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Staguhn ED, Kirkhart T, Allen L, Campbell CM, Wegener ST, Castillo RC. Predictors of participation in online self-management programs: A longitudinal observational study. Rehabil Psychol 2024; 69:102-109. [PMID: 37956087 PMCID: PMC11059776 DOI: 10.1037/rep0000521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
PURPOSE/OBJECTIVE Lack of patient participation and engagement remains a barrier to implementing effective online self-management and behavioral health interventions. Identifying patient characteristics associated with engagement rates may lead to interventions that improve engagement in traditional and online self-management programs. In this study, two online self-management and recovery programs were evaluated to identify factors that predict patient engagement. RESEARCH METHOD/DESIGN Predictors were collected in a questionnaire at baseline before 435 participants started either of the two interventions. One or two online lessons were completed per week with seven or eight total lessons to complete in each program, and each lesson took about 20-30 min to finish. Full patient engagement was defined as completing all lessons and assessments in the program and partial engagement as attempting at least one lesson or assessment. RESULTS Predictors of full patient engagement were self-rated confidence in completing the program or being over 60 years of age. Predictors of at least partial patient engagement were experienced ordering online or being over 50 years of age. CONCLUSIONS/IMPLICATIONS Identifying profiles of individuals who predict poor engagement may improve implementation and the health outcomes of intervention programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Elena D. Staguhn
- Department of Health Policy and Management, Johns Hopkins
Bloomberg School of Public Health
- Physical Medicine and Rehabilitation, Johns Hopkins
Medicine
| | - Tricia Kirkhart
- Physical Medicine and Rehabilitation, Johns Hopkins
Medicine
| | - Lauren Allen
- Department of Health Policy and Management, Johns Hopkins
Bloomberg School of Public Health
| | | | | | - Renan C. Castillo
- Department of Health Policy and Management, Johns Hopkins
Bloomberg School of Public Health
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Saffari M, Chang KC, Chen JS, Potenza MN, Yen CF, Chang CW, Huang PC, Tsai HC, Lin CY. Sleep Quality and Self-Stigma Mediate the Association Between Problematic Use of Social Media and Quality of Life Among People With Schizophrenia in Taiwan: A Longitudinal Study. Psychiatry Investig 2023; 20:1034-1044. [PMID: 37997331 PMCID: PMC10678148 DOI: 10.30773/pi.2023.0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/10/2023] [Accepted: 08/28/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVE Problematic use of social media (PUSM) may affect sleep quality and self-stigma in people with schizophrenia and consequently reduce their quality of life (QoL). This longitudinal study investigated if sleep quality and self-stigma mediated relationships between PUSM and QoL. METHODS One-hundred-and-ninety-three outpatients with schizophrenia were recruited from a psychiatric center in Taiwan from April 2019 to August 2021 and participated in a longitudinal study at intervals of three months between measurements. QoL was assessed using the World Health Organization Quality of Life Questionnaire Brief Version; sleep quality using the Pittsburgh Sleep Quality Index; self-stigma using the Self-Stigma Scale-Short; and PUSM using the Bergen Social Media Addiction Scale. Via SPSS 20.0, general estimating equation models assessed temporal associations between variables. Via R software, mediating effects of self-stigma and sleep quality were examined through Monte Carlo simulations with 20,000 repetitions. RESULTS Mean scores of physical, psychological, social and environmental QoL ranged from 11.86 to 13.02. Mean scores of sleep quality and self-stigma were 9.1±4.5 and 2.2±0.8, respectively. Sleep quality and self-stigma were directly related to QoL (p<0.001) and mediated indirect relationships between PUSM and all components of QoL with a range of 95% confidence intervals spanning from -0.0591 to -0.0107 for physical QoL; -0.0564 to -0.0095 for psychological QoL; -0.0292 to -0.0035 for social QoL; and -0.0357 to -0.0052 for environmental QoL. CONCLUSION Sleep quality and self-stigma mediated relationships between PUSM and QoL in people with schizophrenia. Developing interventions targeting PUSM, sleep, and self-stigma may help improve QoL in people with schizophrenia.
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Affiliation(s)
- Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Kun-Chia Chang
- Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Ching-Wen Chang
- Graduate Institute of Social Work, National Taiwan Normal University, Taipei, Taiwan
| | - Po-Ching Huang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsin-Chi Tsai
- Department of Psychiatry, School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Psychiatry, Tzu Chi General Hospital, Hualien, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- University of Religions and Denominations, Qom, Iran
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Yu E, Xu B, Sequeira L. Determinants of e-Mental Health Use During COVID-19: Cross-sectional Canadian Study. J Med Internet Res 2022; 24:e39662. [DOI: 10.2196/39662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/30/2022] [Accepted: 10/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background
Access to mental health treatment across Canada remains a challenge, with many reporting unmet care needs. National and provincial e-Mental health (eMH) programs have been developed over the past decade across Canada, with many more emerging during COVID-19 in an attempt to reduce barriers related to geography, isolation, transportation, physical disability, and availability.
Objective
The aim of this study was to identify factors associated with the utilization of eMH services across Canada during the COVID-19 pandemic using Andersen and Newman’s framework of health service utilization.
Methods
This study used data gathered from the 2021 Canadian Digital Health Survey, a cross-sectional, web-based survey of 12,052 Canadians aged 16 years and older with internet access. Bivariate associations between the use of eMH services and health service utilization factors (predisposing, enabling, illness level) of survey respondents were assessed using χ2 tests for categorical variables and t tests for the continuous variable. Logistic regression was used to predict the probability of using eMH services given the respondents’ predisposing, enabling, and illness-level factors while adjusting for respondents’ age and gender.
Results
The proportion of eMH service users among survey respondents was small (883/12,052, 7.33%). Results from the logistic regression suggest that users of eMH services were likely to be those with regular family physician access (odds ratio [OR] 1.57, P=.02), living in nonrural communities (OR 1.08, P<.001), having undergraduate (OR 1.40, P=.001) or postgraduate (OR 1.48, P=.003) education, and being eHealth literate (OR 1.05, P<.001). Those with lower eMH usage were less likely to speak English at home (OR 0.06, P<.001).
Conclusions
Our study provides empirical evidence on the impact of individual health utilization factors on the use of eMH among Canadians during the COVID-19 pandemic. Given the opportunities and promise of eMH services in increasing access to care, future digital interventions should both tailor themselves toward users of these services and consider awareness campaigns to reach nonusers. Future research should also focus on understanding the reasons behind the use and nonuse of eMH services.
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Information needs and sources of information among people with depression and anxiety: a scoping review. BMC Psychiatry 2022; 22:502. [PMID: 35896995 PMCID: PMC9326147 DOI: 10.1186/s12888-022-04146-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/05/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Previous studies have identified substantial unmet information needs in people with depression and anxiety. Sufficient information about the disorder, treatment, available services, and strategies for self-management is essential as it may influence quality of care and patients' quality of life. This scoping review aimed to provide a broad overview of information needs of people with depression and anxiety as well as the sources that they use to seek this information. METHODS We included all primary research published in English that investigated information needs or information sources in people with depression or anxiety, with no restrictions imposed on the study design, location, setting, or participant characteristics. Six electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, LISTA, Web of Science) and the grey literature (Google and Google Scholar) were searched for relevant studies published up to November 2021. Two reviewers independently screened articles and extracted data. Narrative synthesis was performed to identify key themes of information needs and information sources. Factors associated with information needs/sources such as demographic variables and symptom severity were also identified. RESULTS Fifty-six studies (comprising 8320 participants) were included. Information needs were categorised into seven themes, including general facts, treatment, lived experience, healthcare services, coping, financial/legal, and other information. The most frequently reported needs in both people with depression and anxiety were general facts and treatment information. Subclinical samples who self-reported depressive/anxious symptoms appeared less interested in treatment information than patients with clinical diagnoses. Information sources were summarised into five categories: health professionals, written materials, media, interpersonal interactions, and organisational resources. Health professionals and media (including the internet) were the most frequently adopted and preferred sources. Although few studies have examined factors associated with information needs and information sources, there is preliminary evidence that symptom severity and disease subtypes are related to information needs/sources, whereas findings on demographic factors were mixed. CONCLUSIONS Information needs appear to be high in people with depression and anxiety. Future research should examine differences between subgroups and associated factors such as the treatment course. Personalised information provision strategies are also needed to customise information according to individual needs and patient profiles. TRIAL REGISTRATION The protocol of this scoping review was registered on Open Science Framework (OSF; link: https://doi.org/10.17605/OSF.IO/DF2M6 ).
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Žaja N, Vukojević J, Žarko T, Marelić M, Vidović D, Vukušić Rukavina T. Internet Use among Patients with Schizophrenia and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095695. [PMID: 35565091 PMCID: PMC9104824 DOI: 10.3390/ijerph19095695] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 12/18/2022]
Abstract
Background: The high and increasing prevalence of internet use in the general population and the significant burden of depression and schizophrenia urge us to investigate the patterns of internet use among patients with these illnesses. The aim of this study is to assess internet use and mental health-related internet use among patients suffering from schizophrenia and depression. Methods: A total of 104 patients with psychosis and 105 patients with depression were surveyed to assess their internet use and mental health-related internet use. Results: The majority of participants were internet users (87.6%), with 66.7% of internet users with psychosis and 71.4% of internet users with depression using it as a source of information on mental health. Participants with psychosis significantly more attributed the internet and mental health internet forums as helpful in coping with their mental illness and were more interested in the utilization of online mental health services than participants with depression. Conclusions: General internet use in patients with schizophrenia and depression corresponds with the internet use of the general population; however, they use it more often as a source of health information than the general population. Mental health service providers should offer more online interventions and treatment programs to patients with psychosis and depression, as our study suggests there is an unmet need for online mental health services for such patients.
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Affiliation(s)
- Nikola Žaja
- University Psychiatric Hospital Vrapče, Bolnička cesta 32, 10000 Zagreb, Croatia; (N.Ž.); (J.V.); (T.Ž.); (D.V.)
| | - Jakša Vukojević
- University Psychiatric Hospital Vrapče, Bolnička cesta 32, 10000 Zagreb, Croatia; (N.Ž.); (J.V.); (T.Ž.); (D.V.)
| | - Tvrtko Žarko
- University Psychiatric Hospital Vrapče, Bolnička cesta 32, 10000 Zagreb, Croatia; (N.Ž.); (J.V.); (T.Ž.); (D.V.)
| | - Marko Marelić
- Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Rockefellerova ulica 4, 10000 Zagreb, Croatia;
| | - Domagoj Vidović
- University Psychiatric Hospital Vrapče, Bolnička cesta 32, 10000 Zagreb, Croatia; (N.Ž.); (J.V.); (T.Ž.); (D.V.)
| | - Tea Vukušić Rukavina
- Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Rockefellerova ulica 4, 10000 Zagreb, Croatia;
- Correspondence: ; Tel.: +385-1459-0100
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Apolinário-Hagen J, Fritsche L, Wopperer J, Wals F, Harrer M, Lehr D, Ebert DD, Salewski C. Investigating the Persuasive Effects of Testimonials on the Acceptance of Digital Stress Management Trainings Among University Students and Underlying Mechanisms: A Randomized Controlled Trial. Front Psychol 2021; 12:738950. [PMID: 34721212 PMCID: PMC8549694 DOI: 10.3389/fpsyg.2021.738950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This experiment aims to investigate the influence of narrative information varying in the degree of perceived similarity and source credibility in supplemented testimonials on the acceptance of digital mental health services (digi-MHSs). Methods: In fall 2020, n=231 university students were randomly assigned to an active control group (aCG, n=55, “information only”) or one of three intervention groups (IGs) receiving information plus different testimonials being presented either by nonacademic staff (IG1, n=60), university students (IG2, n=58) or experts (IG3, n=58). We assessed mediation effects of similarity and credibility on acceptance in terms of attitudes and usage intentions. Results: Exposure to testimonials was associated with higher usage intentions (d=0.50) and more positive attitudes toward digi-MHSs (d=0.32) compared to mere information (aCG). Regarding source-related effects, one-way ANOVA showed group differences in intentions (ηp2=0.13) that were significantly higher after exposure to testimonials targeted at students than in the other groups after adjusting for baseline intentions (ηp2=0.24). Concerning underlying mechanisms, there were full mediation effects of similarity (IG1 versus IG2) on attitudes [95%CI (0.030, 0.441)] and intentions to use digi-MHSs [95%CI (0.100, 0.528)] and of credibility on attitudes [IG2 versus IG3; 95%CI (−0.217, −0.004)], all favoring students’ testimonials. Conclusion: Overall, this study indicates that the acceptance of digi-MHSs can be substantially increased by providing a simple, context-sensitive information intervention, including testimonials by university students. Since we identified mediating effects of credibility on cognitive attitudes and similarity on affect-driven intentions, a future trial could vary these features using narrative versus statistic information on digi-MHSs.
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Affiliation(s)
- Jennifer Apolinário-Hagen
- Institute of Occupational, Social and Environmental Medicine, Centre of Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Lara Fritsche
- Department of Health Psychology, Faculty of Psychology, University of Hagen, Hagen, Germany
| | | | - Frank Wals
- Faculty of Psychology, University of Hagen, Hagen, Germany
| | - Mathias Harrer
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lueneburg, Lueneburg, Germany
| | - David D Ebert
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Christel Salewski
- Department of Health Psychology, Faculty of Psychology, University of Hagen, Hagen, Germany
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Köhnen M, Dreier M, Freuck J, Härter M, Dirmaier J. [Acceptance and Use of the e-Mental Health Website - www.psychenet.de]. PSYCHIATRISCHE PRAXIS 2021; 49:205-212. [PMID: 34102698 DOI: 10.1055/a-1502-0961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Aim of our study was to investigate acceptance and use of the German e-mental health website - www.psychenet.de offering evidence-based health information, self-tests and patient decision aids concerning mental disorders and issues. METHODS The website was evaluated by means of an online survey (acceptance) and automatically generated data by web analysis software (use). RESULTS Overall, the website psychenet.de achieved high acceptance ratings among its users. In addition, the number of visitors to the website has increased steadily. CONCLUSION Results indicate that psychenet.de offers mental health information that are more likely to be used by certain groups (e. g., highly educated persons). Future research should focus on different presentation modes of health information (e. g. text- vs. video-based) for hard to reach target groups in order to potentially increase reach of health information to a broader audience.
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Affiliation(s)
- Moritz Köhnen
- Institut und Poliklinik für Medizinische Psychologie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf
| | - Mareike Dreier
- Institut und Poliklinik für Medizinische Psychologie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf
| | - Jannis Freuck
- Institut und Poliklinik für Medizinische Psychologie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf
| | - Martin Härter
- Institut und Poliklinik für Medizinische Psychologie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf
| | - Jörg Dirmaier
- Institut und Poliklinik für Medizinische Psychologie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf
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