scholarly journals 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

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.

scholarly journals 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 (Preprint)

2020 ◽  
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.

An engagement-facilitation intervention (EFI) for increasing uptake and engagement for self-guided online mental health interventions: Consumer-guided development (Preprint)

2019 ◽  
Author(s):  
Amelia Gulliver ◽  
Alison L Calear ◽  
Matthew Sunderland ◽  
Frances Kay-Lambkin ◽  
Louise M Farrer ◽  
...  
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Health Program ◽  
Mental Health Program ◽  
Health Interventions ◽  
Barriers And Facilitators ◽  
Health Programs ◽  
Current Evidence ◽  
Mental Health Interventions ◽  
Mental Health Programs

BACKGROUND Self-guided online mental health programs are effective in treating and preventing mental health problems. However, both the uptake and engagement with these programs in the community is suboptimal, and there is limited current evidence indicating how to increase the use of existing evidence-based programs. OBJECTIVE The current study aims to investigate the views of people with lived experience of depression and anxiety on the barriers and facilitators to using e-mental health interventions and to use these perspectives to help develop an engagement-facilitation intervention (EFI) to increase uptake and engagement with self-guided online mental health programs. METHODS A total of 24 community members (female = 21; male = 3) with lived experience of depression and/or anxiety participated in four focus groups that discussed: 1) barriers and facilitators to self-guided e-mental health programs, 2) specific details needed to help them decide to use an online program, and 3) the appearance, delivery mode, and functionality of content for the proposed EFI. A total of 14 of the focus group attendees participated in a subsequent follow-up survey to evaluate the resultant draft EFI. Data were thematically analysed using both inductive and deductive methods. RESULTS Participants suggested that the critical component of an EFI was information that would challenge personal barriers to engagement with psychosocial interventions. These were providing personalised feedback about symptoms, information about the content and effectiveness of the e-mental health program, normalisation of participation in e-mental health programs including testimonials, and brief information on data security. Reminders, rewards, feedback about their progress, and coaching were all mentioned as being useful in assisting people to continue to engage with a program once they had started. Feedback on the developed EFI was positive; with participants reporting satisfaction with the content of the EFI and that it would likely positively affect their use of an e-mental health program. CONCLUSIONS EFIs have the potential to improve the uptake of e-mental health programs in the community and should focus on providing information on the content and effectiveness of e-mental health programs, as well as normalising their use. There is strong value in involving people with a lived experience in the design and development of EFIs to maximise their effectiveness.

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

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.

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

10.2196/16949 ◽  
2021 ◽  
Vol 5 (7) ◽  
pp. e16949
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.

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

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.

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

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.

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