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Cunningham JA, Godinho A, Schell C, Studer J, Wardell JD, Garnett C, Bertholet N. Randomized controlled trial of a smartphone app designed to reduce unhealthy alcohol consumption. Internet Interv 2024; 36:100747. [PMID: 38812955 PMCID: PMC11133919 DOI: 10.1016/j.invent.2024.100747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/03/2024] [Accepted: 05/10/2024] [Indexed: 05/31/2024] Open
Abstract
Background and aims Unhealthy alcohol use is common and causes tremendous harm. Most people with unhealthy alcohol use will never seek formal alcohol treatment. As an alternative, smartphone apps have been developed as one means to provide help to people concerned about their alcohol use. The aim of this study was to test the efficacy of a smartphone app targeting unhealthy alcohol consumption in a general population sample. Methods Participants were recruited from across Canada using online advertisements. Eligible participants who consented to the trial were asked to download a research-specific version of the app and were provided with a code that unlocked it (a different code for each participant to prevent sharing). Those who entered the code were randomized to one of two different versions of the app: 1) the Full app containing all intervention modules; or 2) the Educational only app, containing only the educational content of the app. Participants were followed-up at 6 months. The primary outcome variable was number of standard drinks in a typical week. Secondary outcome variables were frequency of heavy drinking days and experience of alcohol-related problems. Results A total of 761 participants were randomized to a condition. The follow-up rate was 81 %. A generalized linear mixed model revealed that participants receiving the full app reduced their typical weekly alcohol consumption to a greater extent than participants receiving the educational only app (incidence rate ratio 0.89; 95 % confidence interval 0.80 to 0.98). No significant differences were observed in the secondary outcome variables (p > .05). Discussion and conclusion The results of this trial provide some supportive evidence that smartphone apps can reduce unhealthy alcohol consumption. As this is the second randomized controlled trial demonstrating an impact of this same app (the first one targeted unhealthy alcohol use in university students), increased confidence is placed on the potential effectiveness of the smartphone app employed in the current trial.ClinicalTrials.org number: NCT04745325.
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Affiliation(s)
- John A. Cunningham
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
- Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | | | - Joseph Studer
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Vaud, Switzerland
- Service of Adult Psychiatry North-West, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Vaud, Switzerland
| | - Jeffrey D. Wardell
- Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of Psychology, York University, Toronto, Canada
| | - Claire Garnett
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Nicolas Bertholet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Vaud, Switzerland
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Knipschild R, Klip H, Winkelhorst K, Stutterheim T, van Minnen A. BLAME-LESS STUDY: a two-arm randomized controlled trial evaluating the effects of an online psychoeducation programme for adolescents who have experienced physical/sexual violence or sexual abuse. Rationale, study design, and methods. Eur J Psychotraumatol 2024; 15:2315794. [PMID: 38372268 PMCID: PMC10878330 DOI: 10.1080/20008066.2024.2315794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/20/2024] [Indexed: 02/20/2024] Open
Abstract
Background: Victims of physical/sexual violence or sexual abuse commonly experience defense responses that result in feelings of guilt and shame. Although trauma-focused interventions are effective in treating post-traumatic stress disorder symptoms, the presence of trauma-related shame and guilt can potentially hinder the process of disclosure during treatment, thus diminishing their overall effectiveness. It is hypothesized that providing psychoeducation about common defense responses will reduce feelings of shame and guilt, thereby increasing receptivity to trauma-focused treatment.Objective: This paper describes the rationale, study design, and methods of the BLAME-LESS study. The effects of a brief online psychoeducation program will be compared with a waiting-list control group. The intervention aims to reduce feelings of trauma-related shame and guilt that adolescents experience regarding their own defense responses during and after physical/sexual violence or sexual abuse.Methods: Adolescents (12 - 18 years old) with a history of physical/sexual violence or sexual abuse who suffer from trauma-related feelings of shame and guilt can participate in the study. The study follows a two-arm RCT that includes 34 participants. The primary outcomes includes trauma-related feelings of shame and guilt. The secondary outcomes includes PTSD symptoms, anxiety and depression symptoms, traumatic cognitions, readiness to disclose details of memories of the trauma, and motivation to engage in trauma-focused therapy. Assessments take place after screening, at baseline, two weeks after allocation to the intervention or waiting-list, and, only for the waiting-list participants, seven weeks after allocation to the intervention.Conclusions: There is a need for treatment approaches that target trauma-related feelings of shame and guilt. A recently developed brief online psychoeducation program on defense responses during and after trauma offers victims of physical/sexual violence or sexual abuse a free and accessible way to obtain reliable and valid information. The proposed RCT will evaluate the effectiveness of this online psychoeducation program.Trial Registration: Request is pending.
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Affiliation(s)
- Rik Knipschild
- Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands
| | - Helen Klip
- Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands
| | | | | | - Agnes van Minnen
- Psychotrauma Expertise Centre (PSYTREC), Bilthoven, the Netherlands
- Behavioural Science Institute (BSI), Radboud University, Nijmegen, the Netherlands
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Arcan C, Hou W, Hoffman K, Reichardt A, Yang X, Clouston SAP, Bromet EJ, Luft B. Mediterranean diet intervention among World Trade Center responders with post-traumatic stress disorder: Feasibility and outcomes of a pilot randomized controlled trial. Obes Sci Pract 2024; 10:e725. [PMID: 38263989 PMCID: PMC10804354 DOI: 10.1002/osp4.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 01/25/2024] Open
Abstract
Objective Responders of the World Trade Center (WTC) disaster suffer from co-morbidities. A Mediterranean Diet (MedDiet) nutrition intervention with physical activity was implemented among WTC responders with overweight/obesity and post-traumatic stress disorder (PTSD). Methods WTC Health Program members (N = 62), 45-65 years, males 87%, body mass index (BMI) 27-45 kg/m2 randomized to MedDiet (n = 31) or usual nutrition counseling (n = 31). The 10-week intervention included online nutrition education, text messages, and group experiential cooking; both groups had three in-person individual nutrition counseling. Anthropometrics, serum biomarkers, psychosocial factors, MedDiet score, and PTSD symptoms were assessed at baseline, post-intervention, and 3-months (follow-up). The primary outcome was intervention feasibility and secondary outcomes were within- and between-group changes of all measures at post-intervention and follow-up. Nonparametric Wilcoxon rank sum tests for between-group comparisons and Wilcoxon signed rank tests for pre-post within-group comparisons. Results A total of 58(94%) and 46(74%) participants completed the post-intervention and follow-up measurements, respectively. Both groups experienced significant improvements in anthropometrics, MedDiet score, oxidized low-density lipoprotein, and PTSD symptoms. Baseline median (range) were weight 100.42 (73.66-135.17) kg, BMI 33.20 (27.50-41.75) kg/m2, and Waist circumference (WC) 109.22 (90.17-150.62) cm. Median % weight loss at post-intervention was MedDiet: -3% (-11%-7%), p = 0.0002; Control: -1% (-13%-4%), p = 0.008 and at follow-up MedDiet: -2% (-14%-12%), p = 0.07; Control: -2% (-20%-3%), p = 0.006. The overall BMI was reduced by -0.68 kg/m2 (-4.61-2.09) kg/m2 p < 0.0001 at post-intervention and by -0.60 kg/m2 (-6.91-3.39) kg/m2, p < 0.0009 at follow-up. Overall, median WC was reduced (p < 0.0001); post-intervention -3.81 cm (-33.00-3.30)cm and follow-up -4.45(-38.10-4.57)cm. There were group differences in HbA1c (p = 0.019) and serum ω6/ω3 (p = 0.029) at post-intervention. Conclusion Online intervention with personal counseling was feasible in this population. Improvements in anthropometrics, MedDiet score, selected serum biomarkers and PTSD symptoms were found in both groups; group differences in HbA1c and serum ω6/ω3. A larger study with a delayed control is needed to better assess intervention effects.
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Affiliation(s)
- Chrisa Arcan
- Department of EpidemiologySchool of Population HealthVirginia Commonwealth UniversityRichmondVirginiaUSA
- Department of FamilyPopulation and Preventive MedicineRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Wei Hou
- Department of FamilyPopulation and Preventive MedicineRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
- Vertex Pharmaceuticals IncorporatedBostonMassachusettsUSA
| | - Kathryn Hoffman
- Stony Brook World Trade Center Health Plan and Wellness ProgramRenaissance School of MedicineStony Brook UniversityCommackNew YorkUSA
| | - Amanda Reichardt
- Stony Brook World Trade Center Health Plan and Wellness ProgramRenaissance School of MedicineStony Brook UniversityCommackNew YorkUSA
| | - Xiaohua Yang
- Stony Brook World Trade Center Health Plan and Wellness ProgramRenaissance School of MedicineStony Brook UniversityCommackNew YorkUSA
| | - Sean A. P. Clouston
- Department of FamilyPopulation and Preventive MedicineRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Evelyn J. Bromet
- Neurosciences InstituteRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Benjamin Luft
- Stony Brook World Trade Center Health Plan and Wellness ProgramRenaissance School of MedicineStony Brook UniversityCommackNew YorkUSA
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Messina A, Amati R, Annoni AM, Bano B, Albanese E, Fiordelli M. Culturally Adapting the World Health Organization Digital Intervention for Family Caregivers of People With Dementia (iSupport): Community-Based Participatory Approach. JMIR Form Res 2024; 8:e46941. [PMID: 38265857 PMCID: PMC10851118 DOI: 10.2196/46941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/21/2023] [Accepted: 12/04/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Informal caregivers of people with dementia are at high risk of developing mental and physical distress because of the intensity of the care provided. iSupport is an evidence-based digital program developed by the World Health Organization to provide education and support for the informal everyday care of people living with dementia. OBJECTIVE Our study aims to describe in detail the cultural adaptation process of iSupport in Switzerland. We specifically focused on the participatory strategies we used to design a culturally adapted, Swiss version of iSupport that informed the development of the desktop version, mobile app, and printed manual. METHODS We used a mixed methods design, with a community-based participatory approach. The adaptation of iSupport followed the World Health Organization adaptation guidelines and was developed in 4 phases: content translation, linguistic and cultural revision by the members of the community advisory board, validation with formal and informal caregivers, and refinement and final adaptation. RESULTS The findings from each phase showed and consolidated the adjustments needed for a culturally adapted, Swiss version of iSupport. We collected feedback and implemented changes related to the following areas: language register and expressions (eg, from "lesson" to "chapter" and from "suffering from" dementia to "affected by" dementia), resources (hyperlinks to local resources for dementia), contents (eg, from general nonfamiliar scenarios to local and verisimilar examples), graphics (eg, from generalized illustrations of objects to human illustrations), and extra features (eg, a glossary, a forum session, and a read-aloud option, as well as a navigation survey). CONCLUSIONS Our study provides evidence on how to culturally adapt a digital program for informal caregivers of people living with dementia. Our results suggest that adopting a community-based participatory approach and collecting lived experiences from the final users and stakeholders is crucial to meet local needs and to inform the further development, testing, and implementation of digital interventions in a specific cultural context.
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Affiliation(s)
- Anna Messina
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Rebecca Amati
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Anna Maria Annoni
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Beatrice Bano
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Maddalena Fiordelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
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Rotondi AJ, Belnap BH, Rothenberger S, Feldman R, Hanusa B, Rollman BL. Predictors of Use and Drop Out From a Web-Based Cognitive Behavioral Therapy Program and Health Community for Depression and Anxiety in Primary Care Patients: Secondary Analysis of a Randomized Controlled Trial. JMIR Ment Health 2024; 11:e52197. [PMID: 38231552 PMCID: PMC10836415 DOI: 10.2196/52197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND A previously reported study examined the treatment of primary care patients with at least moderate severity depressive or anxiety symptoms via an evidence-based computerized cognitive behavioral therapy (CCBT) program (Beating the Blues) and an online health community (OHC) that included a moderated internet support group. The 2 treatment arms proved to be equally successful at 6-month follow-up. OBJECTIVE Although highly promising, e-mental health treatment programs have encountered high rates of noninitiation, poor adherence, and discontinuation. Identifying ways to counter these tendencies is critical for their success. To further explore these issues, this study identified the primary care patient characteristics that increased the chances patients would not initiate the use of an intervention, (ie, not try it even once), initiate use, and go on to discontinue or continue to use an intervention. METHODS The study had 3 arms: one received access to CCBT (n=301); another received CCBT plus OHC (n=302), which included a moderated internet support group; and the third received usual care (n=101). Participants in the 2 active intervention arms of the study were grouped together for analyses of CCBT use (n=603) because both arms had access to CCBT, and there were no differences in outcomes between the 2 arms. Analyses of OHC use were based on 302 participants who were randomized to that arm. RESULTS Several baseline patient characteristics were associated with failure to initiate the use of CCBT, including having worse physical health (measured by the Short Form Health Survey Physical Components Score, P=.01), more interference from pain (by the Patient-Reported Outcomes Measurement Information System Pain Interference score, P=.048), less formal education (P=.02), and being African American or another US minority group (P=.006). Characteristics associated with failure to initiate use of the OHC were better mental health (by the Short Form Health Survey Mental Components Score, P=.04), lower use of the internet (P=.005), and less formal education (P=.001). Those who initiated the use of the CCBT program but went on to complete less of the program had less formal education (P=.01) and lower severity of anxiety symptoms (P=.03). CONCLUSIONS This study found that several patient characteristics predicted whether a patient was likely to not initiate use or discontinue the use of CCBT or OHC. These findings have clear implications for actionable areas that can be targeted during initial and ongoing engagement activities designed to increase patient buy-in, as well as increase subsequent use and the resulting success of eHealth programs. TRIAL REGISTRATION ClinicalTrials.gov NCT01482806; https://clinicaltrials.gov/study/NCT01482806.
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Affiliation(s)
- Armando J Rotondi
- Mental Illness Research Education and Clinical Center, VA Pittsburgh Healthcare System, Veterans Administration, Pittsburgh, PA, United States
- Center for Behavioral Health, Media and Technology, University of Pittsburgh, Pittsburgh, PA, United States
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Veterans Administration, Pittsburgh, PA, United States
| | - Bea Herbeck Belnap
- Center for Behavioral Health, Media and Technology, University of Pittsburgh, Pittsburgh, PA, United States
- Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Scott Rothenberger
- Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Robert Feldman
- Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Barbara Hanusa
- Mental Illness Research Education and Clinical Center, VA Pittsburgh Healthcare System, Veterans Administration, Pittsburgh, PA, United States
| | - Bruce L Rollman
- Center for Behavioral Health, Media and Technology, University of Pittsburgh, Pittsburgh, PA, United States
- Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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Sharma-Misra S, Maru M, Tomita A, Paruk S. Access and use of digital technology by patients with psychosis at a hospital in South Africa. S Afr J Psychiatr 2023; 29:2151. [PMID: 38126039 PMCID: PMC10730447 DOI: 10.4102/sajpsychiatry.v29i0.2151] [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: 07/19/2023] [Accepted: 10/24/2023] [Indexed: 12/23/2023] Open
Abstract
Background There is growing interest in the use of digital information and communication technology (ICT) for mental health care purposes. Information and communication technology tools may enhance mental health literacy and help-seeking behaviour. Aim To describe the access to, use and perception of ICT in people with schizophrenia and other psychotic disorders. Setting The study was conducted at an urban psychiatric hospital in Durban, KwaZulu-Natal (KZN) province, South Africa. Methods Participants completed questionnaires on their socio-demographic characteristics and access to, use and perception of ICT. Multiple ordinal logistic regressions were used to test the association between socio-demographic factors and ICT use and perception. Results Of the 165 participants (mean age = 41 years ± 14.2), 54.5% were male, 37.6% were employed, and most (93.3%) lived in an urban area. Most participants (93%) had access to the internet in past 3 months and a smartphone (89.8%). Age (AOR 0.94, p = 0.06, CI = 0.88-1.00) and marital status (AOR = 0.26, p 0.02, CI = 1.62-253.74) were associated with internet use, while age (AOR = 0.95, p 0.03, CI = 0.9-1.00), marital status (AOR = 3.64, p = 0.05, CI = 1.03-12.90), income (AOR = 4.02, p < 0.01, CI = 1.69-9.54), employment status (AOR = 0.16, p < 0.01, CI = 0.06-0.44), and living with HIV (AOR = 5.41, p < 0.01, CI = 1.39-21.07) were associated with frequency of internet use. Older participants had lower odds of using a mental health care app (AOR = 0.93, p = 0.02, CI= 0.88-0.99). Those with higher incomes had increased odds of seeking mental health information digitally (AOR = 4.33, p = 0.03, CI = 1.13-7.54). Conclusion People living with psychosis do have access to digital technology although pattern of use maybe influenced by sociodemographic factors. Contribution This study provides baseline data on digital technology use in Africa.
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Affiliation(s)
- Smitha Sharma-Misra
- Department of Psychiatry, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Mihoko Maru
- Department of Psychiatry, Boston Medical Center, Boston, United States
| | - Andrew Tomita
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Saeeda Paruk
- Department of Psychiatry, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Wang X, Xu H, Liu X, Yan J, Chen C, Li Y. Evaluating the effect of psychoeducational interventions on prenatal attachment and anxiety/depression in pregnant women and partners: A systematic review and meta-analysis. J Affect Disord 2023; 342:33-44. [PMID: 37689313 DOI: 10.1016/j.jad.2023.08.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/05/2023] [Accepted: 08/29/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Evidence about effective psychoeducational interventions to improve prenatal attachment, anxiety and depression has been increasing, but it lacks a complete synthesis of the results. The aim of this study is to evaluate the effect of psychoeducational intervention on prenatal attachment and anxiety/depression in pregnant women and their partners. METHODS Ten databases were systematically searched to identify randomized controlled trials (RCTs) on the effectiveness of psychoeducational interventions on prenatal attachment from inception to March 2023, then manually screened to include studies of anxiety or depression. Two researchers assessed the methodological quality of the included studies using the Cochrane risk-of-bias tool and meta-analysis was performed using RevMan 5.4 software. RESULTS Ten RCTs with a total of 700 pregnant women and 399 partners were included. Prenatal attachment scores after the intervention (standardized mean difference = 1.10, 95 % CI 0.65 to 1.55, P <.00001) was significantly increased and anxiety scores (standardized mean difference = -0.99, 95 % CI -1.18 to -0.80, P <.00001) was significantly lower. The subgroup analysis showed that the different prenatal attachment assessment tools were the source of heterogeneity in the combined results. The sensitivity analysis results showed reliable pooled results except for the studies using the self-made anxiety scale. CONCLUSION This review suggests that psychoeducational interventions can effectively enhance prenatal attachment, reduce anxiety and depression, providing reference for the promotion of evidence-based practice of psychoeducational interventions in perinatal pregnant women and their partners.
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Affiliation(s)
- Xiaoying Wang
- College of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Han Xu
- College of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Xuejie Liu
- College of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Jingwen Yan
- College of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Caifeng Chen
- College of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Yuhong Li
- College of Nursing, Anhui Medical University, Hefei, Anhui, China.
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Groves‐Williams D, Lavender EC, Comer C, Conner M, Nelligan RK, Bennell KL, Kingsbury SR, Conaghan PG, McHugh GA. Developing and adapting two electronic-rehabilitation programmes for persistent knee pain. Musculoskeletal Care 2023; 21:1307-1314. [PMID: 37622339 PMCID: PMC10947164 DOI: 10.1002/msc.1812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/13/2023] [Indexed: 08/26/2023]
Affiliation(s)
| | | | - Christine Comer
- Musculoskeletal and Rehabilitation ServiceLeeds Community Healthcare NHS TrustLeedsUK
| | - Mark Conner
- School of PsychologyUniversity of LeedsLeedsUK
| | - Rachel K. Nelligan
- Department of PhysiotherapyThe University of Melbourne Centre for Health Exercise and Sports MedicineVictoriaAustralia
| | - Kim L. Bennell
- Department of PhysiotherapyThe University of Melbourne Centre for Health Exercise and Sports MedicineVictoriaAustralia
| | - Sarah R. Kingsbury
- Leeds Institute of Rheumatic and Musculoskeletal MedicineUniversity of LeedsLeedsUK
| | - Philip G. Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal MedicineUniversity of LeedsLeedsUK
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Sampson E. Implementing Digital Cognitive-Behavioral Therapy for Major Depressive Disorder in Routine Psychiatric Appointments: A Pilot Project in a Rural Population. J Psychosoc Nurs Ment Health Serv 2023; 61:44-51. [PMID: 37134285 DOI: 10.3928/02793695-20230424-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Psychotherapy is well-established as an effective treatment for major depressive disorder (MDD). However, many individuals with MDD in rural areas of the United States do not have access to psychotherapy. Self-management (SM) strategies are now the standard of care for chronic medical conditions and may be a viable alternative for individuals without access to psychotherapy. The current article describes the implementation of a 13-week pilot project to integrate digital cognitive-behavioral therapy (dCBT) SM programs into routine psychiatric advanced practice nurse (APN) telehealth appointments in the rural United States. Eight participants completed the project. The project did not meet the benchmark of 20 participants to improve access to treatment; however, one half (n = 4) of participants reported clinically significant improvement in MDD symptoms over 6 weeks. For clients without access to psychotherapy, dCBT SM programs can be effective in improving individual client outcomes when implemented by APNs in routine telehealth appointments. [Journal of Psychosocial Nursing and Mental Health Services, 61(10), 44-51.].
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Ray EC, Perko A, Oehme K, Arpan L, Clark J, Bradley L. Freshmen anxiety and COVID-19: Practical implications from an online intervention for supporting students affected by health inequities. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2234-2243. [PMID: 34449301 DOI: 10.1080/07448481.2021.1965610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 06/22/2021] [Accepted: 08/01/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study explored how college freshmen, particularly those affected by health inequities, are affected by COVID-19 and whether they would use a university-created online wellness intervention for help. PARTICIPANTS Nine-hundred and eighty-nine freshmen at a large southeastern university. METHOD Students responded to an online survey regarding their anxiety, worry, number of life disruptions, perceived resilience and their use of the online intervention during the pandemic (June to mid-September 2020). RESULTS During COVID-19, Latinx, Black, women and non-heterosexual students reported significantly greater worry, daily life disruptions than their non-Latinx, white, male and heterosexual counterparts. Women and non-heterosexual students also reported greater anxiety and less resilience. Additionally, Latinx students reported using the university's online intervention for help during COVID-19 more than others. Overall, freshmen, especially Black and women students, reported the online intervention would help them with struggles. CONCLUSIONS Universities should identify unique worries faced by students during a health crisis and provide institutional support. Practical implications are discussed.
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Affiliation(s)
- Elizabeth C Ray
- School of Communication, College of Communication and Information, Florida State University, Tallahassee, Florida, USA
| | - Ann Perko
- Institute for Family Violence Studies, College of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Karen Oehme
- Institute for Family Violence Studies, College of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Laura Arpan
- School of Communication, College of Communication and Information, Florida State University, Tallahassee, Florida, USA
| | - James Clark
- College of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Lyndi Bradley
- Institute for Family Violence Studies, College of Social Work, Florida State University, Tallahassee, Florida, USA
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Martin-Payo R, Leirós-Díaz C, Armes J, Fu MR, Cachero-Rodríguez J, del Mar Fernandez-Alvarez M. The "Breast-4Y" web app for breast cancer prevention at young age: Development, evaluation, and validation. Internet Interv 2023; 33:100651. [PMID: 37555074 PMCID: PMC10404991 DOI: 10.1016/j.invent.2023.100651] [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: 01/16/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Improving knowledge of risk factors, signs and symptoms positively influence an individual's intention to acquire healthy lifestyle behaviors to prevent breast cancer, to identify breast cancer risk early and seek health advice early. The aim of the present study was to develop and to assess the usability and quality of a web-app (Breast-4Y) designed specifically for younger women to improve their knowledge about breast cancer risk factors and symptoms as well as protective behaviors to reduce their risk. METHODS The development of the Breast-4Y web-app, based on Health Belief Model and the Behaviour Change Wheel, comprised four steps: i) analysis of scientific literature regarding breast cancer risk factors, symptoms and preventive lifestyle behaviors; ii) design of web-app; iii) content review by experts; iv) quality and usability assessment by the end-users (n = 20). Web-app usability was evaluated using the Spanish version of the System Usability Scale for the Assessment of Electronic Tools and the quality using the Spanish version of uMARS. RESULTS The contents were rated 4.25 or above, indicating high content quality. The mean usability score was 84.9 (SD 12.4), the mean rating for objective quality and subjective quality dimensions mean were 4.2 (SD 0.4) and 3.4 (0.777) respectively, indicating excellent usability and quality. Positive associations (p < .05) were observed between numbers of app used and attitudes to change (r = 0.479), and intention to change (r = 0.539). Strong positive associations (p < .001) were also observed between usability satisfaction and attitudes to change (r = 0.584), intention to change (r = 0.656), and help-seeking (r = 0.656). CONCLUSIONS This study provided evidence that Breast-4Y has adequate contents, high quality, and usability. Breast-4Y can be tested in pragmatic trials to assess their effectiveness to reduce the risk of breast cancer, raise women's awareness of breast cancer risk factors, increase women's knowledge of breast cancer symptoms, and adopt protective lifestyle behaviors.
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Affiliation(s)
- Ruben Martin-Payo
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
| | - Claudia Leirós-Díaz
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
- Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Spain
| | - Jo Armes
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, United Kingdom
| | - Mei Rosemary Fu
- The Dorothy and Dale Thompson School of Nursing, University of Missouri-Kansas, United States of America
| | - Judit Cachero-Rodríguez
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
| | - María del Mar Fernandez-Alvarez
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
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Zhao J, McBride CM, Campbell GP, Pentz RD, Escoffery C, Konomos M, Bellcross C, Ward K, Shepperd JR, Guan Y. Your Family Connects: A Theory-Based Intervention to Encourage Communication about Possible Inherited Cancer Risk among Ovarian Cancer Survivors and Close Relatives. Public Health Genomics 2023; 26:77-89. [PMID: 37487468 PMCID: PMC10614520 DOI: 10.1159/000531772] [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] [Received: 12/16/2022] [Accepted: 06/26/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION Encouraging family communication about possible genetic risk has become among the most important avenues for achieving the full potential of genomic discovery for primary and secondary prevention. Yet, effective family-wide risk communication (i.e., conveying genetic risk status and its meaning for other family members) remains a critical gap in the field. We aim to describe the iterative process of developing a scalable population-based communication outreach intervention, Your Family Connects, to reach ovarian cancer survivors and close relatives to communicate the potential for inherited risk and to consider genetic counseling. METHODS Relational-level theories (e.g., interdependence theory) suggest that interventions to promote family cancer risk communication will be most effective if they consider the qualities of specific relationships and activate motives to preserve the relationship. Informed by these theories, we collaborated with 14 citizen scientists (survivors of ovarian cancer or relatives) and collected 261 surveys and 39 structured interviews over 12 weeks of citizen science activities in 2020. RESULTS The citizen science findings and consideration of relational-level theories informed the content and implementation of Your Family Connects (www.yourfamilyconnects.org). CS results showed survivors favor personal contact with close relatives, but relatives were open to alternative contact methods, such as through health professionals. Recognizing the need for varied approaches based on relationship dynamics, we implemented a relative contact menu to enable survivors identify at-risk relatives and provide multiple contact options (i.e., survivor contact, health professional contact, and delayed contact). In line with relational autonomy principles, we included pros and cons for each option, assisting survivors in choosing suitable contact methods for each relative. DISCUSSION Our developed intervention represents a novel application of relational-level theories and partnership with citizen scientists to expand genetic services reach to increase the likelihood for fair distribution of cancer genomic advances. The Your Family Connects intervention as part of a randomized trial in collaboration with the Georgia Cancer Registry compared with standard outreach.
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Affiliation(s)
- Jingsong Zhao
- Department of Behavioral, Social and Health Education Sciences, Emory University, Atlanta, Georgia, USA,
| | - Colleen M McBride
- Department of Behavioral, Social and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| | - Gavin P Campbell
- Department of Behavioral, Social and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| | - Rebecca D Pentz
- Department of Hematology and Oncology, Emory School of Medicine, Atlanta, Georgia, USA
| | - Cam Escoffery
- Department of Behavioral, Social and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| | | | | | - Kevin Ward
- Georgia Center for Cancer Statistics, Emory University, Atlanta, Georgia, USA
| | - James R Shepperd
- Department of Psychology, University of Florida, Gainesville, Florida, USA
| | - Yue Guan
- Department of Behavioral, Social and Health Education Sciences, Emory University, Atlanta, Georgia, USA
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Taylor RW, Male R, Economides M, Bolton H, Cavanagh K. Feasibility and Preliminary Efficacy of Digital Interventions for Depressive Symptoms in Working Adults: Multiarm Randomized Controlled Trial. JMIR Form Res 2023; 7:e41590. [PMID: 37327027 DOI: 10.2196/41590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 03/02/2023] [Accepted: 04/14/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Depressive symptoms are highly prevalent and have broad-ranging negative implications. Digital interventions are increasingly available in the workplace context, but supporting evidence is limited. OBJECTIVE This study aimed to evaluate the feasibility, acceptability, and preliminary efficacy of 3 digital interventions for depressive symptoms in a sample of UK-based working adults experiencing mild to moderate symptoms. METHODS This was a parallel, multiarm, pilot randomized controlled trial. Participants were allocated to 1 of 3 digital interventions or a waitlist control group and had 3 weeks to complete 6 to 8 short self-guided sessions. The 3 interventions are available on the Unmind mental health app for working adults and draw on behavioral activation, cognitive behavioral therapy, and acceptance and commitment therapy. Web-based assessments were conducted at baseline, postintervention (week 3), and at 1-month follow-up (week 7). Participants were recruited via Prolific, a web-based recruitment platform, and the study was conducted entirely on the web. Feasibility and acceptability were assessed using objective engagement data and self-reported feedback. Efficacy outcomes were assessed using validated self-report measures of mental health and functioning and linear mixed models with intention-to-treat principles. RESULTS In total, 2003 individuals were screened for participation, of which 20.22% (405/2003) were randomized. A total of 92% (373/405) of the participants were retained in the study, 97.4% (295/303) initiated their allocated intervention, and 66.3% (201/303) completed all sessions. Moreover, 80.6% (229/284) of the participants rated the quality of their allocated intervention as excellent or good, and 79.6% (226/284) of the participants were satisfied or very satisfied with their intervention. All active groups showed improvements in well-being, functioning, and depressive and anxiety symptoms compared with the control group, which were maintained at 4 weeks. Hedges g effect sizes for depressive symptoms ranged from -0.53 (95% CI -0.25 to -0.81) to -0.74 (95% CI -0.45 to -1.03). CONCLUSIONS All interventions were feasible and acceptable, and the preliminary efficacy findings indicated that their use may improve depressive symptoms, well-being, and functioning. The predefined criteria for a definitive trial were met. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number (ISRCTN) ISRCTN13067492; https://www.isrctn.com/ISRCTN13067492.
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Perich T, Andriessen K. Predictors of digital technology-based mental health programs in young adults for mental health support. Health Promot Int 2023; 38:7150745. [PMID: 37133880 PMCID: PMC10155741 DOI: 10.1093/heapro/daad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Technology-based platforms are widely used to deliver mental health support. The aim of this study was to explore factors associated with the use of technology-based mental health platforms by students who may be vulnerable to develop a mental health condition in an Australian psychology student sample. Participants were 1146 students (18-30 years) at an Australian university who completed a survey regarding their current mental health symptoms and lifetime use of technology-based platforms. The student's country of birth, having a previous mental health diagnosis, having a family member with a mental illness and greater stress scores predicted any type of online/technology-use. Greater symptoms correlated with lower helpfulness of online mental health programs and websites. Apps were perceived as more helpful by those with a mental illness history and associated with higher stress scores. The use of any type of technology-based platform was high in the sample overall. Further research may clarify why mental health programs are less popular, and how these platforms may be utilised to support mental health outcomes.
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Affiliation(s)
- Tania Perich
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Karl Andriessen
- Centre for Mental Health, School of Population and Global Health, University of Melbourne, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
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Rochette A, Thomas A, Salbach NM, Vachon B, Menon A, Poissant L, Boutin M, Grad R, Pluye P. Expected Health Benefits as the Ultimate Outcome of Information Available on Stroke Engine, a Knowledge Translation Stroke Rehabilitation Website: Web-Based Survey. JMIR Rehabil Assist Technol 2023; 10:e44715. [PMID: 37155228 DOI: 10.2196/44715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/15/2023] [Accepted: 03/30/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Electronic knowledge resources are readily available and typically target different audiences, including health professionals and the public, that is, those with lived experience and their relatives. The knowledge-to-action framework, in combination with the information assessment method (IAM), considering both the value-of-information construct and the conceptual model of acquisition-cognition-application, can be used to support the evaluation process of such resources. As an example, Stroke Engine is an evidence-based knowledge translation resource in stroke rehabilitation (assessments and interventions) for health professionals and students as well as individuals who have sustained a stroke and their relatives. According to Google Analytics, the website is perused >10,000 times per week. OBJECTIVE With the overall aim to improve the content available on Stroke Engine, we documented Stroke Engine users' perceptions of situational relevance, cognitive impact, intention to use, and expected patient and health benefits regarding the information consulted. METHODS A web-based survey anchored in the IAM was made available via an invitation tab. The IAM is a validated questionnaire that is designed to assess the value of information. Sociodemographic characteristics were also collected, and a space for free-text comments was provided. Descriptive statistics were used, and thematic analysis was used for the free-text comments. RESULTS The sample consisted of 6634 respondents. Health professionals (3663/6634, 55.22%) and students (2784/6634, 41.97%) represented 97.18% (6447/6634) of the total responses. The remaining 2.82% (187/6634) of the responses were from individuals who had sustained a stroke (87/6634, 1.31%) and their relatives (100/6634, 1.51%). Regarding situational relevance, assessments (including selecting, obtaining, and interpreting results from a test) was the main topic searched by health professionals (1838/3364, 54.64%) and students (1228/2437, 50.39%), whereas general information on stroke rehabilitation was the top-ranked topic for nearly two-thirds of the individuals with stroke (45/76, 59%) and their relatives (57/91, 63%). Cognitive impact was characterized by learning something new. Intention to use was high (4572/6379, 71.67%) among the respondents and varied in context (eg, refine a topic, research, class assignments, teaching, and education). Respondents commented on ways to improve content. Expected patient and health benefits such as improvement in health and well-being was the top-ranked category for all 4 subgroups, followed by the avoidance of unnecessary or inappropriate treatment for health professionals (183/623, 29.4%) and a feeling of being reassured for individuals with stroke (26/75, 35%) and their relatives (28/97, 29%). CONCLUSIONS Valuable feedback on Stroke Engine was obtained in terms of its accessibility, relevance for informational needs and retrieval, accuracy, and applicability; however, of utmost importance is the potential implementation of its evidence-based content in clinical practice and the perceived expected impact on patients, their relatives, and their health professionals. The feedback received allowed for corrections and the identification of key topics for further development.
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Affiliation(s)
- Annie Rochette
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Institute for Health Sciences Education, McGill University, Montreal, QC, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- The KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Brigitte Vachon
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- Centre de recherche Fernand Séguin, Montreal, QC, Canada
| | - Anita Menon
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Lise Poissant
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Maurane Boutin
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Roland Grad
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Pierre Pluye
- Department of Family Medicine, McGill University, Montreal, QC, Canada
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Chrysi MS, Michopoulos I, Dimitriadis G, Peppa M. A modern web-based health promotion program for patients in Greece with diabetes 2 and obesity: an interventional study. BMC Public Health 2023; 23:639. [PMID: 37013500 PMCID: PMC10069363 DOI: 10.1186/s12889-023-15557-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Health promotion programs are most beneficial in chronic diseases such as diabetes and morbid obesity, which can be positively affected by changes in attitudes, beliefs, and lifestyle. OBJECTIVES This study aimed to develop an internet-based modern Health Promotion model using interactive online applications through continuing education and participation. METHODS The goal was to positively impact knowledge, behavior, and quality of life for patients with obesity and/or diabetes. This is a prospective interventional study on patients with obesity or type 2 diabetes. Seventeen two patients who met the inclusion criteria were distributed randomly into two groups (control and intervention) from 2019 to 2021 in Greece. All the participants were given questionaries concerning quality of life anxiety and depression (HADS) attitudes and beliefs, knowledge about their condition and general questions to establish a baseline. A traditional health promotion model was followed for the control group. For participants in the intervention group, a web-based health promotion program was created according to the goals of the research. Participants were instructed to log on 1-2 times a week for 5-15 min, with the understanding that the research team would be monitoring their activities. The website included two knowledge games and personalized educational material based on their needs. RESULTS The sample comprised 72 patients (36 in control and 36 in the intervention groups). The mean age was 47.8 years for the control group and 42.7 years for the intervention group (p = 0.293). Both study groups had a significant increase in knowledge score on diabetes (Control group:3,24, Intervention group 11,88 p < 0,001) and obesity (Control group:4,9, Intervention group 51,63 p < 0,001) along with a positive attitude score towards fighting obesity (Control group: 1,8, Intervention group 13,6 p < 0,001). Still, the overall change was more remarkable for the intervention group, as indicated by the significant interaction effect of the analysis. Anxiety was decreased only in the intervention group (Control group:0,11, Intervention group - 0,17 p < 0,005). Analysis for QOL during follow-up showed that Physical Health and Level of Independence was improved in both study groups but the degree of improvement was more significant in the intervention group (Control group 0,31,Intervention group 0,73 p < 0,001). Psychological Health was improved only in the intervention group, with better scores at 6 and 12 months compared to controls (Control group 0,28,Intervention group 1,42 p < 0,001). Furthermore, Social relationships were improved only in the intervention group (Control group 0,02, Intervention group 0,56 p < 0,001). CONCLUSIONS The results of the present study showed that the participants in the intervention group showed significant improvement in knowledge, attitudes, and beliefs after using the internet as a learning tool. The intervention group also showed significantly reduced anxiety and depression arising from chronic illness. All of this resulted in an improved quality of life regarding physical Health, mental Health, and social relationships. Technology and online-based health promotion programs can revolutionize how we approach the prevention and management of chronic and terminal illnesses by improving accessibility, personalizing care, increasing engagement and motivation, improving data analysis, and disease management.
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Affiliation(s)
- Maria S Chrysi
- Intensive Care Unit, Hellenic Anticancer Institute, "Saint Savvas" Hospital, Athens, Greece.
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, Attikon University Hospital, National and Kapodistrian Athens University Medical School, Athens, 12462, Greece
| | - George Dimitriadis
- 2nd Propaedeutic Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian Athens University Medical School, Athens, 12462, Greece
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Attikon Univeristy Hospital, National and Kapodistrian Athens University Medical School, Athens, Greece
| | - Melpomeni Peppa
- 2nd Propaedeutic Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian Athens University Medical School, Athens, 12462, Greece
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Barceló-Soler A, García-Campayo J, Araya R, Doukani A, Gili M, García-Palacios A, Mayoral F, Montero-Marin J. Working alliance in low-intensity internet-based cognitive behavioral therapy for depression in primary care in Spain: A qualitative study. Front Psychol 2023; 14:1024966. [PMID: 37063543 PMCID: PMC10090318 DOI: 10.3389/fpsyg.2023.1024966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/07/2023] [Indexed: 03/31/2023] Open
Abstract
IntroductionPsychotherapies delivered via the Internet have been promoted as an alternative for improving access to psychological treatments. A conceptual working alliance model of blended (i.e., traditional face-to-face consultation combined with Internet-delivered psychotherapy) cognitive-behavioral therapy (b-CBT) for depression has been developed in the UK. However, little is known about how this important therapeutic process, namely the working alliance (WA), is developed and maintained in Internet-delivered cognitive-behavioral therapy without face-to-face consultation (i-CBT). The aim of this study was to evaluate the validity of the WA model of b-CBT in Spanish patients with depression receiving i-CBT.MethodsForty-one patients suffering from mild-moderate depression were interviewed to assess their experiences of an i-CBT program. Interviews were conducted with participants who received a self-guided application (n = 9), and low-intensity support (n = 10). Three group interviews were also conducted with patients who either did not start the program (n = 8) or did not complete it (n = 6), and with patients who did complete it (n = 8).ResultsQualitative thematic content analysis was performed using the constant comparative method, which revealed four main themes: “bond,” “goals,” “task,” and “usability heuristics,” all consistent with the existing literature. However, a new subcategory emerged, called “anonymity,” which may highlight the social stigma that mental illness still has in the Spanish context.ConclusionResults suggest that the development and maintenance of the WA through i-CBT could offer a better experience of the therapeutic process and improve the clinical impact.Clinical Trial RegistrationClinicaltrials.gov, identifier: NCT01611818.
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Affiliation(s)
- Alberto Barceló-Soler
- Navarra Medical Research Institute (IdiSNA), Pamplona, Spain
- Institute of Health Research of Aragon (IIS Aragon), Zaragoza, Spain
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS Aragon), Zaragoza, Spain
- Department of Psychiatry, University of Zaragoza, Zaragoza, Spain
- *Correspondence: Javier García-Campayo,
| | | | - Asmae Doukani
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Margalida Gili
- Department of Psychology, University of the Balearic Islands, Palma, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | | | - Jesus Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health—CIBERESP), Madrid, Spain
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Rouvinen H, Sormunen M, Kunttu K, Turunen H. Internet, studying and daily rhythm: health symptoms among higher education students. Int J Adolesc Med Health 2023; 35:219-226. [PMID: 36947850 DOI: 10.1515/ijamh-2022-0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/01/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVES Excessive Internet use is a health concern among higher education students leading to reduced academic performance and problems in everyday life. This study aimed to explore the relationship between health and problems of studying and daily rhythm caused by time spent online among students (n=3,050). METHODS A cross-sectional survey was carried out. The data were analyzed using descriptive and chi-square tests and logistic regression analyses. RESULTS Findings indicated that one fifth of students reported having problems of studying and daily rhythm caused by time spent online. Psychological health symptoms such as anxiety (p<0.001) and physical health symptoms including lower back problems (p<0.001) were associated with these problems. According to the logistic regression analyses, problems of studying and daily rhythm caused by time spent online and higher amount of Internet use by time were associated with psychological and physical health symptoms. CONCLUSIONS The findings suggest that problems of studying and daily rhythm and spending more time online are related to health symptoms among the students. The study's findings can be used from a prevention standpoint for early identification and further to identify the need for seeking professional treatment.
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Affiliation(s)
- Hanna Rouvinen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Marjorita Sormunen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | | | - Hannele Turunen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Lin Y, Alshehri Y, Alnazzawi N, Abid M, Khan SA, Jabeen F, Elwarfalli I. Social media analytics and their applications to evaluate an activity in online health interventions using CRITIC and TOPSIS techniques. Soft comput 2023:1-13. [PMID: 37362268 PMCID: PMC10026206 DOI: 10.1007/s00500-023-08004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 06/28/2023]
Abstract
The usage of social media is increasing by leaps and bounds in our day-to-day lives. It affects daily routines and brings a lot of change in different departments like health and education systems during the COVID-19 pandemic. Healthcare research and practice have been significantly impacted by the astounding growth of social media. Social media are changing health information management in several ways, from offering appropriate ways to enhance healthcare professional contact and share health-related knowledge and experience to facilitating the development of innovative medical research and wisdom. Social media analytics (SMAs) are efficient and effective interaction instruments that can be useful for both patients and clinicians in health interventions. Moreover, a significant portion of those involved in clinical practices (such as clinicians, professional colleges, and departments of health) are unaware of the importance of social media, its potential applications in their daily lives, as well as the possible consequences and how these will be handled. In the presented study, we proposed MCDM-based approaches known as "Criteria Importance Through Inter Correlation" (CRITIC) and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) in order to identify the effective alternative among several options and make a better decision. After extracting features from the literature review, we choose six significant and relevant features and assign weights to them using CRITIC techniques while utilizing the TOPSIS technique to rank the alternatives based on their performance values. After the implementation of both methods and evaluation procedure, it is determined that the alternative with the highest score is placed at the top and called the "best alternative," while the alternative with the lowest score is placed at the bottom and called the worst alternative. Finally, we suggest a variety of research initiatives and new research areas where the aforementioned procedures become extremely useful in evaluating SMAs and their uses in online health interventions.
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Affiliation(s)
- Yushan Lin
- School of New Media Art, Xi’an Polytechnic University, Xi’an, Shaanxi Province China
- School of Marxism, Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Yasser Alshehri
- Computer Science and Engineering Department, Yanbu, Industrial College, Royal Commission for Jubail and Yanbu, Yanbu Industrial City, Saudi Arabia
| | - Noha Alnazzawi
- Computer Science and Engineering Department, Yanbu, Industrial College, Royal Commission for Jubail and Yanbu, Yanbu Industrial City, Saudi Arabia
| | - Mohammad Abid
- City University of Science and Information Technology Dalazak Road Peshawar, Peshawar, Pakistan
| | - Samina A. Khan
- School of Computer Sciences, University Sains Malaysia, 11800 Gelugor, Pulau, Penang Malaysia
| | - Fouzia Jabeen
- Department of Computer Science, Shaheed Benazir Bhutto Women University, Peshawar, Pakistan
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Safa A, De Biase G, Gassie K, Garcia D, Abode-Iyamah K, Chen SG. Reliability of YouTube videos on robotic spine surgery for patient education. J Clin Neurosci 2023; 109:6-10. [PMID: 36634473 DOI: 10.1016/j.jocn.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Robotic surgical systems developed to improve spine surgery accuracy. Studies have found significant reductions in screw revisions and radiation exposure with robotic assistance compared with open surgery. YouTube is the largest online video platform for medical education. Therefore, there is a need for the continuous critical assessment of healthcare-related YouTube videos. Our objective is to assess the reliability of YouTube videos on robotic spine surgery for patient education. METHODS In April of 2022, YouTube was queried for the following keywords: "Robotic Spine Surgery". The "Relevance-Based Ranking" filter was applied, and the first 3 result pages were considered. Videos had to be uploaded by universities or hospitals and be in the English. Three independent healthcare personnel evaluated the videos' education quality using the DISCERN tool. RESULTS Our study found that 33 % of videos analyzed scored above a 3 on the DISCERN scoring scale (considered a ''good" video), with overall mean DISCERN score of 2.8 ± 1.3 (SD). The duration of videos was significantly different between the two groups (Good = 16 min ± 21 vs Unhelpful = 4 min ± 4, p = 0.01). In the helpful group, other characteristics were number of views (16331 ± 31308), likes (88 ± 168) and dislikes (5 ± 8). No statistically significant differences were observed compared to the unhelpful group: number of views (6515 ± 9074; P = 0.20), likes (39 ± 55; P = 0.21) and dislikes (3 ± 4; P = 0.33). CONCLUSION Our study shows that YouTube videos on robotic spine surgery lack accuracy and have poor educational value. There should be increased institutional oversight to combat the spread of misinformation.
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Affiliation(s)
- Adrian Safa
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Gaetano De Biase
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Kelly Gassie
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Diogo Garcia
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA
| | | | - Selby G Chen
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA.
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Bockelman D, Huang A, Khosla L, Pak SY, Bamberger J, Weinstein C, Kabarriti A. Quality of Information for Post-Prostatectomy Incontinence Treatments on YouTube. Urology 2023; 172:196-202. [PMID: 36495952 DOI: 10.1016/j.urology.2022.09.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To assess the quality of information on YouTube regarding post-prostatectomy incontinence treatments. The 2019 American Urological Association(AUA)/(SUFU) Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction guidelines recommend the placement of a male sling or artificial urinary sphincter. Patient education is essential for appropriate expectations and patient satisfaction. METHODS The top 100 most relevant (default setting) YouTube videos searched with terms "post-prostatectomy incontinence" and "male stress incontinence" were assessed using the validated DISCERN instrument, Patient Education Materials Assessment Tool for Audiovisual Materials, and a misinformation Likert Scale. Videos with poor video/audio quality, duplicates, and non-English videos were excluded. Four independent raters were randomly assigned such that each video had 2 raters. Data was analyzed using multivariate linear regression, and inter-rater reliability was measured using Cohen's kappa. RESULTS The median DISCERN score was 2.5 with 71% of videos scoring <=3. The median PEMAT Actionability and Understandability scores were 64.6 (range 0-100) and 79.9 (range 52-100), respectively. The median misinformation Likert score was 1 range (1-4). Less than half of the videos discussed realistic treatment outcomes or the risks (39% and 24%, respectively). PEMAT Actionability and risk discussion significantly predicted average DISCERN score (p < .001). There were no significant disagreements between raters. CONCLUSION Our study shows most videos on post-prostatectomy incontinence had moderate to low quality information and were published by medical professionals. The majority did not sufficiently discuss realistic outcomes and risks, which are hallmarks of informed decision making. This provides an opportunity for the urologic community to create educational materials that adequately supplement shared-decision making for patients treated for post-prostatectomy incontinence.
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Affiliation(s)
| | - Aaron Huang
- SUNY Downstate College of Medicine, Brooklyn, NY
| | | | - So Yeon Pak
- SUNY Downstate College of Medicine, Brooklyn, NY
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22
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Pedersen HF, Lamm TT, Fink P, Ørnbøl E, Frostholm L. Internet-delivered treatment for patients suffering from severe functional somatic disorders: Protocol for a randomized controlled trial. Contemp Clin Trials Commun 2023; 32:101069. [PMID: 36698746 PMCID: PMC9868341 DOI: 10.1016/j.conctc.2023.101069] [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: 09/15/2022] [Revised: 12/15/2022] [Accepted: 01/14/2023] [Indexed: 01/19/2023] Open
Abstract
Background Functional somatic disorders (FSDs) with symptoms from multiple organs, i.e., multi-system type, are common in the general population and may lead to disability and reduced quality of life. Evidence for efficient treatment programs has been established, however, there is a need for making treatments accessible to a larger group of patients. Internet-delivered therapy has become prevalent and has proven as effective as face-to-face therapy, while providing a flexible and easily accessible treatment alternative. The aim of the current study is to compare the efficacy of the therapist-assisted internet-delivered treatment program One step at a time (OneStep) with the internet-delivered self-help program Get started (GetStarted). Methods A total of 166 participants aged 18-60 years diagnosed with multi-system FSD will be assessed and randomized to either 1) OneStep: a 14-week program consisting of 11 treatment modules based on principles from cognitive behavioural therapy or 2) GetStarted consisting of 1 module on psychoeducation. The primary outcome is physical health, assessed by a Short Form Health Survey (SF-36) aggregate score of the subscales vitality, physical functioning, and bodily pain 3 months after end-of-treatment and self-reported improvement assessed by the Clinical Global Improvement Scale. Secondary outcomes include symptom load, depression, anxiety, and illness worry. Process measures include emotional distress, illness perception, illness behaviour, and symptom interference. Conclusions This study is the first study to test an internet-delivered treatment program for FSD, multi-system type and has the potential to show the importance of making evidence-based internet-delivered treatment for FSD more accessible.
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Affiliation(s)
- Heidi Frølund Pedersen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark,Corresponding author. Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200 Aarhus N, Denmark.
| | - Thomas Tandrup Lamm
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Per Fink
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Eva Ørnbøl
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Lisbeth Frostholm
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Huntsman JL, Bulaj G. Health education via "empowerment" digital marketing of consumer products and services: Promoting therapeutic benefits of self-care for depression and chronic pain. Front Public Health 2023; 10:949518. [PMID: 36703812 PMCID: PMC9871258 DOI: 10.3389/fpubh.2022.949518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023] Open
Abstract
Increasing health care costs and high economic burden exemplify the impact of chronic diseases on public health. Multifaceted approaches to treating chronic diseases include pharmaceutical drugs, digital therapeutics, and lifestyle medicine. Chronic diseases are largely preventable, and health promotion yields positive outcomes. However, despite positive return on investment (ROI) and cost-to-benefit ratio (CBR) for health promotion (median ROI 2.2, median CBR 14.4), commercial marketing of healthy lifestyles and self-care is limited. The objective of this perspective article is to discuss how digital marketing of consumer goods and services that support therapeutic self-care can also bridge public health and for-profit interests. We describe how "empowerment" marketing campaigns can provide evidence-based associations between products/services and self-care benefits for people living with chronic pain and depression. Such a "health education as marketing" strategy is illustrated by educational ads describing how contact with nature, music, and yoga can improve chronic pain and reduce depressive symptoms. Creating associations between health-related benefits of these activities with products (outdoor and yoga apparel, audio equipment) and services (music streaming services, music mobile apps, eco-tourism, yoga studios) that support them expand their value proposition, thus incentivizing profit-driven companies to engage in public health campaigns. Long-term success of companies that incorporate evidence-based health education as marketing and branding strategies will depend on following ethical considerations and advertising guidelines defined by consumer protection regulatory agencies, such as the Federal Trade Commission (FTC). In conclusion, integration of health education about self-care and commercial marketing can support health care outcomes and disease prevention.
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Affiliation(s)
| | - Grzegorz Bulaj
- OMNI Self-care, LLC, Salt Lake City, UT, United States,L. S. Skaggs College of Pharmacy, University of Utah, Salt Lake City, UT, United States,*Correspondence: Grzegorz Bulaj ✉
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24
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Phillips SEK, Celi AC, Wehbe A, Kaduthodil J, Zera CA. Mobilizing the fourth trimester to improve population health: interventions for postpartum transitions of care. Am J Obstet Gynecol 2022:S0002-9378(22)02587-X. [PMID: 36574875 DOI: 10.1016/j.ajog.2022.12.309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 12/13/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022]
Abstract
Birthing people in the United States, particularly those from marginalized communities, experience an unexpectedly high rate of morbidity and mortality. Optimal postpartum care is an opportunity to address immediate maternal health concerns while providing a connection to further high-value primary care. However, postpartum care in the United States is fragmented and incomplete. In response to this failure, the American College of Obstetricians and Gynecologists has called for obstetricians to develop individualized care plans that facilitate transitions from obstetrical to primary care after delivery. In this clinical opinion, we review previous interventions that have aimed to increase postpartum care engagement and bridge gaps in care. Although numerous interventions have been trialed, few have been both successful and scalable. We provide recommendations on ways to reimagine equitable and effective postpartum care interventions with multidisciplinary collaboration.
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Affiliation(s)
- Sara E K Phillips
- Ariadne Labs, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, Boston, MA.
| | - Ann C Celi
- Ariadne Labs, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, Boston, MA; Divisions of General Medicine and Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Alexandra Wehbe
- Ariadne Labs, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, Boston, MA
| | - Jasmine Kaduthodil
- Ariadne Labs, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, Boston, MA
| | - Chloe A Zera
- Ariadne Labs, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, Boston, MA; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA
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25
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Masterson-Algar P, Egan K, Flynn G, Hughes G, Spector A, Stott J, Windle G. iSupport for Young Carers: An Adaptation of an e-Health Intervention for Young Dementia Carers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:127. [PMID: 36612450 PMCID: PMC9819145 DOI: 10.3390/ijerph20010127] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Young dementia carers need to be recognised and supported in their role. They need help to understand the illness, what changes are expected and how it can affect their family member. Many support services, partly due to the COVID pandemic, have moved online and have been shown to be acceptable as they are low cost and reduce access barriers. iSupport is an evidence-informed e-health training programme developed by the World Health Organization (WHO) to support adult dementia carers. This paper reports on the co-design of an adapted version of iSupport for young carers. A theoretically driven co-design approach, drawing on the lived experiences of young dementia carers and experts who work with this target group was followed. As a result of this study iSupport for Young Carers was created. It is the first e-health intervention of its kind and aims to support the mental health, knowledge and skills of young dementia carers. In turn, it could improve the quality of the support that service providers can offer, and this can result in increased levels of identification of these young people. The work presented also provides opportunities for other countries and demographic groups to translate and adapt iSupport for Young Carers to their specific cultural context.
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Affiliation(s)
| | - Kieren Egan
- Department of Computer and Information Science, University of Strathclyde, Glasgow G11 XH, UK
| | - Greg Flynn
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK
| | - Gwenllian Hughes
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
| | - Joshua Stott
- Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
| | - Gill Windle
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK
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Han A, Kim TH. Efficacy of Internet-Based Acceptance and Commitment Therapy for Depressive Symptoms, Anxiety, Stress, Psychological Distress, and Quality of Life: Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e39727. [PMID: 36485030 PMCID: PMC9789494 DOI: 10.2196/39727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/24/2022] [Accepted: 10/08/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Acceptance and commitment therapy (ACT) is an empirically supported transdiagnostic approach that involves mindfulness processes and behavior change processes for valued living. OBJECTIVE This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to assess the efficacy of internet-based ACT (iACT) for depressive symptoms, anxiety, stress, psychological distress, and quality of life (QoL). METHODS PubMed, CINAHL, PsycINFO, and SCOPUS databases were searched to identify relevant RCTs published up to June 5, 2021. The included RCTs were assessed using the Cochrane Collaboration risk-of-bias tool. The use of either a random effects model or fixed effects model was determined using I2 statistic values for heterogeneity. Subgroup analyses were conducted according to the type of control group, the use of therapist guidance, delivery modes, and the use of targeted participants, when applicable. RESULTS A total of 39 RCTs met the inclusion criteria. Meta-analyses found small effects of iACT on depressive symptoms, anxiety, stress, psychological distress, and QoL at the immediate posttest and follow-up. There was no significant effect of iACT on stress at follow-up. Subgroup analyses showed small to medium effects of iACT on all the outcomes at the immediate posttest and follow-up compared with the passive control groups. In contrast, subgroup analyses that compared iACT with active control groups found no differences between groups on stress, psychological distress, and QoL at the immediate posttest or on depressive symptoms, anxiety, and stress at follow-up. In addition, subgroup analyses conducted according to the use of therapist guidance, delivery modes, and the use of targeted participants found no statistically significant subgroup differences among studies in all the outcomes, except for the subgroup difference among studies according to the use of targeted participants for depressive symptoms at the immediate posttest (ie, a statistically significant, larger effect of iACT when studies targeted people with depressive symptoms). The overall risk of bias across the studies was unclear. CONCLUSIONS The findings of this study contribute to the body of evidence regarding the effects of iACT on depressive symptoms, anxiety, stress, psychological distress, and QoL and may be applicable in any population, as ACT is a transdiagnostic approach. Few studies have compared iACT with active control conditions, especially for stress and psychological distress at the immediate posttest and follow-up. In addition, the active control conditions varied among the included studies. Further high-quality studies are needed to better understand whether iACT is comparable or superior to other evidence-based interventions, such as cognitive behavioral therapy, in decreasing depressive symptoms, anxiety, stress, and psychological distress and improving QoL.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei Wonju Medical College, Wonju, Republic of Korea
- Department of Psychiatry, Wonju Severance Christian Hospital, Wonju, Republic of Korea
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Liu N, He Y, Li Z. The Relationship between Internet Use and Self-Rated Health among Older Adults in China: The Mediating Role of Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14785. [PMID: 36429504 PMCID: PMC9690403 DOI: 10.3390/ijerph192214785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
The development of Internet technology has significantly impacted how people live their daily lives. How this disparity in Internet use affects the self-rated health of older adults needs to be further explored. This paper studies the impact of Internet use on self-rated health, aiming to examine the effect of Internet use and social support on the self-rated health of older adults in China. This study used data from the 2017 China General Social Survey (CGSS) to verify the effect of Internet use on older adults' self-rated health. The results showed that Chinese elderly who used the Internet had a higher self-rated health, and social support from relatives and friends significantly improved the elderly's self-rated health. This social support played a critical, partially mediating role between Internet use and self-rated health. In China, the effect of Internet use on older adults' self-rated health was heterogeneous. Among them, the impact of Internet use was more significant for the male elderly, younger elderly, and rural elderly. The results suggest that the government should formulate targeted policies to improve the utilization of the Internet and maintain a good Internet environment to enhance the well-being of older adults according to the trend of population aging and the popularity of the Internet.
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Affiliation(s)
- Ningning Liu
- School of Public Administration, Central South University, Changsha 410083, China
| | - Yujing He
- School of Architecture and Art, Central South University, Changsha 410083, China
| | - Zhirong Li
- School of Architecture and Art, Central South University, Changsha 410083, China
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Kanmodi KK, Salami AA, Nwafor JN, Olomo CA, Nnyanzi LA. Trend Analysis of Global Web Searches (2004–2022) on Oral Cancer and Its Major Risk Factors. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1756479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background Oral cancer is the 15th leading cause of mortality globally. The Internet is an online source of information pertaining to oral cancer and its major risk factors. This study aims to analyze the trend of global online interest on oral cancer and its major risk factors through an analysis of web searches of oral cancer.
Materials and Methods This study analyzed the web searches conducted, from 2004 to January 2022, on oral cancer and its major risk factors (tobacco use, harmful alcohol use, and human papillomavirus [HPV] infection) using data obtained from Google Trends.
Results Within the time frame under study, oral cancer had multiple peak search periods, with the highest relative search volume index (SVI) for a period being 1; the peak search period for alcohol was March 2020 (SVI = 100); the peak search periods for tobacco were March to April 2004 (SVI = 17); and the peak search period of HPV was April 2004 (SVI = 1). Globally, alcohol was the most common searched term among these four terms (oral cancer, alcohol, tobacco, and HPV) except in Turkey where tobacco was the most common (55%) searched term. The top 25 search queries for oral cancer, HPV, tobacco, and alcohol had SVI ranges of 22 to 100, 12 to 100, 28 to 100, and 18 to 100, respectively. From these search queries, it was observed that people have interest in oral cancer symptomatology, and the adverse effects of tobacco, alcohol, and HPV.
Conclusion This study revealed an overall decline in the online interest on oral cancer and its major risk factors on a global scale.
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Affiliation(s)
- Kehinde Kazeem Kanmodi
- Oral Health Working Group (Health Students Research Network), School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria
| | - Afeez Abolarinwa Salami
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria
- Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Nigeria
| | - Jacob Njideka Nwafor
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria
- Department of Medicine, Nottingham University Hospital NHS Trust, Nottingham, United Kingdom
| | - Charles Adetokunbo Olomo
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria
- Department of Oral Pathology/Oral Medicine, University College Hospital, Ibadan, Nigeria
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Lawrence Achilles Nnyanzi
- Oral Health Working Group (Health Students Research Network), School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
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29
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Sippel A, Riemann-Lorenz K, Pöttgen J, Wiedemann R, Drixler K, Bitzer EM, Holmberg C, Lezius S, Heesen C. Validation of the German eHealth impact questionnaire for online health information users affected by multiple sclerosis. BMC Med Inform Decis Mak 2022; 22:219. [PMID: 35974395 PMCID: PMC9380659 DOI: 10.1186/s12911-022-01968-6] [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: 04/11/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background Persons with multiple sclerosis (MS) are confronted by an overwhelming amount of online health information, which can be valuable but also vary in quality and aim. Therefore, it is of great importance for developers and providers of eHealth information to understand its impact on the users. The eHealth Impact Questionnaire (eHIQ) has been developed in the United Kingdom to measure the potential effects of health and experimental information websites. This contains user’s general attitudes towards using the internet to gain health information and attitudes towards a specific health related website. The self-complete questionnaire is divided into two independently administered and scored parts: the 11-item eHIQ part 1 and the 26-item eHIQ part 2. This study aimed to validate the psychometric properties of the German version of the eHealth Impact Questionnaire (eHIQ-G). Methods 162 people with multiple sclerosis browsed one of two possible websites containing information on MS and completed an online survey. Internal consistency was assessed by Cronbach’s alpha and structural validity by Confirmatory Factor Analysis. Construct validity was examined by assessing correlations with the reference instruments eHealth Literacy Questionnaire and the General Self-Efficacy Scale measuring related, but dissimilar constructs. Moreover, we investigated the mean difference of the eHIQ-G score between the two websites. Data were analyzed using SPSS and AMOS software. Results The eHIQ-G subscales showed high internal consistency with Cronbach’s alpha from 0.833 to 0.885. The 2-factor model of eHIQ part 1 achieved acceptable levels of goodness-of-fit indices, whereas the fit for the 3-factor model of eHIQ part 2 was poor and likewise for the alternative modified models. The correlations with the reference instruments were 0.08–0.62 and as expected. Older age was related with lower eHIQ part 1 score, whereas no significant effect was found for education on eHIQ part 1. Although not significant, the website ‘AMSEL’ reached higher mean scores on eHIQ part 2. Conclusions The eHIQ-G has good internal consistency, and sufficient structural and construct validity. This instrument will facilitate the measurement of the potential impact of eHealth tools. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-022-01968-6.
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Affiliation(s)
- Anna Sippel
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Karin Riemann-Lorenz
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Jana Pöttgen
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.,Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.,Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Potsdam, Germany
| | - Susanne Lezius
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Heesen
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.,Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Han A, Kim TH. Effects of internet-delivered behavioral activation on individuals with depressive symptoms: A systematic review and meta-analysis. J Psychiatr Res 2022; 152:104-118. [PMID: 35717866 DOI: 10.1016/j.jpsychires.2022.05.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/28/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Behavioral activation is recognized as a stand-alone, evidence-based therapy for depression. Internet-delivered psychological interventions are easy to access and low cost. Therefore, it is important to determine whether internet-delivered behavioral activation (iBA) is an effective option for improving depressive symptoms and other health-related outcomes. This systematic review and meta-analysis aimed to examine the effects of iBA on individuals with depressive symptoms. METHODS A comprehensive search was conducted within four databases to identify randomized controlled trials (RCTs) that involved iBA for people with depressive symptoms. The quality of the included RCTs was assessed using the Cochrane Collaboration risk-of-bias tool. Depending on I2 statistic values for heterogeneity, either a random effects model or fixed effects model was used. Subgroup analyses were conducted according to the type of control groups. RESULTS Twenty RCTs met the eligibility criteria. Meta-analyses showed iBA had small to medium effects on depressive symptoms, anxiety, quality of life, functioning, perceived social support, and behavioral activation (BA) in people suffering from depressive symptoms at the immediate posttest and follow-up compared to control conditions. LIMITATIONS Relatively fewer studies were conducted to compare effects of iBA on outcomes other than depressive symptoms and BA process measures compared to comparison or control conditions. The overall risk of bias across the included RCTs was unclear. CONCLUSIONS Further high-quality studies are needed to verify the effects of iBA on varied health outcomes and BA process measures for individuals with depressive symptoms.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, SHPB 340, 1720 2nd Ave South, Birmingham, AL, 35294, USA
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwon province, 26426, South Korea.
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Smith-Lickess SK, Stefanic N, Shaw J, Shepherd H, Naehrig D, Turner RM, Cabrera-Aguas M, Meiser B, Halkett GK, Jackson M, Saade G, Bucci J, Milross C, Dhillon HM. What is the effect of a low literacy talking book on patient knowledge, anxiety and communication before radiation therapy starts? A pilot study. J Med Radiat Sci 2022; 69:463-472. [PMID: 35839313 DOI: 10.1002/jmrs.606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 06/29/2022] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Radiation therapy is a common cancer treatment, requiring timely information to help patients prepare for treatment. We pilot tested a low literacy, psycho-educational talking book (written booklet, with accompanying audio recording) to examine (i) the effect of the tool on knowledge, anxiety and communication; (ii) acceptability, and (iii) how it was used in appointments. METHODS A pre-post design was employed. Patients scheduled to receive radiation therapy for any cancer were recruited from two hospitals in Sydney, Australia. Participants were sent the talking book before treatment planning and completed baseline and follow-up surveys, before and after the intervention. RESULTS Forty participants were recruited, and 39 completed all study assessments. Overall, knowledge increased after receiving the talking book by 3.8 points from 13.9 to 17.7/20 (95% confidence interval (CI) 2.7, 4.8, P < 0.001). Anxiety and concerns were significantly lower after receiving the talking book (P = 0.015 and P = 0.004, respectively). Nearly half of participants (s = 17, 48%) reported using the book during appointments. Most reported finding it easier to communicate (n = 31, 89%) and to ask more questions (n = 21, 62%). CONCLUSION The talking book shows promise in improving knowledge, reducing anxiety and enhancing communication. Strategies to support the implementation of the talking book are required. Further studies to translate the book into different languages are also planned.
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Affiliation(s)
- Sian K Smith-Lickess
- Psychosocial Research Group, Prince of Wales Clinical School, UNSW Sydney, Sydney, NSW, Australia.,Department of Psychology, University of Bath, Bath, UK
| | - Natalie Stefanic
- Psychosocial Research Group, Prince of Wales Clinical School, UNSW Sydney, Sydney, NSW, Australia
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Heather Shepherd
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Diana Naehrig
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Chris O'Brien Lifehouse, Radiation Oncology and Medical Services, Sydney, NSW, Australia
| | - Robin M Turner
- Dunedin School of Medicine, Otago University, Wellington, New Zealand
| | - Maria Cabrera-Aguas
- Psychosocial Research Group, Prince of Wales Clinical School, UNSW Sydney, Sydney, NSW, Australia.,The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, NSW, Australia
| | - Bettina Meiser
- Psychosocial Research Group, Prince of Wales Clinical School, UNSW Sydney, Sydney, NSW, Australia
| | - Georgia Kb Halkett
- Faculty of Health Sciences, Curtin School of Nursing, Curtin University, Perth, WA, Australia
| | - Michael Jackson
- UNSW Sydney, Prince of Wales Clinical School, Randwick, Sydney, NSW, Australia.,Department of Radiation Oncology, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia
| | - George Saade
- Department of Radiation Oncology, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Joseph Bucci
- St George Hospital Cancer Care, Radiation Oncology Unit, Sydney, NSW, Australia
| | - Christopher Milross
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Chris O'Brien Lifehouse, Radiation Oncology and Medical Services, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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Shou S, Xiu S, Li Y, Zhang N, Yu J, Ding J, Wang J. Efficacy of Online Intervention for ADHD: A Meta-Analysis and Systematic Review. Front Psychol 2022; 13:854810. [PMID: 35837629 PMCID: PMC9274127 DOI: 10.3389/fpsyg.2022.854810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background With the popularity of computers, the internet, and the global spread of COVID-19, more and more attention deficit hyperactivity disorder (ADHD) patients need timely interventions through the internet. At present, there are many online intervention schemes may help these patients. It is necessary to integrate data to analyze their effectiveness. Objectives Our purpose is to integrate the ADHD online interventions trials, study its treatment effect and analyze its feasibility, and provide reference information for doctors in other institutions to formulate better treatment plans. Methods We searched PubMed, EMBASE and Cochrane libraries. We didn't limit the start date and end date of search results. Our last search was on December 1, 2021. The keyword is ADHD online therapy. We used the Cochrane bias risk tool to assess the quality of included studies, used the standardized mean difference (SMD) as an effect scale indicator to measure data. Random effects model, subgroup analysis were used to analyze the data. Results Six randomized controlled trials (RCTs) were identified, including 261 patients with ADHD. These studies showed that online interventions was more effective than waiting list in improving attention deficit and social function of adults and children with ADHD. The attention deficit scores of subjects were calculated in six studies. The sample size of the test group was 123, the sample size of the control group was 133, and the combined SMD was −0.73 (95% confidence interval: −1.01, −0.44). The social function scores of subjects were calculated in six studies. The sample size of the experimental group was 123 and the control group was 133. The combined SMD was −0.59 (95% confidence interval: −0.85, −0.33). Conclusions The results show that online interventions of ADHD may be an effective intervention. In the future, we need more online intervention researches to improve the symptoms of different patients, especially for some patients who have difficulties in accepting face-to-face treatment.
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Affiliation(s)
- Songting Shou
- Department of Pediatrics, Dongzhimen Hospital, Beijing, China
| | - Shengyao Xiu
- Department of Pediatrics, Dongzhimen Hospital, Beijing, China
| | - Yuanliang Li
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Ning Zhang
- Department of Pediatrics, Dongzhimen Hospital, Beijing, China
| | - Jinglong Yu
- Department of Pediatrics, Dongzhimen Hospital, Beijing, China
| | - Jie Ding
- Department of Pediatrics, Dongzhimen Hospital, Beijing, China
| | - Junhong Wang
- Department of Pediatrics, Dongzhimen Hospital, Beijing, China
- *Correspondence: Junhong Wang
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Nixon P, Ebert DD, Boss L, Angerer P, Dragano N, Lehr D. Efficacy of a web-based stress management intervention for employees experiencing adverse working conditions and occupational self-efficacy as mediator: A randomized controlled trial (Preprint). J Med Internet Res 2022; 24:e40488. [DOI: 10.2196/40488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/11/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
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Han A, Kim TH. Effects of internet-based acceptance and commitment therapy on process measures: A systematic review and meta-analysis (Preprint). J Med Internet Res 2022; 24:e39182. [PMID: 36040783 PMCID: PMC9472046 DOI: 10.2196/39182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/22/2022] [Accepted: 07/29/2022] [Indexed: 12/03/2022] Open
Abstract
Background Acceptance and commitment therapy (ACT) is based on a psychological flexibility model that encompasses 6 processes: acceptance, cognitive defusion, self-as-context, being present, values, and committed action. Objective This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to examine the effects of internet-based ACT (iACT) on process measures. Methods A comprehensive search was conducted using 4 databases. The quality of the included RCTs was assessed using the Cochrane Collaboration Risk of Bias Tool. A random-effects or fixed-effects model was used. Subgroup analyses for each outcome were conducted according to the type of control group, use of therapist guidance, delivery modes, and use of targeted participants, when applicable. Results A total of 34 RCTs met the inclusion criteria. This meta-analysis found that iACT had a medium effect on psychological flexibility and small effects on mindfulness, valued living, and cognitive defusion at the immediate posttest. In addition, iACT had a small effect on psychological flexibility at follow-up. The overall risk of bias across studies was unclear. Conclusions Relatively few studies have compared the effects of iACT with active control groups and measured the effects on mindfulness, valued living, and cognitive defusion. These findings support the processes of change in iACT, which mental health practitioners can use to support the use of iACT.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Gangwon province, Republic of Korea
- Department of Psychiatry, Yonsei University Wonju Christian Hospital, Wonju, Gangwon province, Republic of Korea
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Tarp K, Rasmussen J, Mejldal A, Folker MP, Nielsen AS. Blended Treatment for Alcohol Use Disorder (Blend-A): Explorative Mixed Methods Pilot and Feasibility Study. JMIR Form Res 2022; 6:e17761. [PMID: 35468082 PMCID: PMC9086873 DOI: 10.2196/17761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/05/2020] [Accepted: 02/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background In Denmark, approximately 150,000 people have alcohol use disorder (AUD). However, only approximately 10% seek AUD treatment, preferably outside conventional health care settings and opening hours. The AUD treatment area experiences low adherence to treatment, as well as high numbers of no-show and premature dropouts. Objective The purpose of the Blend-A (Blended Treatment for Alcohol Use Disorder) feasibility and pilot study was to describe the process of translating and adapting the Dutch treatment protocol into Danish and Danish culture with a high amount of user involvement and to report how patients and therapists perceived the adapted version, when trying it out. Methods The settings were 3 Danish public municipal outpatient alcohol clinics. Study participants were patients and therapists from the 3 settings. Data consisted of survey data from the System Usability Scale, individual patient interviews, and therapist group interviews. Statistical analyses were conducted using the Stata software and Excel. Qualitative analysis was conducted using a theoretical thematic analysis. Results The usability of the treatment platform was rated above average. The patients chose to use the blended treatment format because it ensured anonymity and had a flexible design. Platform use formed the basis of face-to-face sessions. The use of the self-determined platform resulted in a more thorough process. Patient involvement qualified development of a feasible system. Managerial support for time use was essential. Guidance from an experienced peer was useful. Conclusions This study indicates that, during the processes of translating, adapting, and implementing blended, guided, internet-based, and face-to-face AUD treatment, it is relevant to focus on patient involvement, managerial support, and guidance from experienced peers. Owing to the discrete and flexible design of the blended offer, it appears that it may reach patient groups who would not otherwise have sought treatment. Therefore, blended treatment may increase access to treatment and contribute to reaching people affected by excessive alcohol use, who would not otherwise have sought treatment. In addition, it seems that the blended offer may enhance the participants’ perceived satisfaction and the effect of the treatment course. Thus, it appears that Blend-A may be able to contribute to existing treatment offers. Such findings highlight the need to determine the actual effect of the Blend-A offer; therefore, an effectiveness study with a controlled design is warranted.
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Affiliation(s)
- Kristine Tarp
- Centre for Telepsychiatry, Mental Health Services, Region of Southern Denmark, Odense, Denmark.,Research Unit for Telepsychiatry and E-mental Health, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Anna Mejldal
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN Odense Patient data Explorative Network, Odense, Denmark
| | - Marie Paldam Folker
- Centre for Telepsychiatry, Mental Health Services, Region of Southern Denmark, Odense, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Psychiatry, Mental Health Services, Region of Southern Denmark, Odense, Denmark.,BRIDGE, Brain Research - Inter-Disciplinary Guided Excellence, Odense, Denmark
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Tarp K, Sari S, Nielsen AS. Why treatment is not an option: Treatment naïve individuals, suffering from alcohol use disorders’ narratives about alcohol use and treatment seeking. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 39:437-452. [PMID: 36003123 PMCID: PMC9379291 DOI: 10.1177/14550725221082512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aims: To investigate the narratives of in- and outpatients at mental health and somatic hospitals, who suffer from alcohol use disorders (AUD) but have never sought AUD treatment. More specifically, to understand how the individuals view their alcohol use and explore their reasons for not seeking treatment. Methods: Individuals suffering from AUD were recruited at somatic and mental health hospitals. The study was qualitative, based on semi-structured individual interviews. A narrative analysis was performed. A total of six patients participated: three recruited at a mental health hospital, three from a somatic hospital. Results: The individuals described how heavy alcohol use had always characterised their lives; it was part of their surroundings and it added to their quality of life. Two narrative forms within the individuals’ stories were identified, in which treatment was considered either as a positive option for others but not relevant for themselves, or as representing a threat to the individuals’ autonomy. The participants expressed that they did not believe treatment was relevant for them, and if necessary, they preferred to deal with their heavy drinking themselves. Conclusions: Our findings indicate that a broad focus is needed if relatively more individuals suffering from AUD should seek treatment, since they – in spite of clearly suffering from AUD – nevertheless see themselves as heavy drinkers and have not even thought of seeking treatment. Thus, it is not (only) a question about the attractiveness of the treatment offer or due to lack of knowledge about treatment options that patients suffering from AUD do not seek treatment.
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Affiliation(s)
- Kristine Tarp
- Centre for Telepsychiatry, Region of Southern Denmark, Odense, Denmark; and University of Southern Denmark, Odense, Denmark
| | - Sengül Sari
- University of Southern Denmark, Odense, Denmark
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Strongylou DE, Flowers P, McKenna R, Kincaid RA, Clutterbuck D, Hammoud MA, Heng J, Kerr Y, McDaid L, Frankis JS. Understanding and responding to remote mental health help-seeking by gay, bisexual and other men who have sex with men (GBMSM) in the U.K. and Republic of Ireland: a mixed-method study conducted in the context of COVID-19. Health Psychol Behav Med 2022; 10:357-378. [PMID: 35402086 PMCID: PMC8986177 DOI: 10.1080/21642850.2022.2053687] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Gay, bisexual and other men who have sex with men (GBMSM) are at far greater risk of experiencing poor mental health (MH) than wider society. This disparity was exacerbated by additional ‘unique to sexual minority status’ COVID-19 stressors. Objective: This sequential, mixed-methods study examined remote MH help-seeking among GBMSM in the U.K. and Ireland during the first COVID-19 lockdown. Methods and Results: Quantitative survey data (n = 1368), analysed with logistic regression, suggested GBMSM experiencing moderate-to-severe anxiety and those with a past MH diagnosis were most likely to seek MH support. Thematic analysis of qualitative interview (n = 18) data identified multiple barriers and enablers to GBMSM seeking remote MH help, with the help primarily sought from GBMSM-facing organisations and generic online resources. Finally, the behaviour change wheel was used to generate theoretically informed recommendations to promote MH help-seeking among GBMSM in Scotland. Implications: We discuss how applying these recommendations in the short, medium and long term will begin to address GBMSM’s MH needs, post COVID-19.
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Affiliation(s)
| | - Paul Flowers
- Department of Psychology, University of Strathclyde, Glasgow, UK
| | | | | | | | | | - Julian Heng
- Public Health Department, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Yvonne Kerr
- Public Health and Health Policy Department, NHS Lothian, Edinburgh, UK
| | - Lisa McDaid
- Institute for Social Sciences Research, The University of Queensland, Brisbane, Australia
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Lara MA, Patiño P, Tiburcio M, Navarrete L. Satisfaction and Acceptability Ratings of a Web-Based Self-help Intervention for Depression: Retrospective Cross-sectional Study From a Resource-Limited Country. JMIR Form Res 2022; 6:e29566. [PMID: 35377324 PMCID: PMC9016498 DOI: 10.2196/29566] [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] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 10/25/2021] [Accepted: 12/03/2021] [Indexed: 01/27/2023] Open
Abstract
Background Web-based interventions are at an early stage in non–English-speaking low- and middle-income countries, where they remain scarce. Help for Depression (HDep) is one of the few unguided web-based interventions available in Latin America. The results of a use/usability analysis of the original version served as the basis for generating a more user-friendly second version. Objective The aim of this study is to explore participants’ satisfaction and acceptability for the second version of HDep. Methods A retrospective cross-sectional design was used. An email invitation to complete a web-based survey was sent to all people who accessed HDep in 2018. The questionnaire included satisfaction and acceptability scales and open-ended questions. Complete questionnaires were retrieved from 191 participants: 35.1% (67/191) from those who visited only the home page (home page users [HPUs]) and 6.47% (124/1916) from those who registered to use the program (program users [PUs]). Results In all groups, users experienced high levels of depressive symptoms (189/191, 98.9%; Center for Epidemiological Studies Scale-Depression >16). Moderate levels of satisfaction (HPUs: mean 21.9, SD 6.7; PUs: mean 21.1, SD 5.8; range: 8-32) and acceptability (HPUs: mean 13.8, SD 3.9; PUs: mean 13.9, SD 3.2; range: 5-20) were found in both groups. Logistic regression analyses showed that among HPUs, women were more satisfied with HDep (odds ratio [OR] 3.4, 95% CI 1.1-10.0), whereas among PUs, older respondents (OR 1.04, 95% CI 1.01-1.08), those with paid work (OR 3.1, 95% CI 2.4-7.6), those who had not been in therapy (OR 2.42, 95% CI 1.09-5.98), and those who had not attempted suicide (OR 3.4, 95% CI 1.1-11.1) showed higher satisfaction. None of the sociodemographic/mental health variables distinguished the acceptability ratings among HPUs. Among PUs, those with paid work (OR 2.5, 95% CI 1.1-5.5), those who had not been in therapy (OR 3.1, 95% CI 1.3-7.3), those without disability (OR 2.9, 95% CI 1.3-6.6), and those who had not attempted suicide (OR 2.6, 95% CI 1.0-6.6) showed higher acceptability. Conclusions HDep has good levels of satisfaction and acceptability for approximately half of its users, and the information provided by respondents suggested feasible ways to remedy some of the deficiencies. This qualitative–quantitative study from a low- to middle-income, non–English-speaking country adds to existing knowledge regarding acceptance and satisfaction with web-based interventions for depression in resource-limited countries. This information is important for the creation and adaptation of web-based interventions in low- and middle-income countries, where access to treatment is a major concern, and web-based prevention and treatment programs can help deliver evidence-based alternatives. It is necessary to document the pitfalls, strengths, and challenges of such interventions in this context. Understanding how users perceive an intervention might suggest modifications to increase adherence.
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Affiliation(s)
- Ma Asunción Lara
- Department of Psychosocial Studies in Specific Population, Division of Epidemiological and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Pamela Patiño
- Division of Epidemiological and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Marcela Tiburcio
- Department of Social Sciences in Health, Division of Epidemiological and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Laura Navarrete
- Department of Psychosocial Studies in Specific Population, Division of Epidemiological and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
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Guillén V, Fonseca-Baeza S, Fernández-Felipe I, Botella C, Baños R, García-Palacios A, Marco J. Effectiveness of family connections intervention for family members of persons with personality disorders in two different formats: Online vs face-to-face. Internet Interv 2022; 28:100532. [PMID: 35646607 PMCID: PMC9136357 DOI: 10.1016/j.invent.2022.100532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Personality disorders (PD) have a serious impact on the lives of individuals who suffer from them and those around them. It is common for family members to experience high levels of burden, anxiety, and depression, and deterioration in their quality of life. It is curious that few interventions have been developed for family members of people with PD. However, Family Connections (FC) (Hoffman and Fruzzetti, 2005) is the most empirically supported intervention for family members of people with Borderline Personality Disorder (BPD). AIM The aim of this study is to explore the effectiveness of online vs face-to-face FC. Given the current social constraints resulting from SARS-CoV-2, interventions have been delivered online and modified. METHOD This was a non-randomized pilot study with a pre-post evaluation and two conditions: The sample consisted of 45 family members distributed in two conditions: FC face-to-face (20) performed by groups before the pandemic, and FC online (25), performed by groups during the pandemic. All participants completed the evaluation protocol before and after the intervention. RESULTS There is a statistically significant improvement in levels of burden (η 2 = 0.471), depression, anxiety, and stress (η 2 = 0.279), family empowerment (η 2 = 0.243), family functioning (η 2 = 0.345), and quality of life (μ2 η 2 = 0.237). There were no differences based on the application format burden (η 2 = 0.134); depression, anxiety, and stress (η 2 = 0.087); family empowerment (η 2 = 0,27), family functioning (η 2 = 0.219); and quality of life (η 2 = 0.006), respectively). CONCLUSIONS This study provides relevant data about the possibility of implementing an intervention in a sample of family members of people with PD in an online format without losing its effectiveness. During the pandemic, and despite the initial reluctance of family members and the therapists to carry out the interventions online, this work shows the effectiveness of the results and the satisfaction of the family members. These results are particularly relevant in a pandemic context, where there was no possibility of providing help in other ways. All of this represents a great step forward in terms of providing psychological treatment.
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Affiliation(s)
- V. Guillén
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain,Corresponding author at: Dep. of Personality, Evaluation and Psychological Treatments, University of Valencia, Av. Blasco Ibañez 21, 46010, Spain.
| | | | - I. Fernández-Felipe
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - C. Botella
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - R. Baños
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - A. García-Palacios
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - J.H. Marco
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
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Does Internet Use Impact the Health Status of Middle-Aged and Older Populations? Evidence from China Health and Retirement Longitudinal Study (CHARLS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063619. [PMID: 35329305 PMCID: PMC8954843 DOI: 10.3390/ijerph19063619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 02/05/2023]
Abstract
In the context of both rapid technological development and increasing aging, the relationship between technological development and the health of the middle-aged and older population is gradually receiving academic attention. This study empirically examined the health consequences of the Internet for the middle-aged and older population in China using data from the 2018 China Health and Retirement Longitudinal Study. The results indicated that Internet use was effective in improving the self-assessed health and chronic disease status of the middle-aged and older population. However, the effect of Internet use on the improvement of chronic disease conditions in this population was more pronounced than self-assessed health. In the heterogeneity analysis, the effect of Internet use on the health of female and middle-aged adults was more significant than that of male and older adults aged >60 years. This paper also used a propensity score matching model to eliminate the endogeneity problem caused by sample selectivity bias. The results revealed that the propensity score matching model analysis was more robust. Moreover, if sample selectivity bias was not eliminated, the effect of Internet use on the improvement of self-assessed health in the middle-aged and older population would be underestimated, whereas the effect of Internet use on the chronic disease status of the middle-aged and older adults would be overestimated.
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Turesson C, Liedberg G, Björk M. Development of a Digital Support Application With Evidence-Based Content for Sustainable Return to Work for Persons With Chronic Pain and Their Employers: User-Centered Agile Design Approach. JMIR Hum Factors 2022; 9:e33571. [PMID: 35285814 PMCID: PMC8961348 DOI: 10.2196/33571] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Persons with chronic pain experience a lack of support after completing rehabilitation and the responsibility for the return-to-work (RTW) process is taken over by the employer. In addition, employers describe not knowing how to support their employees. Smartphone apps have been increasingly used for self-management, but there is a lack of available eHealth apps with evidence-based content providing digital support for persons with chronic pain and their employers when they return to work. OBJECTIVE This study aims to describe the development of a digital support application with evidence-based content that includes a biopsychosocial perspective on chronic pain for sustainable RTW for persons with chronic pain and their employers (SWEPPE [Sustainable Worker Digital Support for Persons With Chronic Pain and Their Employers]). METHODS A user-centered agile design approach was applied. The multidisciplinary project team consisted of health care researchers, a user representative, and a software team. A total of 2 reference groups of 7 persons with chronic pain and 4 employers participated in the development process and usability testing. Mixed methods were used for data collection. The design was revised using feedback from the reference groups. The content of SWEPPE was developed based on existing evidence and input from the reference groups. RESULTS The reference groups identified the following as important characteristics to include in SWEPPE: keeping users motivated, tracking health status and work situation, and following progress. SWEPPE was developed as a smartphone app for the persons with chronic pain and as a web application for their employers. SWEPPE consists of six modules: the action plan, daily self-rating, self-monitoring graphs, the coach, the library, and shared information with the employer. The employers found the following functions in SWEPPE to be the most useful: employees' goals related to RTW, barriers to RTW, support wanted from the employer, and the ability to follow employees' progress. The persons with chronic pain found the following functions in SWEPPE to be the most useful: setting a goal related to RTW, identifying barriers and strategies, and self-monitoring. Usability testing revealed that SWEPPE was safe, useful (ie, provided relevant information), logical, and easy to use with an appealing interface. CONCLUSIONS This study reports the development of a digital support application for persons with chronic pain and their employers. SWEPPE fulfilled the need of support after an interdisciplinary pain rehabilitation program with useful functions such as setting a goal related to RTW, identification of barriers and strategies for RTW, self-monitoring, and sharing information between the employee and the employer. The user-centered agile design approach contributed to creating SWEPPE as a relevant and easy-to-use eHealth intervention. Further studies are needed to examine the effectiveness of SWEPPE in a clinical setting.
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Affiliation(s)
- Christina Turesson
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Gunilla Liedberg
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Mathilda Björk
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Wang Z, Fan Y, Lv H, Deng S, Xie H, Zhang L, Luo A, Wang F. The Gap Between Self-Rated Health Information Literacy and Internet Health Information-Seeking Ability for Patients With Chronic Diseases in Rural Communities: Cross-sectional Study. J Med Internet Res 2022; 24:e26308. [PMID: 35099401 PMCID: PMC8845012 DOI: 10.2196/26308] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/28/2021] [Accepted: 12/28/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The internet has become one of the most important channels for residents to seek health information, particularly in remote rural areas in China. OBJECTIVE In this study, we aimed to explore the gap between self-rated health information literacy and internet health information seeking ability for patients with chronic diseases in rural communities and to preliminarily evaluate their barriers when seeking health information via the internet. METHODS Residents from rural communities near Bengbu City and with chronic diseases were included in this study. A self-rated questionnaire was used to evaluate their health information literacy, 3 behavioral competency tasks were designed to preliminarily evaluate their ability to seek health information on the internet and semistructured interviews were used to investigate their barriers to obtaining health information via the internet. A small audiorecorder was used to record the interview content, and screen-recording software was used to record the participants' behavior during the web-based operational tasks. RESULTS A total of 70 respondents completed the self-rated health information literacy questionnaire and the behavioral competence test, and 56 respondents participated in the semistructured interviews. Self-rated health information literacy (score out of 70: mean 46.21, SD 4.90) of the 70 respondents were moderate. Although 91% (64/70) of the respondents could find health websites, and 93% (65/70) of the respondents could find information on treatment that they thought was the best, 35% (23/65) of respondents did not know how to save the results they had found. The operational tasks indicated that most articles selected by the respondents came from websites with encyclopedic knowledge or answers from people based on their own experiences rather than authoritative health information websites. After combining the results of the semistructured interviews with the DISCERN scale test results, we found that most interviewees had difficulty obtaining high-quality health information via the internet. CONCLUSIONS Although the health information literacy level of patients with rural chronic disease was moderate, they lack the ability to access high-quality health information via the internet. The vast majority of respondents recognized the importance of accessing health information but were not very proactive in accessing such information.
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Affiliation(s)
- Zhuoxin Wang
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Yanyan Fan
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Hekai Lv
- School of Health Management, Bengbu Medical College, Bengbu, China.,Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China
| | - Shanshan Deng
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Hui Xie
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Li Zhang
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Aijing Luo
- Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha, China.,The Second Xiangya Hospital, Central South University, Changsha, China
| | - Fuzhi Wang
- School of Health Management, Bengbu Medical College, Bengbu, China.,Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China
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Zhou L, Zhou Y, Yu P, Meng F, Xu Y, Jiang Y. Effects of e-health interventions on health outcomes in patients with rheumatoid arthritis: a systematic review and meta-analysis. J Clin Nurs 2022; 32:1748-1759. [PMID: 35102628 DOI: 10.1111/jocn.16236] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/10/2021] [Accepted: 12/14/2021] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES To evaluate the effects of e-health interventions on disease activity, self-efficacy, pain and quality of life among patients with rheumatoid arthritis (RA). BACKGROUND Prior systematic reviews have only reported the quality and features of e-health interventions in patients with RA. However, the effect of e-health interventions in patients with RA is unclear. DESIGN Systematic review and meta-analysis. METHODS This review was conducted following the PRISMA guideline. We searched 5 databases, including PubMed, EMBASE, CINAHL, Scopus and the Cochrane library. The risk of bias was assessed using the Cochrane risk of bias tool. The quality of the evidence was assessed via the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. Using a random-effects model adopted the standardised mean difference (SMD) with a 95% confidence interval (CI). A chi-squared test and an I2 test were used to assess heterogeneity. Subgroup analyses were conducted based on different controls. RESULTS A total of 9 randomised control trials were included in this study. Compared with the control group, disease activity of the e-health group significantly decreased (SMD with 95% CI: -.17 [-.30, -.04], p = .01, I2 = 1%). Meanwhile, trials with usual care control had a larger effect on disease activity (SMD with 95% CI: -.21 [-.40, -.02], p = .03, I2 = 38%). The effect of e-health interventions on self-efficacy was controversial; pain and quality of life were negative in the currently included studies. The quality of evidence was rated as low for disease activity and very low for pain, self-efficacy and quality of life. CONCLUSIONS The effect of e-health interventions on disease activity was statistically significant. More well-designed randomised controlled trials are still needed to verify the effects in the future. RELEVANCE TO CLINICAL PRACTICE This study shows the potential value of e-health in improving health outcomes in patients with RA.
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Affiliation(s)
- Lixue Zhou
- School of Nursing, Qingdao University, Qingdao, China
| | - Yunping Zhou
- School of Nursing, Qingdao University, Qingdao, China
| | - Pengli Yu
- School of Nursing, Qingdao University, Qingdao, China
| | - Fei Meng
- School of Nursing, Qingdao University, Qingdao, China
| | - Yanhong Xu
- School of Nursing, Qingdao University, Qingdao, China
| | - Yunxia Jiang
- School of Nursing, Qingdao University, Qingdao, China
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Possemato K, Wu J, Greene C, MacQueen R, Blonigen D, Wade M, Owen J, Keane T, Brief D, Lindley S, Prins A, Mackintosh MA, Carlson E. Web-Based Problem-solving Training With and Without Peer Support in Veterans With Unmet Mental Health Needs: Pilot Study of Feasibility, User Acceptability, and Participant Engagement. J Med Internet Res 2022; 24:e29559. [PMID: 35023846 PMCID: PMC8796046 DOI: 10.2196/29559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/13/2021] [Accepted: 10/14/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND eHealth tools have the potential to meet the mental health needs of individuals who experience barriers to accessing in-person treatment. However, most users have less than optimal engagement with eHealth tools. Coaching from peer specialists may increase their engagement with eHealth. OBJECTIVE This pilot study aims to test the feasibility and acceptability of a novel, completely automated web-based system to recruit, screen, enroll, assess, randomize, and then deliver an intervention to a national sample of military veterans with unmet mental health needs; investigate whether phone-based peer support increases the use of web-based problem-solving training compared with self-directed use; and generate hypotheses about potential mechanisms of action for problem-solving and peer support for future full-scale research. METHODS Veterans (N=81) with unmet mental health needs were recruited via social media advertising and enrolled and randomized to the self-directed use of a web-based problem-solving training called Moving Forward (28/81, 35%), peer-supported Moving Forward (27/81, 33%), or waitlist control (26/81, 32%). The objective use of Moving Forward was measured with the number of log-ins. Participants completed pre- and poststudy measures of mental health symptoms and problem-solving confidence. Satisfaction was also assessed post treatment. RESULTS Automated recruitment, enrollment, and initial assessment methods were feasible and resulted in a diverse sample of veterans with unmet mental health needs from 38 states. Automated follow-up methods resulted in 46% (37/81) of participants completing follow-up assessments. Peer support was delivered with high fidelity and was associated with favorable participant satisfaction. Participants randomized to receive peer support had significantly more Moving Forward log-ins than those of self-directed Moving Forward participants, and those who received peer support had a greater decrease in depression. Problem-solving confidence was associated with greater Moving Forward use and improvements in mental health symptoms among participants both with and without peer support. CONCLUSIONS Enrolling and assessing individuals in eHealth studies without human contact is feasible; however, different methods or designs are necessary to achieve acceptable participant engagement and follow-up rates. Peer support shows potential for increasing engagement in web-based interventions and reducing symptoms. Future research should investigate when and for whom peer support for eHealth is helpful. Problem-solving confidence should be further investigated as a mechanism of action for web-based problem-solving training. TRIAL REGISTRATION ClinicalTrials.gov NCT03555435; http://clinicaltrials.gov/ct2/show/NCT03555435.
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Affiliation(s)
- Kyle Possemato
- Veterans Affairs Center for Integrated Healthcare, Syracuse, NY, United States
| | - Justina Wu
- National Center for Post Traumatic Stress Disorder, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Carolyn Greene
- Veterans Affairs Office of Mental Health Services and Suicide Prevention, Washington, DC, United States
| | - Rex MacQueen
- Veterans Affairs Center for Integrated Healthcare, Syracuse, NY, United States
| | - Daniel Blonigen
- Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, United States
| | - Michael Wade
- Veterans Affairs Center for Integrated Healthcare, Syracuse, NY, United States
| | - Jason Owen
- National Center for Post Traumatic Stress Disorder, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Terence Keane
- National Center for Post Traumatic Stress Disorder, Veterans Affairs Boston Healthcare System, Boston, MA, United States
| | - Deborah Brief
- National Center for Post Traumatic Stress Disorder, Veterans Affairs Boston Healthcare System, Boston, MA, United States
| | - Steven Lindley
- Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, United States
| | - Annabel Prins
- National Center for Post Traumatic Stress Disorder, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Margaret-Anne Mackintosh
- National Center for Post Traumatic Stress Disorder, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Eve Carlson
- National Center for Post Traumatic Stress Disorder, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
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Holmberg TT, Sainte-Marie M, Jensen EK, Linnet J, Runge E, Lichtenstein MB, Tarp K. An analysis of patient motivation for seeking online treatment for binge eating disorder-A mixed methods study combining systematic text condensation with sentiment analysis. Front Psychiatry 2022; 13:969115. [PMID: 36405908 PMCID: PMC9672086 DOI: 10.3389/fpsyt.2022.969115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Online treatment for binge eating disorder (BED) is an easily available option for treatment compared to most standard treatment procedures. However, little is known about how motivation types characterize this population and how these impact treatment adherence and effect in an online setting. Therefore, we aimed to investigate a sample of written motivation statements from BED patients, to learn more about how treatment and online treatment in particular, presents in this population. METHODS Using self-determination theory in a mixed methods context, we investigated which types of motivation were prevalent in our sample, how this was connected with patient sentiment, and how these constructs influence treatment and adherence. RESULTS Contrary to what most current literature suggests, we found that in our sample (n = 148), motivation type was not connected with treatment outcome. We did find a strong association between sentiment scores and motivation types, indicating the model is apt at detecting effects. We found that when comparing an adult and young adult population, they did not differ in motivation type and the treatment was equally effective in young adults and adults. In the sentiment scores there was a difference between sentiment score and adherence in the young adult group, as the more positive the young adults were, the less likely they were to complete the program. DISCUSSION Because motivation type does not influence online treatment to the same degree as it would in face-to-face treatment it indicates that the typical barriers to treatment may be less crucial in an online setting. This should be considered during intake; as less motivated patients may be able to adhere better to online treatment, because the latter imposes fewer barriers of the kind that only strong motivation can overcome. The fact that motivation type and sentiment score of the written texts are strongly associated, indicate a potential for automated models to detect motivation based on sentiment.
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Affiliation(s)
- Trine Theresa Holmberg
- Research Unit for Digital Psychiatry, Center for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Maxime Sainte-Marie
- Department of Political Science, Danish Center for Studies in Research and Research Policy, Aarhus University, Aarhus, Denmark
| | - Esben Kjems Jensen
- Research Unit for Digital Psychiatry, Center for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jakob Linnet
- Research Unit for Digital Psychiatry, Center for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.,Clinic on Gambling- and Binge Eating Disorder, Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark
| | - Eik Runge
- Research Unit for Digital Psychiatry, Center for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Mia Beck Lichtenstein
- Research Unit for Digital Psychiatry, Center for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Kristine Tarp
- Research Unit for Digital Psychiatry, Center for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Imai H, Tajika A, Narita H, Yoshinaga N, Kimura K, Nakamura H, Takeshima N, Hayasaka Y, Ogawa Y, Furukawa T. Unguided computer-assisted self-help interventions without human contact in patients with obsessive-compulsive disorder: a systematic review and meta-analysis (Preprint). J Med Internet Res 2021; 24:e35940. [PMID: 35451993 PMCID: PMC9073609 DOI: 10.2196/35940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/07/2022] [Accepted: 03/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background Computer-assisted treatment may reduce therapist contact and costs and promote client participation. This meta-analysis examined the efficacy and acceptability of an unguided computer-assisted therapy in patients with obsessive-compulsive disorder (OCD) compared with a waiting list or attention placebo. Objective This study aimed to evaluate the effectiveness and adherence of computer-assisted self-help treatment without human contact in patients with OCD using a systematic review and meta-analysis approach. Methods Randomized controlled trials with participants primarily diagnosed with OCD by health professionals with clinically significant OCD symptoms as measured with validated scales were included. The interventions included self-help treatment through the internet, computers, and smartphones. We excluded interventions that used human contact. We conducted a search on PubMed, Cochrane Central Register of Controlled Trials, EMBASE, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov, as well as the reference lists of the included studies. The risk of bias was evaluated using version 2 of the Cochrane risk-of-bias tool for randomized trials. We calculated the standardized mean differences for continuous outcomes and risk ratios for dichotomous outcomes. The primary outcomes were short-term improvement of OCD symptoms measured by validated scales and dropout for any reason. Results We included 11 randomized controlled trials with a total of 983 participants. The results indicated that unguided computer-assisted self-help therapy was significantly more effective than a waiting list or psychological placebo (standard mean difference −0.47, 95% CI −0.73 to −0.22). Unguided computer-assisted self-help therapy had more dropouts for any reason than waiting list or psychological placebo (risk ratio 1.98, 95% CI 1.21 to 3.23). However, the quality of evidence was very low because of the risk of bias and inconsistent results among the included studies. The subgroup analysis showed that exposure response and prevention and an intervention duration of more than 4 weeks strengthen the efficacy without worsening acceptability. Only a few studies have examined the interaction between participants and systems, and no study has used gamification. Most researchers only used text-based interventions, and no study has used a mobile device. The overall risk of bias of the included studies was high and the heterogeneity of results was moderate to considerable. Conclusions Unguided computer-assisted self-help therapy for OCD is effective compared with waiting lists or psychological placebo. An exposure response and prevention component and intervention duration of more than 4 weeks may strengthen the efficacy without worsening the acceptability of the therapy. Trial Registration PROSPERO (International Prospective Register of Systematic Reviews) CRD42021264644; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=264644
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Affiliation(s)
- Hissei Imai
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Aran Tajika
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Hisashi Narita
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Neurology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Naoki Yoshinaga
- School of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Kenichi Kimura
- Department of Psychiatry, Hakodate Watanabe Hospital, Hakodate, Japan
| | - Hideki Nakamura
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nozomi Takeshima
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Yu Hayasaka
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Yusuke Ogawa
- Department of Healthcare Epidemiology, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Toshi Furukawa
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
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Tzelepis F, Mitchell A, Wilson L, Byrnes E, Haschek A, Leigh L, Oldmeadow C. The Long-Term Effectiveness of Internet-Based Interventions on Multiple Health Risk Behaviors: Systematic Review and Robust Variance Estimation Meta-analysis. J Med Internet Res 2021; 23:e23513. [PMID: 34931990 PMCID: PMC8734928 DOI: 10.2196/23513] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/09/2020] [Accepted: 11/22/2021] [Indexed: 11/26/2022] Open
Abstract
Background Smoking tobacco, poor nutrition, risky alcohol use, and physical inactivity (SNAP) behaviors tend to cluster together. Health benefits may be maximized if interventions targeted multiple health risk behaviors together rather than addressing single behaviors. The internet has wide reach and is a sustainable mode for delivery of interventions for multiple health behaviors. However, no systematic reviews have examined the long-term effectiveness of internet-based interventions on any combination of or all SNAP behaviors in adults aged 18 years or older. Objective This systematic review examined, among adults (aged ≥18 years), the effectiveness of internet-based interventions on SNAP behaviors collectively in the long term compared with a control condition. Methods The electronic databases Medline, PsycINFO, Embase, CINAHL, and Scopus were searched to retrieve studies describing the effectiveness of internet-based interventions on ≥2 SNAP behaviors published by November 18, 2019. The reference lists of retrieved articles were also checked to identify eligible publications. The inclusion criteria were randomized controlled trials or cluster randomized controlled trials with adults examining an internet-based intervention measuring the effect on ≥2 SNAP behaviors at least 6 months postrecruitment and published in English in a peer-reviewed journal. Two reviewers independently extracted data from included studies and assessed methodological quality using the Quality Assessment Tool for Quantitative Studies. A robust variance estimation meta-analysis was performed to examine the long-term effectiveness of internet-based interventions on all 4 SNAP risk behavior outcomes. All SNAP outcomes were coded so they were in the same direction, with higher scores equating to worse health risk behaviors. Results The inclusion criteria were met by 11 studies: 7 studies measured the effect of an internet-based intervention on nutrition and physical activity; 1 study measured the effect on smoking, nutrition, and physical activity; and 3 studies measured the effect on all SNAP behaviors. Compared with the control group, internet-based interventions achieved an overall significant improvement across all SNAP behaviors in the long term (standardized mean difference –0.12 [improvement as higher scores = worse health risk outcomes], 95% CI –0.19 to –0.05; I2=1.5%, P=.01). The global methodological quality rating was “moderate” for 1 study, while the remaining 10 studies were rated as “weak.” Conclusions Internet-based interventions were found to produce an overall significant improvement across all SNAP behaviors collectively in the long term. Internet-based interventions targeting multiple SNAP behaviors have the potential to maximize long-term improvements to preventive health outcomes.
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Affiliation(s)
- Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Aimee Mitchell
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
| | - Louise Wilson
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
| | - Emma Byrnes
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Alexandra Haschek
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia.,The Cooperative Research Centre for Living with Autism, Brisbane, Australia
| | - Lucy Leigh
- Hunter Medical Research Institute, New Lambton Heights, Australia
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Chatterjee P, Beck AM, Brager JAL, Durand DJ, D'Adamo CR. The Effect of an Automated Mobile Patient Engagement Application on Emergency Department Revisits: Prospective Observational Study. JMIR Form Res 2021; 5:e17839. [PMID: 34898451 PMCID: PMC8713095 DOI: 10.2196/17839] [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: 01/15/2020] [Revised: 01/20/2021] [Accepted: 07/06/2021] [Indexed: 11/19/2022] Open
Abstract
Background Revisits within 30 days to an emergency department (ED), observation care unit, or inpatient setting following patient discharge continue to be a challenge, especially in urban settings. In addition to the consequences for the patient, these revisits have a negative impact on a health system’s finances in a value-based care or global budget environment. LifeBridge Health, a community health system in Maryland, United States, implemented an automated mobile patient engagement application as part of our enterprise-wide digital health strategy to improve patient engagement and reduce revisits to the ED. Objective The aim of this paper was to evaluate the effectiveness of a customized automated digital patient engagement application (GetWell Loop) to reduce 30-day revisits after home discharge from an ED. Methods The LifeBridge Health Innovation Department and ED staff from 2 participating health system hospitals collaborated with GetWellNetwork to customize their patient engagement application with automated check-in questions and other on-demand resources (eg, streaming content explaining aspects of self-care during COVID-19). An application link was emailed to adult patients discharged home from the ED. A study of ED visits for patients treated for general medicine and cardiology conditions between August 1, 2018, and July 31, 2019, was conducted using CRISP (Chesapeake Regional Information System for our Patients), Maryland’s state-designated health information exchange. We also used data within GetWell Loop (GetWellNetwork) to track patient activation and engagement. The primary outcome was the number of ED patients who experienced a 30-day revisit and who did or did not activate their GetWell Loop account. Secondary outcomes included the overall activation rate and the rate of engagement as measured by the number of logins, alerts, and comments generated by patients through the application. Bivariate analysis comparing outcomes among patients who activated the GetWell Loop application to patients who did not was conducted using the Fisher exact test. Multivariate logistic regression modeling with elastic net regularization was also performed to account for potential confounders and potential collinearity of covariates. Results During this 1-year study, 1062 (27.4%) of 3866 of all emergency patients treated for general medicine or cardiology conditions, who received an invite to use the digital application, activated their account. The patients discharged from the ED, who were treated for general medicine conditions (n=2087) and who activated their GetWell Loop account, experienced a 30-day revisit rate of 17.3% (n=101) compared with 24.6% (n=369) for those who did not activate their account (P<.001). Of the patients treated for cardiology conditions (n=1779), 12.8% (n=61) of those who activated their GetWell account experienced a 30-day revisit compared with 17.7% (n=231) of those who did not activate their account (P=.01). The significance of these findings persisted after adjustment for confounding variables including age, race, sex, and payor in logistic regression modeling (adjusted odds ratio 0.75, 95% CI 0.62-0.92; P=.006). Conclusions Our results suggest that a significant percentage of patients are willing to utilize a digital application following ED discharge to better engage in their own care, and that usage of such digital applications may significantly reduce 30-day revisit rates. LifeBridge Health’s experience demonstrates that health care systems can leverage automated mobile apps to improve patient engagement and successfully impact clinical outcomes at scale.
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Affiliation(s)
- Pothik Chatterjee
- Innovation and Research Department, LifeBridge Health, Baltimore, MD, United States
| | - Adam M Beck
- Innovation and Research Department, LifeBridge Health, Baltimore, MD, United States
| | | | - Daniel J Durand
- Innovation and Research Department, LifeBridge Health, Baltimore, MD, United States
| | - Christopher R D'Adamo
- Department of Family & Community Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
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Keller MM, Dolph B, Cavuoto L, Ranahan M, Feeley TH, Kayler LK. Formative Usability of the Kidneytime Online Live Donor Kidney Transplant Education Tool Among Transplant Candidates. Prog Transplant 2021; 31:314-322. [PMID: 34719298 DOI: 10.1177/15269248211046035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Web-based education may be a powerful tool to support transplant candidates' learning and communication about live donor kidney transplantation. Few educational interventions are web-based and have education sharing for living donor transplant as a primary goal. METHODS Through user-centered design and iterative usability testing, we developed a web platform, called KidneyTIME, to support an educational intervention for adult transplant candidates. KidneyTIME delivers animated videos to improve candidate knowledge, motivation, and self-efficacy to pursue living donor transplantation and to promote outreach through video sharing. The animated-video educational content was previously produced by the researchers. We conducted a formative usability evaluation of the KidneyTIME web platform to enable users to find, view, and share the previously produced videos. A total of 30 kidney transplant candidates were involved in 4 rounds of testing at one transplant center, with amendments made after each round. RESULTS Transplant candidates were predominantly White non-Hispanic; 47% had incomes <$30 000 and >43% had vision or motor impairment. Readability, navigation, and failure to find videos were the main usability issues identified. Substantial improvements were found in the usability of most functions after implementing certain features, such as enlarging text and buttons, enhancing contrast, and simplifying presentation. Participants reported that the intervention was user friendly and easy to navigate. CONCLUSION Considering feedback from a wide spectrum of users has improved the usability of KidneyTIME. A salient concern for End stage kidney disease populations is ensuring online accessibility despite vision and motor impairments.
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Affiliation(s)
- Maria M Keller
- Department of Community Health and Health Behavior, University at Buffalo, State University of New York, Buffalo, NY, USA.,Transplant and Kidney Care Regional Center of Excellence, Erie County Medical Center, Buffalo, NY, USA
| | - Beth Dolph
- 12291Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, USA
| | - Lora Cavuoto
- Department of Industrial and Systems Engineering, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Molly Ranahan
- Transplant and Kidney Care Regional Center of Excellence, Erie County Medical Center, Buffalo, NY, USA
| | - Thomas H Feeley
- Department of Communication, University at Buffalo, State University of New York, Buffalo, NYI, USA
| | - Liise K Kayler
- Transplant and Kidney Care Regional Center of Excellence, Erie County Medical Center, Buffalo, NY, USA.,12291Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, USA
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Zoellner JM, Porter KJ, You W, Reid AL, Frederick C, Hilgart M, Brock DJP, Tate DF, Ritterband LM. Study protocol for iSIPsmarter: A randomized-controlled trial to evaluate the efficacy, reach, and engagement of a technology-based behavioral intervention to reduce sugary beverages among rural Appalachian adults. Contemp Clin Trials 2021; 110:106566. [PMID: 34492306 PMCID: PMC8595813 DOI: 10.1016/j.cct.2021.106566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 01/09/2023]
Abstract
Sugar-sweetened beverage (SSB) consumption is disproportionately high among rural Appalachian adults, with intakes double the national average and nearly four times the recommended amount. This trial targets this major dietary risk factor and addresses notable gaps in the rural digital health intervention literature. iSIPsmarter is a technology-based behavior and health literacy intervention aimed at improving SSB behaviors. It is comprised of six Internet-delivered, interactive Cores delivered weekly, an integrated short message service (SMS) strategy to engage users in tracking and reporting SSB behaviors, and a cellular-enabled scale for in-home weighing. iSIPsmarter is adapted from an evidence-based intervention and is grounded by the Theory of Planned Behavior and health literacy, numeracy, and media literacy concepts. The RCT is guided by the RE-AIM framework and targets 244 rural Appalachian adults. The goal is to examine the efficacy of iSIPsmarter to reduce SSB in a two-group design [iSIPsmarter vs. static Participant Education website] with four assessment points. Changes in secondary outcomes (e.g., diet quality, weight, quality of life) and maintenance of outcomes will also be evaluated. Additional secondary aims are to examine reach and representativeness, patterns of user engagement, and cost. Two tertiary aims are exploratory mediation analyses and a systems-level, participatory evaluation to understand context for future organizational-level adoption of iSIPsmarter. The long-term goal is to sustain an effective, scalable, and high reach behavioral intervention to reduce SSB-related health inequities and related chronic conditions (i.e., obesity, diabetes, some obesity-related cancers, heart disease, hypertension, dental decay) in rural Appalachia and beyond. ClinicalTrial registry: NCT05030753.
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Affiliation(s)
- Jamie M Zoellner
- University of Virginia, School of Medicine, Department of Public Health Sciences, Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA.
| | - Kathleen J Porter
- University of Virginia, School of Medicine, Department of Public Health Sciences, Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA
| | - Wen You
- University of Virginia, School of Medicine, Department of Public Health Sciences, 560 Ray C Hunt Drive, Charlottesville, VA 22908, USA
| | - Annie L Reid
- University of Virginia, School of Medicine, Department of Public Health Sciences, Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA
| | - Christina Frederick
- University of Virginia, School of Medicine, Department of Psychiatry and Neurobehavioral Sciences, 560 Ray C Hunt Drive, Charlottesville, VA 22908, USA
| | - Michelle Hilgart
- University of Virginia, School of Medicine, Department of Psychiatry and Neurobehavioral Sciences, 560 Ray C Hunt Drive, Charlottesville, VA 22908, USA
| | - Donna-Jean P Brock
- University of Virginia, School of Medicine, Department of Public Health Sciences, Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA
| | - Deborah F Tate
- University of North Carolina, Gillings School of Global Public Health, Department of Health Behavior, Chapel Hill, NC 27599, USA
| | - Lee M Ritterband
- University of Virginia, School of Medicine, Department of Psychiatry and Neurobehavioral Sciences, 560 Ray C Hunt Drive, Charlottesville, VA 22908, USA
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