthew Sunderland ◽

Frances Kay-Lambkin ◽

Louise M Farrer ◽

...

Keyword(s):

Mental Health ◽

Focus Groups ◽

Lived Experience ◽

Health Programs ◽

Delivery Mode ◽

Depression And Anxiety ◽

Web Based ◽

Factors Influencing ◽

Mental Health Programs ◽

Evaluation Survey

Background Self-guided web-based mental health programs are effective in treating and preventing mental health problems. However, current engagement with these programs in the community is suboptimal, and there is limited evidence indicating how to increase the use of existing evidence-based programs. Objective This study aims to investigate the views of people with lived experience of depression and anxiety on factors influencing their engagement with self-guided web-based mental health (e–mental health) programs and to use these perspectives to develop an engagement-facilitation intervention (EFI) to increase engagement (defined as both uptake and adherence) with these programs. Methods A total of 24 community members (female=21; male=3) with lived experience of depression and anxiety or depression or anxiety alone participated in 1 of 4 focus groups discussing the factors influencing their engagement with self-guided e–mental health programs and the appearance, delivery mode, and functionality of content for the proposed EFI. A subsequent evaluation survey of the focus group participants (n=14) was conducted to evaluate the resultant draft EFI. Data were thematically analyzed using both inductive and deductive qualitative methods. Results Participants suggested that the critical component of an EFI was information that would challenge personal barriers to engagement, including receiving personalized symptom feedback, information regarding the program’s content or effectiveness and data security, and normalization of using e–mental health programs (eg, testimonials). Reminders, rewards, feedback about progress, and coaching were all mentioned as facilitating adherence. Conclusions EFIs have the potential to improve community uptake of e–mental health programs. They should focus on providing information on the content and effectiveness of e–mental health programs and normalizing their use. Given that the sample comprised predominantly young females, this study may not be generalizable to other population groups. There is a strong value in involving people with a lived experience in the design and development of EFIs to maximize their effectiveness.

Download Full-text

Be a Mom’s Efficacy in Enhancing Positive Mental Health among Postpartum Women Presenting Low Risk for Postpartum Depression: Results from a Pilot Randomized Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17134679 ◽

2020 ◽

Vol 17 (13) ◽

pp. 4679

Author(s):

Fabiana Monteiro ◽

Marco Pereira ◽

Maria Cristina Canavarro ◽

Ana Fonseca

Keyword(s):

Mental Health ◽

Postpartum Depression ◽

Preliminary Investigation ◽

Intervention Group ◽

Preliminary Evidence ◽

Positive Mental Health ◽

Low Risk ◽

Control Group ◽

Postpartum Women ◽

Web Based

In this study, we conducted a preliminary investigation of the efficacy of Be a Mom, a web-based self-guided intervention, in enhancing positive mental health among postpartum women at low risk for postpartum depression. Additionally, we examined Be a Mom’s efficacy regarding secondary outcomes as well as its acceptability and adherence. A total of 367 participants were randomly assigned to the Be a Mom group (n = 191) or to the waiting-list control group (n = 176) and completed baseline (T1) and postintervention (T2) assessments. The intervention group reported significant increases in positive mental health between T1 and T2 compared to the control group. Additionally, group effects were found for depressive and anxiety symptoms. A significantly higher proportion of participants in the Be a Mom group had an improvement trajectory (from not flourishing at T1 to flourishing at T2). A total of 62 (32.5%) women completed Be a Mom, and most would use it again if needed (n = 82/113; 72.6%). This study provides preliminary evidence of Be a Mom’s efficacy in increasing positive mental health among low-risk postpartum women. Our findings support mental health promotion strategies in the postpartum period and highlight the important role of web-based CBT interventions.

Download Full-text

Be a Mom, a Web-Based Intervention to Promote Positive Mental Health Among Postpartum Women With Low Risk for Postpartum Depression: Exploring Psychological Mechanisms of Change

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.701107 ◽

2021 ◽

Vol 12 ◽

Author(s):

Fabiana Monteiro ◽

Marco Pereira ◽

Maria Cristina Canavarro ◽

Ana Fonseca

Keyword(s):

Mental Health ◽

Intervention Group ◽

Positive Mental Health ◽

Low Risk ◽

Control Group ◽

Postpartum Women ◽

Psychological Processes ◽

Web Based ◽

Self Compassion

Background: This study explored whether Be a Mom, a brief and unguided cognitive behavioral web-based intervention, was effective in promoting psychological processes (self-compassion, psychological flexibility, emotion regulation) among low-risk postpartum women. Effects of Be a Mom in psychological processes compared with a control group were examined at post-intervention and at 4-months follow-up. Additionally, this work explored whether changes in psychological processes mediated improvements in positive mental health at postintervention.Methods: In total, 367 postpartum women presenting low risk for postpartum depression were randomly assigned to the intervention group (n = 191) or to a waiting-list control group (n = 176).Results: Compared with the control group, the intervention group reported significantly greater baseline to postintervention increases in self-compassion. No significant effects were found at the 4-month follow-up. Multilevel mediation showed that self-compassion improvements significantly mediated improvements in positive mental health among the intervention group. No significant results were found for psychological flexibility or emotion regulation.Conclusions: This study suggests that Be a Mom has the potential to cultivate self-compassion among low-risk postpartum women and that this may be a key mechanism for promoting positive mental health in this context.Clinical Trial Registration:www.clinicaltrials.gov, identifier: NCT04055974.

Download Full-text