Engagement, Predictors, and Outcomes of a Trauma Recovery Digital Mental Health Intervention: Longitudinal Study (Preprint)

2021 ◽  
Author(s):  
Carolyn M. Yeager ◽  
Charles C. Benight
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Self Efficacy ◽  
Longitudinal Research ◽  
Outcome Expectations ◽  
Model Fit ◽  
Symptom Reduction ◽  
Trauma Recovery ◽  
Adequate Model ◽  
Latent Construct

BACKGROUND Worldwide, exposure to potentially traumatic events is extremely common and many will develop posttraumatic stress disorder (PTSD) along with other disorders. Unfortunately, considerable barriers to treatment exist. One promising approach to overcoming treatment barriers are digital mental health interventions (DMHIs). Yet, engagement with DMHIs is a concern and theoretically based research in this area is sparse and often inconclusive. OBJECTIVE The focus of this study was on the complex issue of DMHI engagement. Based on the social cognitive theoretical (SCT), the conceptualization of engagement and a theoretically based model of predictors and outcomes were investigated using a DMHI for trauma recovery. METHODS A 6-week longitudinal study with a national sample of trauma survivors was performed that measured engagement, predictors of engagement, and mediational pathways to symptom reduction while using a trauma recovery DMHI (NT1 = 915, NT2 = 350, NT3 = 168, NT4 = 101). RESULTS Confirmatory factor analysis of the engagement latent construct of duration, frequency, interest, attention, and affect produced an acceptable model fit, (χ² = 8.35, df = 2, P = .015, CFI = .973, RMSEA = .059, 90% CI = [.022, .103]. Using the latent construct, the longitudinal theoretical model demonstrated adequate model fit, CFI = .929, RMSEA = .052, 90% CI [.040, .064] and indicated that engagement self-efficacy (β = .35, P < .001) and outcome expectations (β = .37, P < .001) were significant predictors of engagement (R2 = 39%). The relationship between engagement and outcomes was mediated by both activation self-efficacy (β = .80, P < .001), and trauma coping self-efficacy (β = .40, P < .001), which predicted a reduction in PTSD symptoms (β = -.20, P = .017). CONCLUSIONS The results of this study may provide a solid foundation toward formalizing the nascent science of engagement. The engagement conceptualization consisted of general measures of attention, interest, affect, and usage that could be applied to other applications. The longitudinal research model supported two theoretically based predictors of engagement, engagement self-efficacy and outcome expectancies. Two task specific self-efficacies, activation and coping, proved to be significant mediators between engagement and symptom reduction. Taken together, this model can be applied to other DMHIs to understand engagement as well as predictors and mechanisms of action. Ultimately, this could help improve the design and development of engaging and effective trauma recovery DMHIs.

Future Aspirations of Young Women With Disabilities: An Examination of Social Cognitive Career Theory

2020 ◽  
Vol 43 (3) ◽  
pp. 169-179
Author(s):  
Yen K. Pham ◽  
Kara A. Hirano ◽  
Lauren Lindstrom ◽  
David S. DeGarmo
Keyword(s):  
Mental Health ◽  
Young Women ◽  
Self Efficacy ◽  
Social Cognitive Career Theory ◽  
Social Cognitive ◽  
Outcome Expectations ◽  
Career Theory ◽  
Women With Disabilities ◽  
Future Aspirations ◽  
Social Cognitive Career

Young women with disabilities face multiple barriers that limit their career pathways. Little research has been conducted to examine how cognitive constructs of career self-efficacy and outcome expectations contribute to their future aspirations. This study examined direct relationships between career self-efficacy and outcome expectations on future aspirations, mediating effects of autonomy and self-realization on these relationships, and moderating effects of mental health on these links for young women with disabilities. Although existing research on social cognitive career theory has focused on career self-efficacy, results from this study indicated that outcome expectations might have an even stronger influence on future aspirations. Mental health barriers negatively impact future aspirations of the study’s sample. Limitations and implications for research and practice were discussed.

scholarly journals Engagement With a Trauma Recovery Internet Intervention Explained With the Health Action Process Approach (HAPA): Longitudinal Study

2018 ◽  
Vol 5 (2) ◽  
pp. e29 ◽  
Author(s):  
Carolyn M Yeager ◽  
Kotaro Shoji ◽  
Aleksandra Luszczynska ◽  
Charles C Benight
Keyword(s):  
Self Efficacy ◽  
Outcome Expectations ◽  
Trauma Survivors ◽  
Trauma Recovery ◽  
Trauma Symptoms ◽  
Perceived Need ◽  
Distress Symptoms ◽  
Health Action ◽  
Action Process ◽  
Ehealth Intervention

Background There has been a growing trend in the delivery of mental health treatment via technology (ie, electronic health, eHealth). However, engagement with eHealth interventions is a concern, and theoretically based research in this area is sparse. Factors that influence engagement are poorly understood, especially in trauma survivors with symptoms of posttraumatic stress. Objective The aim of this study was to examine engagement with a trauma recovery eHealth intervention using the Health Action Process Approach theoretical model. Outcome expectancy, perceived need, pretreatment self-efficacy, and trauma symptoms influence the formation of intentions (motivational phase), followed by planning, which mediates the translation of intentions into engagement (volitional phase). We hypothesized the mediational effect of planning would be moderated by level of treatment self-efficacy. Methods Trauma survivors from around the United States used the eHealth intervention for 2 weeks. We collected baseline demographic, social cognitive predictors, and distress symptoms and measured engagement subjectively and objectively throughout the intervention. Results The motivational phase model explained 48% of the variance, and outcome expectations (beta=.36), perceived need (beta=.32), pretreatment self-efficacy (beta=.13), and trauma symptoms (beta=.21) were significant predictors of intention (N=440). In the volitional phase, results of the moderated mediation model indicated for low levels of treatment self-efficacy, planning mediated the effects of intention on levels of engagement (B=0.89, 95% CI 0.143-2.605; N=115). Conclusions Though many factors can affect engagement, these results offer a theoretical framework for understanding engagement with an eHealth intervention. This study highlighted the importance of perceived need, outcome expectations, self-efficacy, and baseline distress symptoms in the formation of intentions to use the intervention. For those low in treatment self-efficacy, planning may play an important role in the translation of intentions into engagement. Results of this study may help bring some clarification to the question of what makes eHealth interventions work.

scholarly journals Engagement With a Trauma Recovery Internet Intervention Explained With the Health Action Process Approach (HAPA): Longitudinal Study (Preprint)

2017 ◽  
Author(s):  
Carolyn M Yeager ◽  
Kotaro Shoji ◽  
Aleksandra Luszczynska ◽  
Charles C Benight
Keyword(s):  
Self Efficacy ◽  
Outcome Expectations ◽  
Trauma Survivors ◽  
Trauma Recovery ◽  
Trauma Symptoms ◽  
Perceived Need ◽  
Distress Symptoms ◽  
Health Action ◽  
Action Process ◽  
Ehealth Intervention

BACKGROUND There has been a growing trend in the delivery of mental health treatment via technology (ie, electronic health, eHealth). However, engagement with eHealth interventions is a concern, and theoretically based research in this area is sparse. Factors that influence engagement are poorly understood, especially in trauma survivors with symptoms of posttraumatic stress. OBJECTIVE The aim of this study was to examine engagement with a trauma recovery eHealth intervention using the Health Action Process Approach theoretical model. Outcome expectancy, perceived need, pretreatment self-efficacy, and trauma symptoms influence the formation of intentions (motivational phase), followed by planning, which mediates the translation of intentions into engagement (volitional phase). We hypothesized the mediational effect of planning would be moderated by level of treatment self-efficacy. METHODS Trauma survivors from around the United States used the eHealth intervention for 2 weeks. We collected baseline demographic, social cognitive predictors, and distress symptoms and measured engagement subjectively and objectively throughout the intervention. RESULTS The motivational phase model explained 48% of the variance, and outcome expectations (beta=.36), perceived need (beta=.32), pretreatment self-efficacy (beta=.13), and trauma symptoms (beta=.21) were significant predictors of intention (N=440). In the volitional phase, results of the moderated mediation model indicated for low levels of treatment self-efficacy, planning mediated the effects of intention on levels of engagement (B=0.89, 95% CI 0.143-2.605; N=115). CONCLUSIONS Though many factors can affect engagement, these results offer a theoretical framework for understanding engagement with an eHealth intervention. This study highlighted the importance of perceived need, outcome expectations, self-efficacy, and baseline distress symptoms in the formation of intentions to use the intervention. For those low in treatment self-efficacy, planning may play an important role in the translation of intentions into engagement. Results of this study may help bring some clarification to the question of what makes eHealth interventions work.

Longitudinal study of a dual-factor model of mental health in Chinese youth

2017 ◽  
Vol 38 (3) ◽  
pp. 287-303 ◽  
Author(s):  
Junmei Xiong ◽  
Yi Qin ◽  
Miaomiao Gao ◽  
Man Hai
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Self Efficacy ◽  
Group Membership ◽  
Factor Model ◽  
Significant Group ◽  
Academic Emotions ◽  
Complete Mental Health ◽  
Health Group ◽  
Academic Self Efficacy

By incorporating psychopathology and subjective well-being (SWB), the dual-factor model of mental health (DFM) can comprehensively measure psychological health. We examined the utility of the DFM among 1,293 Chinese adolescents (Grades 7–12). Furthermore, we examined the dynamics of mental health group membership via a two-wave longitudinal study of 531 students. SWB, psychopathology, affective self-regulatory efficacy, academic self-efficacy, and academic emotions were measured via self-report scales. Mental health group membership was determined according to combinations of high or low SWB and high or low psychopathology. The DFM was supported by our identification of its four constituent groups (i.e. complete mental health, vulnerable, troubled, and symptomatic but content). Significant group differences were found in affective self-regulatory efficacy, academic self-efficacy, and academic emotions, with clear contrasts observed between adolescents with complete mental health and their vulnerable peers, as well as between troubled adolescents and their symptomatic but content peers. Moreover, youth with complete mental health demonstrated the highest stability and troubled youth the lowest, whereas vulnerable youth had the highest rates of transitioning into both the complete mental health and troubled groups. Implications for practice are explored within the context of screening and intervention.

Testing a Model of Overall Activity in Older Adults

2001 ◽  
Vol 9 (2) ◽  
pp. 142-160 ◽  
Author(s):  
Barbara Resnick
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Physical Health ◽  
Self Efficacy ◽  
Outcome Expectations ◽  
Retirement Community ◽  
Continuing Care ◽  
Efficacy Expectations ◽  
The Mean ◽  
Mental And Physical Health

The purpose of this study was to test a model of overall activity in older adults. It was hypothesized that (a) mental and physical health directly influence sell-efficacy expectations; (b) mental and physical health, age, and self-efficacy expectations influence outcome expectations; and (c) all of these variables directly or indirectly influence overall activity. The sample included 175 older adults living in a continuing care retirement community, and a one-time interview was conducted. The mean age of the participants was 86 ± 5.7 years, and the majority were Caucasian (n = 173, 99%), women (n = 136, 78%), and unmarried (widowed or single; n = 137, 78%). Seven of the 10 hypothesized paths were significant. The variables physical health, self-efficacy expectations. and outcome expectations directly influenced activity, and age and mental health indirectly influenced activity through self-efficacy and outcome expectations. The data fit the model, and combined, these variables accounted for 29% of the variance in activity.

scholarly journals Evaluation of the E-Mental Health Mindfulness-Based and Skills-Based “CoPE It” Intervention to Reduce Psychological Distress in Times of COVID-19: Results of a Bicentre Longitudinal Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Alexander Bäuerle ◽  
Lisa Jahre ◽  
Martin Teufel ◽  
Christoph Jansen ◽  
Venja Musche ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Depressive Symptoms ◽  
Longitudinal Study ◽  
Self Efficacy ◽  
Primary Outcome ◽  
Anxiety Symptoms ◽  
Generalized Anxiety ◽  
Post Intervention ◽  
Secondary Outcomes

Background: The SARS-CoV-2 pandemic poses immense challenges for health care systems and population-wide mental health. The e-mental health intervention “CoPE It” has been developed to offer standardized and manualized support to overcome psychological distress caused by the pandemic. The aim of this study was to assess the effectiveness of “CoPE It” in terms of reducing distress (primary outcome), depression and anxiety symptoms, and improving self-efficacy, and mindfulness (secondary outcomes). Furthermore, the intervention's usability, feasibility, and participants' satisfaction with “CoPE It” was evaluated (tertiary outcome). The study protocol has been published previously.Methods: A bicentre longitudinal study was conducted from April 27th 2020 to May 3rd 2021. N = 110 participants were included in the analyses. The intervention consisted of four modules featuring different media promoting evidence-based methods of cognitive behavioral therapy and mindfulness-based stress reduction. Difference in psychological distress between baseline (T0) and post-intervention (T1) were analyzed by repeated measure analysis of covariance. Mixed linear models were applied to assess moderating effects. Depressive symptoms, generalized anxiety symptoms, self-efficacy, and mindfulness were compared between baseline (T0) and post-intervention (T1) via t-tests. Usability of the “CoPE It” intervention and participants' satisfaction was evaluated by calculation means and frequencies.Results:Primary outcome: A significant effect of time on psychological distress at post-intervention (T1) after controlling for age, gender, education, mental illness and attitudes toward online interventions was found. Depressive and anxiety symptoms, and mindfulness were a significant moderators of the relationship between time and psychological distress for consistent wording. Secondary outcomes: There was a significant decrease in depressive symptoms and generalized anxiety, and a significant increase in self-efficacy and mindfulness between baseline (T0) and post-intervention (T1). Tertiary outcomes: 95.83% of the participants thought the “CoPE It” intervention was easy to use and 87.50% were satisfied with the “CoPE It” intervention in an overall, general sense.Conclusion: The e-mental health “CoPE It” intervention seems to be an effective approach in reducing psychological distress, anxiety and depressive symptoms, and in enhancing self-efficacy and mindfulness during the COVID-19 pandemic. Participants' satisfaction and the program‘s feasibility, and usability were proven to be high.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: DRKS00021301.

scholarly journals The Influence of Masculine Norms and Occupational Factors on Mental Health: Evidence From the Baseline of the Australian Longitudinal Study on Male Health

2018 ◽  
Vol 12 (4) ◽  
pp. 696-705 ◽  
Author(s):  
Allison Milner ◽  
Anne Kavanagh ◽  
Tania King ◽  
Dianne Currier
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Mental Health Problems ◽  
Longitudinal Research ◽  
Baseline Survey ◽  
Masculine Norms ◽  
Work Related ◽  
Male Health ◽  
Australian Longitudinal Study ◽  
Male Dominated

Men employed in male-dominated occupations are at elevated risk of work-related fatalities, injuries, and suicide. Prior research has focused on associations between psychosocial and physical exposures at work and health outcomes. However, masculine norms may also contribute to mental health. We used data from the baseline survey of the Australian Longitudinal Study on Male Health to examine whether: (a) men in male-dominated jobs report greater adherence to masculine norms; (b) being in a male-dominated occupation is associated with poorer mental health; and (c) being in a male-dominated occupation modifies the association between masculine norms and mental health. Masculine norms were measured using the Conformity to Masculine Norms Inventory (CMNI-22). Mental health was assessed using the SF-12. Results of regression analysis (adjusted for covariates) suggest a linear relationship between the extent to which an occupation is male-dominated and endorsement of values on the CMNI-22. Many CMNI-22 subscales were related to poorer mental health. However, the need for self-reliance was identified as the strongest predictor of poorer mental health. The mental health scale did not appear to be patterned by occupational gender composition and we did not find an interaction between the gender ratio of an occupation and the CNMI-22 scale. These findings highlight the need to address harmful aspects of masculinity as a potential cause of mental health problems. More longitudinal research is needed on the social domains in which gender and health are experienced, such as in the workplace.

A Longitudinal Study of Mental Health in Emerging Adults

2014 ◽  
Vol 73 (3) ◽  
pp. 135-141 ◽  
Author(s):  
Monica S. Bachmann ◽  
Hansjörg Znoj ◽  
Katja Haemmerli
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Emerging Adults ◽  
Poor Mental Health ◽  
Need Satisfaction ◽  
Computer Assisted ◽  
Consistency Model ◽  
Negative Effect ◽  
The Cross ◽  
Health Model

Emerging adulthood is a time of instability. This longitudinal study investigated the relationship between mental health and need satisfaction among emerging adults over a period of five years and focused on gender-specific differences. Two possible causal models were examined: (1) the mental health model, which predicts that incongruence is due to the presence of impaired mental health at an earlier point in time; (2) the consistency model, which predicts that impaired mental health is due to a higher level of incongruence reported at an earlier point in time. Emerging adults (N = 1,017) aged 18–24 completed computer-assisted telephone interviews in 2003 (T1), 2005 (T2), and 2008 (T3). The results indicate that better mental health at T1 predicts a lower level of incongruence two years later (T2), when prior level of incongruence is controlled for. The same cross-lagged effect is shown for T3. However, the cross-lagged paths from incongruence to mental health are marginally associated when prior mental health is controlled for. No gender differences were found in the cross-lagged model. The results support the mental health model and show that incongruence does not have a long-lasting negative effect on mental health. The results highlight the importance of identifying emerging adults with poor mental health early to provide support regarding need satisfaction.

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