Internet Interventions-The Application of Information Technology in Mental and Behavioural Health最新文献

{"title":"Additive effects of adjunctive app-based interventions for mental disorders - A systematic review and meta-analysis of randomised controlled trials","authors":"Lukas M. Fuhrmann ,&nbsp;Kiona K. Weisel ,&nbsp;Mathias Harrer ,&nbsp;Jennifer K. Kulke ,&nbsp;Harald Baumeister ,&nbsp;Pim Cuijpers ,&nbsp;David D. Ebert ,&nbsp;Matthias Berking","doi":"10.1016/j.invent.2023.100703","DOIUrl":"10.1016/j.invent.2023.100703","url":null,"abstract":"<div><h3>Background</h3><p>It is uncertain whether app-based interventions add value to existing mental health care.</p></div><div><h3>Objective</h3><p>To examine the incremental effects of app-based interventions when used as adjunct to mental health interventions.</p></div><div><h3>Methods</h3><p>We searched PubMed, PsycINFO, Scopus, Web of Science, and Cochrane Library databases on September 15th, 2023, for randomised controlled trials (RCTs) on mental health interventions with an adjunct app-based intervention compared to the same intervention-only arm for adults with mental disorders or respective clinically relevant symptomatology. We conducted meta-analyses on symptoms of different mental disorders at postintervention. PROSPERO, CRD42018098545.</p></div><div><h3>Results</h3><p>We identified 46 RCTs (4869 participants). Thirty-two adjunctive app-based interventions passively or actively monitored symptoms and behaviour, and in 13 interventions, the monitored data were sent to a therapist. We found additive effects on symptoms of depression (<em>g</em> = 0.17; 95 % CI 0.02 to 0.33; <em>k</em> = 7 comparisons), anxiety (<em>g</em> = 0.80; 95 % CI 0.06 to 1.54; <em>k</em> = 3), mania (<em>g</em> = 0.2; 95 % CI 0.02 to 0.38; <em>k</em> = 4), smoking cessation (<em>g</em> = 0.43; 95 % CI 0.29 to 0.58; <em>k</em> = 10), and alcohol use (<em>g</em> = 0.23; 95 % CI 0.08 to 0.39; <em>k</em> = 7). No significant effects were found on symptoms of depression within a bipolar disorder (<em>g</em> = -0.07; 95 % CI -0.37 to 0.23, <em>k</em> = 4) and eating disorders (<em>g</em> = -0.02; 95 % CI -0.44 to 0.4, <em>k</em> = 3). Studies on depression, mania, smoking, and alcohol use had a low heterogeneity between the trials. For other mental disorders, only single studies were identified. Only ten studies had a low risk of bias, and 25 studies reported insufficient statistical power.</p></div><div><h3>Discussion</h3><p>App-based interventions may be used to enhance mental health interventions to further reduce symptoms of depression, anxiety, mania, smoking, and alcohol use. However, the effects were small, except for anxiety, and limited due to study quality. Further high-quality research with larger sample sizes is warranted to better understand how app-based interventions can be most effectively combined with established interventions to improve outcomes.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100703"},"PeriodicalIF":4.3,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782923001033/pdfft?md5=0b9572b9aa5c9b6d516150fc75f1e86d&pid=1-s2.0-S2214782923001033-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138743045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors and moderators of outcome of ICBT for loneliness with guidance or automated messages - A secondary analysis of a randomized controlled trial","authors":"Noëmi Seewer ,&nbsp;Andrej Skoko ,&nbsp;Anton Käll ,&nbsp;Gerhard Andersson ,&nbsp;Thomas Berger ,&nbsp;Tobias Krieger","doi":"10.1016/j.invent.2023.100701","DOIUrl":"10.1016/j.invent.2023.100701","url":null,"abstract":"<div><p>Internet-based cognitive behavioral therapy (ICBT) is promising in alleviating loneliness in adults. Identifying individuals who benefit from ICBT for loneliness is pivotal to offering this intervention in a more targeted way and improving the intervention for those who do not benefit. This secondary analysis of a randomized controlled trial (RCT) aimed to identify predictors and moderators of outcome of an ICBT with guidance or automated messages for loneliness. In the RCT, 243 participants suffering from loneliness were randomly assigned to an ICBT with guidance (<em>n</em> = 98), automated messages (<em>n</em> = 97), or a waitlist-control condition (<em>n</em> = 48). In total, 180 participants completed the post-assessment (i.e., 10 weeks post-randomization). Outcomes were treatment outcome assessed with the UCLA-9 Loneliness Scale at post-assessment and treatment response, i.e., reliable improvement on the UCLA-9 from pre- to post. The relationship between a wide range of patient characteristics (grouped into socio-demographic, clinical, loneliness-specific, and treatment-related variables) and outcome was analyzed using multiple linear and logistic regressions. Feeling less burdened by loneliness resulted in higher odds of reliable improvement in guided ICBT compared to the waitlist-control condition. No treatment outcome or response moderators were identified for ICBT with automated messages compared to the waitlist-control group. Across active intervention groups, loneliness at baseline, age and fit between the tasks and goals of the intervention and participants' need predicted treatment outcome. Predictors of treatment response for ICBT with guidance and automated messages were not identified, and no variables differentially predicted the effects of ICBT with guidance or automated messages on the outcomes. In conclusion, individuals less burdened by their feelings of loneliness benefited more from guided ICBT. Lower baseline loneliness scores, younger age, and a better match between tasks and goals of the intervention and participants' needs also predicted a more favorable treatment outcome for both ICBT with guidance and automated messages.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100701"},"PeriodicalIF":4.3,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221478292300101X/pdfft?md5=039cd3c0657b7adc06e904a4390d8af7&pid=1-s2.0-S221478292300101X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138743038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"App-based intervention for parents of children with crying, sleeping, and feeding problems: Usability, usefulness and implications for improvement","authors":"Michaela Augustin ,&nbsp;Anne Sophie Wenzel ,&nbsp;Maria Licata-Dandel ,&nbsp;Linda D. Breeman ,&nbsp;Ayten Bilgin ,&nbsp;Dieter Wolke ,&nbsp;Margret Ziegler ,&nbsp;Volker Mall ,&nbsp;Anna Friedmann","doi":"10.1016/j.invent.2023.100700","DOIUrl":"10.1016/j.invent.2023.100700","url":null,"abstract":"<div><h3>Background</h3><p>There is a lack of evidence-based app guidance for parents of children with crying, sleeping, and feeding problems who are often highly burdened and not likely to seek professional help. A new psychoeducational app for parents providing scientifically sound information via text and videos, a diary function, selfcare strategies, a chat forum and a regional directory of specialized counseling centers may serve as a low-threshold intervention for this target group.</p></div><div><h3>Objective</h3><p>We investigated how parents perceived the app in terms of the following: (1) overall impression and usability, (2) feedback on specific app functions regarding usefulness and (3) possible future improvements.</p></div><div><h3>Methods</h3><p>Our clinical sample of <em>N</em> = 137 parents of children aged from 0 to 24 months was recruited from a cry baby outpatient clinic in Southern Germany between 2019 and 2022. A convergent parallel mixed methods design was used to collect and analyse cross-sectional data on app evaluation. After app use within the framework of a clinical trial, parents filled in an app evaluation questionnaire.</p></div><div><h3>Results</h3><p>Most participants used the app at least once a week (86, 62.8 %) over an average period of 19.06 days (<em>SD</em> = 15.00). Participants rated overall impression and usability as good, and the informational texts, expert videos and regional register of counseling centers as appealing and useful. The diary function and chat forum were found to be helpful in theory, but improvements in implementation were requested, such as a timer function for the diary entry. Regarding future functionality, parents posed several suggestions such as the option to contact counseling centers directly via app, and the inclusion of the profile of their partners.</p></div><div><h3>Conclusions</h3><p>Positive ratings of overall impression, usability, and specific app functions are important prerequisites for the app to be effective. App-based guidance for this target group should include easy-to-use information. The app is intended to serve as a secondary preventive low-threshold offer and to complement professional counseling.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100700"},"PeriodicalIF":4.3,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782923001008/pdfft?md5=485a9f1979e2bb28eee74accb168028d&pid=1-s2.0-S2214782923001008-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138688550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of organizational models on the implementation of internet-based cognitive behavior therapy in primary care: A mixed methods study using the RE-AIM framework","authors":"Elisabet Gervind ,&nbsp;Mathilda Ben Salem ,&nbsp;Cecilia Svanborg ,&nbsp;Monica E. Nyström ,&nbsp;Josefine L. Lilja ,&nbsp;Viktor Kaldo ,&nbsp;Sandra Weineland","doi":"10.1016/j.invent.2023.100698","DOIUrl":"10.1016/j.invent.2023.100698","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Internet-Based Cognitive Behavioral Therapy (iCBT) holds great potential in addressing mental health issues, yet its real-world implementation poses significant challenges. While prior research has predominantly focused on centralized care models, this study explores the implementation of iCBT in the context of decentralized organizational structures within the Swedish primary care setting, where all interventions traditionally are delivered at local Primary Care Centers (PCCs).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;p&gt;This study aims to enhance our understanding of iCBT implementation in primary care and assess the impact of organizational models on the implementation's outcome using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;p&gt;A mixed-methods research design was employed to identify the factors influencing iCBT implementation across different levels, involving patients, therapists and managers. Data spanning two years was collected and analyzed through thematic analysis and statistical tests. The study encompassed 104 primary care centers, with patient data (&lt;em&gt;n&lt;/em&gt; = 1979) sourced from the Swedish National Quality Register for Internet-Based Psychological Treatment (SibeR). Additionally, 53 iCBT therapists and 50 PCC managers completed the Normalization Measure Development Questionnaire, and 15 leaders participated in interviews.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Our investigation identified two implementation approaches, one concentrated and one decentralized. Implementation effectiveness was evident through adherence rates suggesting that iCBT is a promising approach for treating mental ill-health in primary care, although challenges were observed concerning patient assessment and therapist drift towards unstructured treatment. Mandatory implementation, along with managerial and organizational support, positively impacted adoption. Results vary in terms of adherence to established protocols, with therapists working in concentrated model showing a significantly higher percentage of registration in the quality register SibeR (X&lt;sup&gt;2&lt;/sup&gt; (1, &lt;em&gt;N&lt;/em&gt; = 2973) = 430.5774, &lt;em&gt;p&lt;/em&gt; = 0.001). They also showed significantly higher means in cognitive participation (Z = −2.179, &lt;em&gt;p&lt;/em&gt; = 0.029) and in reflective monitoring (Z = −2.548, &lt;em&gt;p&lt;/em&gt; = 0.011).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;p&gt;Overall, the study results demonstrate that iCBT, as a complex and qualitatively different intervention from traditional psychological treatment, can be widely implemented in primary care settings. The study's key finding highlights the substantial advantages of the concentrated organizational model. This model has strengths in sustainability, encourages reflective monitoring among therapists, the use of quality registers, and enforces established protocols.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;In conclusion, this study significantly contributes to the understanding of","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100698"},"PeriodicalIF":4.3,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782923000982/pdfft?md5=385dcfeab0222f2f82fb5efcf6bc3a7a&pid=1-s2.0-S2214782923000982-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138630587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid-delivered community psychoeducation for people aged 50 and older: A mixed-method evaluation and lesson learned","authors":"Dara Kiu Yi Leung ,&nbsp;Nicole Hiu Ling Wong ,&nbsp;Jessie Ho Yin Yau ,&nbsp;Frankie Ho Chun Wong ,&nbsp;Tianyin Liu ,&nbsp;Wai-wai Kwok ,&nbsp;Gloria Hoi Yan Wong ,&nbsp;Terry Yat Sang Lum","doi":"10.1016/j.invent.2023.100699","DOIUrl":"10.1016/j.invent.2023.100699","url":null,"abstract":"<div><h3>Introduction</h3><p>Hybrid training mode comprising in-person and teleconferencing sessions is effective and sustainable, yet no standardized principles guide its development for older people. This study aimed to develop a set of principles for hybrid-mode psychoeducation for older people from the experiences of middle-aged and older people in two folds: (1) examining the effects of hybrid-mode community psychoeducation and (2) identifying features that could enhance participants' experience.</p></div><div><h3>Methods</h3><p>We delivered 12-hour Older Person Mental Health First Aid and 3-hour late-life depression training to adults aged 50 and older in in-person and hybrid modes. Hybrid group participants received technology-related support, including in-advance training and on-site support. All participants completed assessments on depression literacy, depression stigma, meaning in life, social support, depressive symptoms, and anxiety pre-and post-intervention and evaluated the program in open-ended questions.</p></div><div><h3>Results</h3><p>A total of 471 in-person and 346 hybrid group participants completed the psychoeducation and post-assessment (80.4 % female, mean age = 64.73 years, SD = 7.29). Linear mixed models revealed improvements in depression literacy, depression stigma, meaning in life, social support, and anxiety (B = −1.43 to 0.13, all <em>p</em> &lt; .001), with no significant difference between in-person and hybrid groups. Thematic analysis of open-ended questions identified three themes: (1) informational content with case studies, (2) hardcopy course handouts, and (3) interactive learning environment.</p></div><div><h3>Discussion/conclusion</h3><p>Hybrid-mode and in-person psychoeducation had comparable benefits on middle-aged and older people. The TORCH principles, an acronym for Technology provision, On-site technical support, Rehearsal, Connection with group members, and Hardcopy notes, was derived from practice wisdom and qualitative findings to support older people in online learning.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100699"},"PeriodicalIF":4.3,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782923000994/pdfft?md5=40a5aeaea23c8a4aa1216c3d1a5e23bf&pid=1-s2.0-S2214782923000994-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138577405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare use in patients with cardiovascular disease and depressive symptoms – The impact of a nurse-led internet-delivered cognitive behavioural therapy program. A secondary analysis of a RCT","authors":"Ghassan Mourad ,&nbsp;Johan Lundgren ,&nbsp;Gerhard Andersson ,&nbsp;Peter Johansson","doi":"10.1016/j.invent.2023.100696","DOIUrl":"https://doi.org/10.1016/j.invent.2023.100696","url":null,"abstract":"<div><h3>Background</h3><p>Depressive symptoms in patients with cardiovascular disease (CVD) can lead to increased healthcare use. In a randomized controlled trial (<span>ClinicalTrials.gov</span><svg><path></path></svg>, <span>NCT02778074</span><svg><path></path></svg>), we reported that a 9-week internet-delivered cognitive behavioural therapy (iCBT) program (<em>n</em> = 72) compared to an online discussion forum (ODF) (n = 72) had moderate to large effect on depression in CVD outpatients. In this secondary analysis, we aimed to describe and compare the effect of iCBT compared to ODF regarding healthcare use and to identify factors impacting healthcare use in these groups.</p></div><div><h3>Methods</h3><p>Data on healthcare use were retrieved from care data registries in five hospitals in Southeastern Sweden.</p></div><div><h3>Results</h3><p>The year prior to intervention, the iCBT group had a mean of 31 outpatient clinic/primary care contacts per patient compared with 21 contacts the year after. The corresponding numbers for the ODF group were 37 and 25. The decrease was 32 % in both groups and did not differ significantly (<em>p</em> = 0.261 and <em>p</em> = 0.354) between the groups. Regarding hospital admissions, the iCBT group had 0.8 admissions per patient the year before and 0.6 the year after the intervention, a decrease by 25 %, whereas the ODF group had 1.1 and 0.6 admissions respectively, a decrease by 45 %. The difference was not statistically significant <em>(p</em> <em>=</em> <em>0.270 and p</em> <em>=</em> <em>0.883)</em> between the groups. Improvement in depressive symptoms post intervention were significantly (Beta = 0.459, <em>p</em> = 0.047) associated with a decrease in number of outpatient contacts in the iCBT group. In the ODF group, better mental health-related quality of life post intervention was significantly (Beta = −0.429, <em>p</em> = 0.045) associated with a decrease in number of hospital admissions.</p></div><div><h3>Conclusion</h3><p>Reduced depressive symptom scores following intervention were associated with lower outpatient service use, but iCBT was not superior compared to ODF. This implicates that reducing depression in CVD patients, regardless of the type of internet-delivered intervention used, is important since it may reduce healthcare use in these patients.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100696"},"PeriodicalIF":4.3,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782923000969/pdfft?md5=c9875c42703258b8e007642e44f5e804&pid=1-s2.0-S2214782923000969-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138490472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the adherence gap in internet interventions: A randomized controlled trial study protocol investigating context-specific self-efficacy","authors":"Ewelina Smoktunowicz ,&nbsp;Jan Maciejewski ,&nbsp;Magdalena Lesnierowska ,&nbsp;Per Carlbring","doi":"10.1016/j.invent.2023.100697","DOIUrl":"https://doi.org/10.1016/j.invent.2023.100697","url":null,"abstract":"<div><p>Low adherence in self-guided internet interventions is linked to poorer outcomes. Although some predictors of adherence have been identified, few are modifiable for widespread application. One personal variable with the potential to increase adherence in internet interventions is context-specific self-efficacy. This protocol outlines a randomized controlled trial design, divided into two phases. In Phase 1 (students, <em>N</em> = 216), participants will complete a self-efficacy-enhancing exercise, which will be compared to a waitlist control group to test its effectiveness in increasing internet intervention adherence self-efficacy. Phase 2 will be the main two-arm trial, where all participants (medical students, <em>N</em> = 952) will undergo an internet intervention called Med-Stress Student. In the experimental group, the program will be preceded by the self-efficacy-enhancing exercise developed in Phase 1. We anticipate that participants in the experimental group will show higher adherence (primary outcome) to the intervention and greater improvement in intervention outcomes (secondary outcomes i.e., lower stress and higher work engagement) at posttest, as well as at six-month and one-year follow-ups. If effective, enhancing context-specific self-efficacy could be recommended before any internet intervention as a relatively simple way to boost participants' adherence.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100697"},"PeriodicalIF":4.3,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782923000970/pdfft?md5=c852bb6391dac009ba1694f9d7ba7037&pid=1-s2.0-S2214782923000970-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138490540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile sensing to advance tumor modeling in cancer patients: A conceptual framework","authors":"Philip I. Chow ,&nbsp;Devin G. Roller ,&nbsp;Mehdi Boukhechba ,&nbsp;Kelly M. Shaffer ,&nbsp;Lee M. Ritterband ,&nbsp;Matthew J. Reilley ,&nbsp;Tri M. Le ,&nbsp;Paul R. Kunk ,&nbsp;Todd W. Bauer ,&nbsp;Daniel G. Gioeli","doi":"10.1016/j.invent.2023.100644","DOIUrl":"10.1016/j.invent.2023.100644","url":null,"abstract":"<div><p>As mobile and wearable devices continue to grow in popularity, there is strong yet unrealized potential to harness people's mobile sensing data to improve our understanding of their cellular and biologically-based diseases. Breakthrough technical innovations in tumor modeling, such as the three dimensional tumor microenvironment system (TMES), allow researchers to study the behavior of tumor cells in a controlled environment that closely mimics the human body. Although patients' health behaviors are known to impact their tumor growth through circulating hormones (cortisol, melatonin), capturing this process is a challenge to rendering realistic tumor models in the TMES or similar tumor modeling systems. The goal of this paper is to propose a conceptual framework that unifies researchers from digital health, data science, oncology, and cellular signaling, in a common cause to improve cancer patients' treatment outcomes through mobile sensing. In support of our framework, existing studies indicate that it is feasible to use people's mobile sensing data to approximate their underlying hormone levels. Further, it was found that when cortisol is cycled through the TMES based on actual patients' cortisol levels, there is a significant increase in pancreatic tumor cell growth compared to when cortisol levels are at normal healthy levels. Taken together, findings from these studies indicate that continuous monitoring of people's hormone levels through mobile sensing may improve experimentation in the TMES, by informing how hormones should be introduced. We hope our framework inspires digital health researchers in the psychosocial sciences to consider how their expertise can be applied to advancing outcomes across levels of inquiry, from behavioral to cellular.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"34 ","pages":"Article 100644"},"PeriodicalIF":4.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782923000441/pdfft?md5=9405840ce38b5e079321463e2b5d1df1&pid=1-s2.0-S2214782923000441-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42038849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporating technology in research with older bereaved adults: Lessons learned from conducting an internet-based randomized controlled trial","authors":"Thandi Lyew ,&nbsp;Joseph Kazan ,&nbsp;Khusbu Patel ,&nbsp;Emilee Croswell ,&nbsp;Sejuty Minhaj ,&nbsp;Adrianna Lopaczynski ,&nbsp;Ioana Neagoe ,&nbsp;Sarah T. Stahl","doi":"10.1016/j.invent.2023.100645","DOIUrl":"10.1016/j.invent.2023.100645","url":null,"abstract":"<div><h3>Objective</h3><p>Digital health interventions (DHI) involve multiple interactions between the user, technology platform, and study team, posing challenges for implementation. This paper describes the lessons learned while implementing an internet-based randomized controlled trial (RCT) for reducing depression symptom burden in older acutely-bereaved adults.</p></div><div><h3>Methods</h3><p>The RCT was entitled “Widowed Elders' Lifestyle after Loss” (or WELL), which compared the efficacy of a DHI to an enhanced usual care (EUC) for reducing depression symptoms in adults 60+ years who lost their spouse/life partner within the previous 12 months. Participants randomized to the DHI used their own tablet, smartphone, or pc to record the timing and regularity of sleep, meals, and physical activity twice daily, for 12 weeks. The also received weekly health coaching sessions from a clinician certified in motivational interviewing. Participants randomized to the EUC arm received weekly calls from research staff and were assessed on the same schedule as intervention participants. All study procedures were conducted virtually. Methodological and procedural challenges were discussed weekly with study staff and the primary investigator.</p></div><div><h3>Results</h3><p>Many challenges can be categorized as follows recruiting virtually, obtaining informed consent, training older adults to use technology, and establishing rapport with older adults. Solutions required researcher and interventionist flexibility in adapting to new strategies. For instance, we redesigned the informed consent process to include a user-friendly brochure that enhanced participants' understanding of the RCT and improved our enrollment rate. We also utilized user-engagement in refining an intervention protocol.</p></div><div><h3>Conclusion</h3><p>We resolved implementation challenges without compromising internal validity via interdisciplinary collaborations with mobile programmers to ensure our technology met the unique and varied needs of aging users. The solutions from this study may promote the recruitment and retainment of older adults in research studies that use technology-based interventions.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"34 ","pages":"Article 100645"},"PeriodicalIF":4.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782923000453/pdfft?md5=80e5d7346218570e162eef1271b0277f&pid=1-s2.0-S2214782923000453-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45790207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of client stories in internet-delivered cognitive behaviour therapy: A mixed-methods evaluation","authors":"Heather D. Hadjistavropoulos ,&nbsp;Taylor G. Hill ,&nbsp;Aaron E. Philipp-Muller ,&nbsp;Blake Dear ,&nbsp;Nick Titov","doi":"10.1016/j.invent.2023.100692","DOIUrl":"https://doi.org/10.1016/j.invent.2023.100692","url":null,"abstract":"<div><p>Internet-delivered Cognitive-Behavioural Therapy (ICBT) aims to support people with mental health concerns using online treatment materials. Client stories (either real or a composite based on many clients) are often used in ICBT to facilitate learning. However, these stories remain understudied in terms of how they are perceived by clients, as well as their relationship to ICBT engagement, satisfaction, and outcomes. Among a sample of 324 clients enrolled in transdiagnostic ICBT targeting symptoms of depression and anxiety, we examined client perceptions of stories through mixed-method qualitative (open-ended) and quantitative (closed-ended) data collection. Specifically, 234 (72.22 %) clients responded to questions about stories at 4 weeks and 221 (68.21 %) responded to questions at 8 weeks. Most clients who responded to questions endorsed reviewing at least some stories (79.06 % at 4 weeks, 71.95 % at 8 weeks). Moreover, they rated stories positively in terms of being relatable, making clients feel less alone, increasing knowledge, providing ideas for how to use skills, and motivating clients to use skills. These perceptions of stories remained stable over the course of treatment. Stories were perceived more positively among those with lower symptom severity at 8 weeks as well as those who were more satisfied with ICBT at 8 weeks. Story perceptions at 4 weeks were predictive of decreased post-treatment anxiety symptom severity but not depression while controlling for baseline scores, age, and education. 26.49 % of clients at 4 weeks who reviewed stories and 33.33 % at 8 weeks provided suggestions about how to improve stories. In a qualitative analysis, we found 5 categories of suggestions including increasing the variety of issues and relatability of stories, ensuring the stories are realistic, refining the formatting, and making the stories shorter. Overall, this study provides insights into how client stories could be improved to play a more significant role in future ICBT programs.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"34 ","pages":"Article 100692"},"PeriodicalIF":4.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782923000921/pdfft?md5=6fd28c36143792274e12f62c07678e74&pid=1-s2.0-S2214782923000921-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138471792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}