Implementing a peer advocate mental health program: a descriptive pilot study for Ohio youth (Preprint)

BACKGROUND In the United States, millions of adolescents report poor mental health, where one in five teenagers consider suicide. Reducing stigma and fostering peer support remain critical for positive mental health interventions and programs. Increasingly, digital mental health tools have emerged with great promise, leveraging social networks. Despite the potential, limited understanding of such comprehensive programs and their implementation exist. OBJECTIVE The objective of this study investigates a piloted digital mental health training program (Be Present) for youth, specifically describing the impact on youth behavioral outcomes, user engagement, and identifying high-risk youth in the early phases on prevention METHODS Eligibility included Ohio residents (14-22y) to be enrolled as either a “Friend” or a “Peer Advocate”. From May – June 2019, participants completed the Advocate Training course, taking pre-post surveys. Single-arm descriptive analyses measured youth outcomes (self-efficacy, intentions, behaviors, social support, knowledge, and sources of strength), engagement, and assess risk based on survey responses. RESULTS A total of 65 adolescents participated, with 54 completing both pre-post surveys. The majority of participants included non-Hispanic White females. Findings illustrated a significant increase in self-report of referrals for mental health services as well as in perceptions that youth had of experiencing social support, however no significant differences were found for measures self-efficacy, knowledge, and sources of strength between pre-post surveys. Roughly two-thirds of the participants completed all of the Advocate training modules, observing a gradual decline in engagement. Most respondents who received escalated high-risk response messages identified as female. CONCLUSIONS The pilot presented promise for implementing a digital mental health program focused on peer support, specifically observing reported youth behavioral outcomes, user engagement, and identifying high-risk youth. Various limitations exist given the small nonrepresentative sample and lack of control group. All findings should be considered preliminary to a larger trial and underscore the feasibility of delivering online training programs to bolster adolescent mental health. Such formative evaluation proved critical for future implementation and research, offering opportunity for substantial improvements for real world digital mental health programs.

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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.

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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.

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