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Brandl L, Cabrita M, Brodbeck J, Heylen D, van Velsen L. Consulting the Oracle: A Delphi study for determining parameters for a mental health user profile and personalization strategy for an online service to aid grieving older adults. Internet Interv 2022; 28:100534. [PMID: 35462943 PMCID: PMC9019256 DOI: 10.1016/j.invent.2022.100534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 03/29/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022] Open
Abstract
While much effort has been devoted to the development of mental e-health interventions, the tailoring of these applications to user characteristics and needs is a comparatively novel field of research. The premise of personalizing mental e-health interventions is that personalization increases user motivation and (thereby) mitigates intervention dropout and enhances clinical effectiveness. In this study, we selected user profile parameters for personalizing a mental e-health intervention for older adults who lost their spouse. We conducted a three-round Delphi study involving an international and interdisciplinary expert panel (N = 16) with two objectives. The first aim was to elicit adaptation strategies that can be used to dynamically readjust the intervention to the user's needs. The second aim was to identify a set of meaningful indicators for monitoring the user from within the grief intervention to escalate from self-help to blended care, whenever advisable. This Delphi study used as starting point an evaluated, text-based grief intervention composed of ten modules, including psychoeducation about grief and cognitive-behavioral exercises to support the user in adjusting their lives after bereavement. Every user follows this grief intervention in a linear fashion from beginning to end. The resulting conceptual adaptation model encompasses dynamic adjustments, as well as one-time adjustments performed at the initialization of the service. On the level of the application structure, the adaptations affect when which topic module is presented to the user. The adaptations further provide strategies for adjusting the text-based content of individual intervention modules dependent on user characteristics and for selecting appropriate reactions to user input. Eighteen monitoring parameters were elicited and grouped into four categories: clinical, behavioral/emotional, interactive, and external. Parameters that were perceived as most urgent to attend to for escalation were Suicidality, Self-destructive behavior, Client-initiated escalation, Unresponsiveness and (Complicated) Grief symptoms.
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Affiliation(s)
- Lena Brandl
- Roessingh Research and Development, P.O. Box 1212, Enschede, the Netherlands,University of Twente, Faculty of Electrical Engineering, Mathematics and Computer Science, Department of Human Media Interaction, P.O. Box 217, 7500AE Enschede, the Netherlands,Corresponding author at: University of Twente, Faculty of Electrical Engineering, Mathematics and Computer Science, Department of Human Media Interaction, P.O. Box 217, 7500AE Enschede, the Netherlands.
| | - Miriam Cabrita
- Roessingh Research and Development, P.O. Box 1212, Enschede, the Netherlands,University of Twente, Faculty of Electrical Engineering, Mathematics and Computer Science, Department of Biomedical Signals and Systems, P.O. Box 217, 7500AE Enschede, the Netherlands
| | - Jeannette Brodbeck
- Institute for Consulting, Coaching and Social Management, FHNW School of Social Work, Riggenbachstrasse 16, 4600 Olten, Switzerland,Universität Bern, Institut für Psychologie, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Dirk Heylen
- University of Twente, Faculty of Electrical Engineering, Mathematics and Computer Science, Department of Human Media Interaction, P.O. Box 217, 7500AE Enschede, the Netherlands
| | - Lex van Velsen
- Roessingh Research and Development, P.O. Box 1212, Enschede, the Netherlands,University of Twente, Faculty of Electrical Engineering, Mathematics and Computer Science, Department of Biomedical Signals and Systems, P.O. Box 217, 7500AE Enschede, the Netherlands
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