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

{"title":"Patient-reported preferences in eHealth-based cardiac rehabilitation: A qualitative investigation of behavior change techniques, barriers and facilitators","authors":"Emma R. Douma ,&nbsp;Svenja Wirtz ,&nbsp;Manuela Sestayo Fernandez ,&nbsp;Hendrik Schäfer ,&nbsp;Jos W.M.G. Widdershoven ,&nbsp;Mirela Habibović ,&nbsp;Carlos Peña Gil ,&nbsp;Jos A. Bosch ,&nbsp;Boris Schmitz ,&nbsp;Willem J. Kop","doi":"10.1016/j.invent.2024.100728","DOIUrl":"https://doi.org/10.1016/j.invent.2024.100728","url":null,"abstract":"<div><h3>Background</h3><p>Cardiac rehabilitation (CR) reduces recurrent cardiac events and mortality in patients with cardiovascular diseases (CVD). Innovative eHealth methods can facilitate CR uptake and effectiveness by addressing barriers associated with clinic-based rehabilitation. Tailoring eHealth-based CR to patient preferences is needed to further enhance CR.</p></div><div><h3>Purpose</h3><p>To identify preferred behavior change techniques (BCTs) as well as barriers and facilitators for the different health behaviors targeted in eHealth-based CR among patients who have been referred to CR.</p></div><div><h3>Methods</h3><p>Thirty-nine patients were interviewed in nine focus groups in The Netherlands, Germany, and Spain. A thematic analysis, using a combined deductive and inductive approach to coding, was conducted to identify BCTs and barriers and facilitators to behavior change. Behaviors under investigation included physical activity, medication adherence, eating a cardiac healthy-diet, stress reduction and smoking cessation.</p></div><div><h3>Results</h3><p>The perceived helpfulness of BCTs depended on the specific behavior targeted. Common barriers were <em>negative emotional state</em> and <em>physical limitations.</em> A <em>desire to feel physically</em> or <em>mentally well</em> and <em>having experienced a cardiac life event</em> were the most common facilitators across health behaviors. Specific BCTs, barriers and facilitators were found for each of the health behavior.</p></div><div><h3>Conclusions</h3><p>Behavior change techniques that patients preferred for each health behavior targeted in eHealth-based CR were identified. A negative emotional state, experiencing a life event, and improving physical functioning are important barriers and facilitators in multiple behaviors targeted in eHealth-based CR programs. Additional tailoring of interventions to patient preferences for BCTs and patient-specific barriers and facilitators per health behavior could lead to further improvement of eHealth-based CR.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100728"},"PeriodicalIF":4.3,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782924000216/pdfft?md5=6f51639a8b9bebeeb199ebcdefd148bc&pid=1-s2.0-S2214782924000216-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139748936","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":"Efficacy of a smartphone-based Cognitive Bias Modification program for emotion regulation: A randomized-controlled crossover trial","authors":"Fanny Alexandra Dietel ,&nbsp;Raphael Rupprecht ,&nbsp;Alexander Mohamed Seriyo ,&nbsp;Malte Post ,&nbsp;Bastian Sudhoff ,&nbsp;Jacqueline Reichart ,&nbsp;Matthias Berking ,&nbsp;Ulrike Buhlmann","doi":"10.1016/j.invent.2024.100719","DOIUrl":"https://doi.org/10.1016/j.invent.2024.100719","url":null,"abstract":"<div><p>Previous research has identified maladaptive emotion regulation as a key factor in psychopathology. Thus, addressing emotion regulation via scalable, low-threshold digital interventions – such as smartphone-based Cognitive Bias Modification (CBM) – holds important therapeutic potential. Using a randomized-controlled crossover trial, we tested the efficacy of an integrated CBM module within the Affect Regulation Training (ART, i.e., CBM-ART) that targeted emotion regulation through elements of appraisal-based and approach avoidance training.</p><p>Undergraduate students reporting elevated stress were randomized to a one-week active intervention (<em>Mindgames</em>; including psychoeducation, a quiz, and CBM-ART; <em>n</em> = 40), active control training (<em>Emo Shape</em>; including placebo psychoeducation, a quiz, and a placebo swiping task; <em>n</em> <em>=</em> 36) or waitlist (<em>n</em> <em>=</em> 25). Before and after the intervention, we assessed emotion regulation, interpretation bias, stress and depression. We further tested post-training stress reactivity using an anagram task.</p><p>Results indicated that the active intervention improved negative (OR = 0.35) and positive (OR = 2.40) interpretation biases and symptom measures (<em>d</em> = 0.52–0.87). However, active control training showed attenuated concurrent pre-post changes on interpretation biases (i.e., OR = 0.53 for negative, and OR = 1.49 for positive interpretations) and symptom measures (<em>d</em> = 0.26–0.91). The active intervention was rated positively in terms of acceptability and usability.</p><p>These findings provide initial evidence for the efficacy and acceptability of an integrated app-based CBM intervention for emotion regulation in reducing interpretation biases and psychopathological symptoms, including stress. However, future studies should disentangle specific mechanisms underlying interventional effects.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100719"},"PeriodicalIF":4.3,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782924000125/pdfft?md5=d064f067786e9fe6b866ec352ba74bed&pid=1-s2.0-S2214782924000125-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139714126","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":"Human cues in eHealth to promote lifestyle change: An experimental field study to examine adherence to self-help interventions","authors":"Talia R. Cohen Rodrigues ,&nbsp;David R. de Buisonjé ,&nbsp;Thomas Reijnders ,&nbsp;Prabhakaran Santhanam ,&nbsp;Tobias Kowatsch ,&nbsp;Linda D. Breeman ,&nbsp;Veronica R. Janssen ,&nbsp;Roderik A. Kraaijenhagen ,&nbsp;Douwe E. Atsma ,&nbsp;Andrea W.M. Evers ,&nbsp;the BENEFIT consortium","doi":"10.1016/j.invent.2024.100726","DOIUrl":"https://doi.org/10.1016/j.invent.2024.100726","url":null,"abstract":"<div><p>eHealth lifestyle interventions without human support (self-help interventions) are generally less effective, as they suffer from lower adherence levels. To solve this, we investigated whether (1) using a text-based conversational agent (TCA) and applying human cues contribute to a working alliance with the TCA, and whether (2) adding human cues and establishing a positive working alliance increase intervention adherence. Participants (<em>N</em> = 121) followed a TCA-supported app-based physical activity intervention. We manipulated two types of human cues: visual (ie, message appearance) and relational (ie, message content). We employed a 2 (visual cues: yes, no) x 2 (relational cues: yes, no) between-subjects design, resulting in four experimental groups: (1) visual and relational cues, (2) visual cues only, (3) relational cues only, or (4) no human cues. We measured the working alliance with the Working Alliance Inventory Short Revised form and intervention adherence as the number of days participants responded to the TCA's messages. Contrary to expectations, the working alliance was unaffected by using human cues. Working alliance was positively related to adherence (<em>t</em>(78) = 3.606, <em>p</em> = .001). Furthermore, groups who received visual cues showed lower adherence levels compared to those who received relational cues only or no cues (<em>U</em> = 1140.5, <em>z</em> = −3.520, <em>p</em> &lt; .001). We replicated the finding that establishing a working alliance contributes to intervention adherence, independently of the use of human cues in a TCA. However, we were unable to show that adding human cues impacted the working alliance and increased adherence. The results indicate that adding visual cues to a TCA may even negatively affect adherence, possibly because it may create confusion concerning the true nature of the coach, which may prompt unrealistic expectations.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100726"},"PeriodicalIF":4.3,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782924000198/pdfft?md5=beb70913e6a512ef1a7e522b7bd5caec&pid=1-s2.0-S2214782924000198-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139719142","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":"Long-term effectiveness and cost-effectiveness of guided internet-based cognitive behavioral therapy for obsessive-compulsive disorder: 24-month follow-up","authors":"Kazuki Matsumoto ,&nbsp;Sayo Hamatani ,&nbsp;Eiji Shimizu","doi":"10.1016/j.invent.2024.100725","DOIUrl":"https://doi.org/10.1016/j.invent.2024.100725","url":null,"abstract":"<div><p>This study investigated the long-term effectiveness and cost-effectiveness of guided internet-based cognitive behavioral therapy (ICBT) for obsessive-compulsive disorder (OCD). Twenty-five patients with OCD who had undergone guided ICBT in a randomized controlled trial or a single-arm trial were followed up for 6, 12, and 24 months. Missing data were imputed using the mice package in R, and a one-way analysis of variance with repeated measures was performed. The total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score significantly decreased from baseline to all endpoints <em>(p</em> &lt; 0.001). OCD remission (the total Y-BOCS score &lt; 14) rates significantly increased from post-treatment (48 %) at the 12 months (80 %) and 24 months (76 %) follow-up (χ2 (1) = 7.11–11.08, <em>p</em> &lt; 0.01) post guided ICBT. Regression analysis predicted the maintenance of remission at 12 and 24 months following post-treatment remission (z = 2.20, <em>p</em> = 0.03). An incremental cost-effectiveness ratio was calculated to assess the cost-effectiveness of guided ICBT. The incremental cost-effectiveness ratio was JPY 999,495, below the JPY 5 million threshold for willingness to pay in Japan. Our findings demonstrate the long-term effectiveness and cost-effectiveness of guided ICBT for OCD. Guided ICBT can mitigate the severity of OCD even after treatment.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100725"},"PeriodicalIF":4.3,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782924000186/pdfft?md5=8d275a91eae9cac63026f33b98640e4a&pid=1-s2.0-S2214782924000186-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139719143","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":"TONI - One for all? Participatory development of a transtheoretic and transdiagnostic online intervention for blended care","authors":"S. Behr ,&nbsp;F. Fenski ,&nbsp;J. Boettcher ,&nbsp;C. Knaevelsrud ,&nbsp;L. Hammelrath ,&nbsp;G. Kovacs ,&nbsp;W. Schirmer ,&nbsp;H. Petrick ,&nbsp;P. Becker ,&nbsp;C. Schaeuffele","doi":"10.1016/j.invent.2024.100723","DOIUrl":"https://doi.org/10.1016/j.invent.2024.100723","url":null,"abstract":"<div><h3>Background</h3><p>Internet-based interventions offer a way to meet the high demand for psychological support. However, this setting also has disadvantages, such as the lack of personal contact and the limited ability to respond to crises. Blended care combines Internet-based interventions with face-to-face psychotherapy and merges the benefits of both settings. To ensure the uptake of blended care in routine care, Internet-based interventions need to be suitable for different therapeutic approaches and mental disorders.</p></div><div><h3>Objective</h3><p>This paper describes the participatory development process of the Internet-based intervention “TONI” using a common therapeutic language and content on various transdiagnostic topics to be integrated into routine outpatient psychotherapy.</p></div><div><h3>Methods</h3><p>To develop this intervention in a participatory manner, we followed the Integrate, Design, Assess, and Share (IDEAS) framework. In a multilevel development process, we used a combination of interviews, focus groups, and proofreading to optimally tailor online modules to routine outpatient psychotherapy. Building on well-established cognitive-behavioral online content, we included expert interviews with psychodynamic (<em>n</em> = 20) and systemic psychotherapists (<em>n</em> = 9) as well as focus groups with psychotherapists of different approaches (<em>n</em> = 10) and persons with lived experience of mental illness (PWLE; n = 10).</p></div><div><h3>Results</h3><p>We describe the development process of TONI step-by-step, outlining the specific requirements that therapists from different therapeutic approaches as well as PWLE have and how we implemented them in our intervention. This includes the content and specific exercises in the online modules, aspects of data protection, language, design, and usability.</p></div><div><h3>Conclusion</h3><p>Internet-based interventions that use a common therapeutic language and address therapeutic principles across different approaches have the potential to advance digitalization in psychotherapy. Involving psychotherapists and PWLE in intervention development may positively impact acceptance and usage in practice. This study shows how participatory intervention development involving both psychotherapists and PWLE can be carried out.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100723"},"PeriodicalIF":4.3,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782924000162/pdfft?md5=cdf0b4ab77ea4a2aed5044ca6f723fad&pid=1-s2.0-S2214782924000162-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139719145","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":"Understanding university students' attitudes and preferences for internet-based mental health interventions","authors":"Ömer Özer ,&nbsp;Burak Köksal ,&nbsp;Ahmet Altinok","doi":"10.1016/j.invent.2024.100722","DOIUrl":"https://doi.org/10.1016/j.invent.2024.100722","url":null,"abstract":"<div><p>Internet-based interventions are recognised as a practical approach to address mental health issues. The acceptance and utilisation of such interventions are closely linked to user attitudes and preferences. This study aims to examine the predictors of university students' attitudes towards internet-based interventions. Additionally, it seeks to elucidate students' preferences regarding crucial features of these interventions, such as the format, delivery mode, content type, and structural components, to understand better what makes these interventions appealing and practical for university students.</p><p>A total of 273 university students (comprising 68 % females and 32 % males) participated in the study. The data collection instruments employed were the Personal Information Form, Internet-Based Intervention Preference Survey, E-therapy Attitude Measure (ETAM), Digital Literacy Scale, Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 (GAD-7). The data were analysed utilising descriptive statistics, Pearson correlation analysis, and multiple linear regression analysis.</p><p>The multiple regression analysis revealed digital literacy as a predictive factor for attitudes towards internet-based interventions. Demographic variables, such as age and gender, and psychological variables, such as depression and anxiety levels, were found not to be associated with attitudes towards these interventions.</p><p>While students are actively seeking mental health information online, a significant majority remain unaware of internet-based interventions. They show a preference for interventions offering greater human interaction, including face-to-face guidance and video content featuring people. Participants favour completing one or two sessions of the intervention weekly. Desired features of internet-based interventions include self-assessment scales, relatable characters, voice relaxation exercises, practical daily life activity tasks, and weekly reminders throughout the process.</p><p>In conclusion, initiatives aimed at enhancing digital literacy levels could foster more positive attitudes towards internet-based interventions among students. Developers creating Internet-Based Interventions (IBI) for university students should consider these preferences.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100722"},"PeriodicalIF":4.3,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782924000150/pdfft?md5=202d9a2d70f20f090f0bda0c10d79817&pid=1-s2.0-S2214782924000150-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139709660","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":"Feasibility and utility of mobile health interventions for depression and anxiety in rural populations: A scoping review","authors":"Michael J. McCarthy ,&nbsp;Alexandra Wicker ,&nbsp;Juliette Roddy ,&nbsp;Mark Remiker ,&nbsp;Indrakshi Roy ,&nbsp;Megan McCoy ,&nbsp;Eric S. Cerino ,&nbsp;Julie Baldwin","doi":"10.1016/j.invent.2024.100724","DOIUrl":"10.1016/j.invent.2024.100724","url":null,"abstract":"<div><p>Despite the potential of mobile health (mHealth) to address high rates of depression and anxiety in underserved rural communities, most mHealth interventions do not explicitly consider the realities of rural life. The aim of this scoping review is to identify and examine the available literature on mHealth interventions that consider the needs of rural populations in order to gauge their feasibility and utility for addressing depression and anxiety. Additionally, we provide an overview of rural users' perceptions about and preferences for mHealth-delivered mental health screening and intervention systems. Out of 169 articles identified, 16 met inclusion criteria. Studies were conducted across a wide range of countries, age groups, and rural subpopulations including individuals with bipolar disorder, anxiety, perinatal depression, PTSD, and chronic pain, as well as refugees, veterans, and transgender and LGBTQ+ individuals. All interventions were in the feasibility/acceptability testing stage for rural users. Identified strengths included their simplicity, accessibility, convenience, availability of support between sessions with providers, and remote access to a care team. Weaknesses included problems with charging phone batteries and exceeding data limits, privacy concerns, and general lack of comfort with app-based support. Based upon this review, we provide recommendations for future mHealth intervention development including the value of developer-user coproduction methods, the need to consider user variation in access to and comfort with smartphones, and potential data or connectivity limitations, mental health stigma, and confidentiality concerns in rural communities.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100724"},"PeriodicalIF":4.3,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782924000174/pdfft?md5=bb7f9ea9435f78b73bd5e30ab730f803&pid=1-s2.0-S2214782924000174-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139670020","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":"User-centered development of an internet-based CBT intervention for the treatment of loneliness in older individuals","authors":"Christine Dworschak ,&nbsp;Eva Heim ,&nbsp;Nadine Kuhn ,&nbsp;Jessica Schwager ,&nbsp;Alicia Tröster ,&nbsp;Andreas Maercker","doi":"10.1016/j.invent.2024.100720","DOIUrl":"10.1016/j.invent.2024.100720","url":null,"abstract":"<div><h3>Background</h3><p>Loneliness is a widespread phenomenon associated with a number of negative health outcomes. Older individuals may constitute one important target group with a need for effective interventions. However, despite evidence showing that addressing maladaptive social cognition (e.g., via cognitive behavioral therapy [CBT]) is the most effective intervention strategy for reducing loneliness, most existing programs aimed at older individuals do not use that method. Further, in terms of mental health service use, older individuals have been found to be an extremely undertreated population. When developing interventions, active involvement of end users in the development process is essential to increase later uptake.</p></div><div><h3>Objective</h3><p>The aim of the present study was to develop an internet-based CBT intervention for loneliness in older individuals (i.e., aged ≥65 years) applying a user-centered design. The present report provides an in-depth description of the development process.</p></div><div><h3>Methods</h3><p>Two phases of qualitative data collection were conducted in parallel with intervention development using a sample of <em>N</em> = 12 participants including both potential end users (i.e., older adults) as well as experts (i.e., psychotherapists). Measures included semi-structured interviews and usability testing.</p></div><div><h3>Results</h3><p>In Phase 1 interviews, participants indicated that they were predominantly positive about the idea of an internet-based program for loneliness targeting older individuals. Individualization and interactivity were named as crucial features. In Phase 2, usability testing of a prototype program provided important insights into technical barriers to intervention use. Further, participants reported that they were missing content on philosophy/theology and the role of descendants/relatives. Valuable insights from Phase 1 and Phase 2 were incorporated into the intervention program resulting in a 7-module internet-based self-help CBT intervention.</p></div><div><h3>Discussion</h3><p>Findings of this study highlight the significance of including relevant stakeholders in the development process of an intervention. Additionally, results emphasize the high acceptance of internet-based interventions in this population, but also underline the need for considering age-specific aspects when developing treatments.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100720"},"PeriodicalIF":4.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782924000137/pdfft?md5=ea6a28ae2f72adfab269c7b0f93a5919&pid=1-s2.0-S2214782924000137-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139658211","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":"Development and evaluation of an internet- and mobile-based intervention for individualized return to work planning after inpatient rehabilitation - Study protocol for a randomized-controlled-trial","authors":"Adina Kreis ,&nbsp;Anna Gomes ,&nbsp;Angeliki Tsiouris ,&nbsp;Manfred E. Beutel ,&nbsp;Christian Ruckes ,&nbsp;Ingo Dahn ,&nbsp;Annika Schiller ,&nbsp;Guido Loy ,&nbsp;Hiltrud Zajac ,&nbsp;Gregor Kosmuetzky ,&nbsp;Patrick Ziser ,&nbsp;Eckard Sträßner ,&nbsp;Vera Schneider ,&nbsp;Thomas Wilde ,&nbsp;Martin Leber ,&nbsp;Hannah Schäfer ,&nbsp;Rebecca Kilian ,&nbsp;Rüdiger Zwerenz","doi":"10.1016/j.invent.2024.100721","DOIUrl":"10.1016/j.invent.2024.100721","url":null,"abstract":"<div><h3>Background</h3><p>Following discharge, it is crucial for patients to transfer intentions and action plans from inpatient rehabilitation into everyday life. This ensures their reintegration into social and working life and prevents economic costs due to sick leave or reduced earning capacity pension. However, most established aftercare programs do not specifically address occupational problems or challenges during occupational measures such as graded return to work. The aim of this study is to evaluate the efficacy of the low-threshold online self-help intervention <em>marena</em> (Meine Arbeitsbezogene Reha-Nachsorge - My Work-related Rehabilitation Aftercare) to support return to work.</p></div><div><h3>Methods</h3><p>A two-arm randomized-controlled-trial (RCT) will be conducted. A total of <em>N</em> = 400 rehabilitation inpatients across different indication areas (psychosomatic, orthopedic, or cardiologic) aged 18 to 65 years with a planned return to work after medical rehabilitation, have a heightened social-medical risk and private internet access and are insured with the German Pension insurance or statutory health insurance, will be recruited in four medical and psychosomatic clinics in Germany. Participants will be allocated to either the intervention (IG) or the control group (CG). In a stepped-care model, participants of the IG will receive access to the non-guided internet- and mobile-based intervention <em>marena</em> (IG subgroup 1) or <em>marena</em> in combination with <em>GSA-Online plus</em> (IG subgroup 2), a guided psychodynamic internet-based intervention that has proven effective in two trials regarding occupational and health objectives. Based on a priori defined indication criteria, clinic staff will recommend either IG subgroup 1 or IG subgroup 2. The CG will receive optimized treatment as usual with access to a survey feature within <em>marena</em>. The primary outcome will be work status after 6 months (T2) and 12 months (T4). The endpoint at 12 months (T4) after discharge from inpatient rehabilitation will be considered as secondary endpoint. Work status is defined as positive if the participant is working and has ≤ 6 weeks of sick leave at T2 and ≤ 12 weeks of sick leave at T4. Secondary outcomes include successful completion of graded return to work, successful application for benefits for participation in working life, current work ability, social-medical risk, subjective prognosis of future employment, quality of life, somatic symptoms, coping, social support, depression, anxiety, and psychosocial stress.</p></div><div><h3>Discussion</h3><p>This study will contribute to the evidence concerning efficacy of online aftercare interventions. If proven efficacious, <em>marena</em> could provide an individualized and adaptable self-help approach to promote return to work following inpatient rehabilitation.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100721"},"PeriodicalIF":4.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782924000149/pdfft?md5=1f1ae87e9dd2dc934e3ff76b29ff1e0e&pid=1-s2.0-S2214782924000149-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139658313","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":"Examining how organizational leaders perceive internet-delivered cognitive behavioural therapy for public safety personnel using the RE-AIM implementation framework","authors":"Janine D. Beahm ,&nbsp;Hugh C. McCall ,&nbsp;R. Nicholas Carleton ,&nbsp;Nicholas Jones ,&nbsp;Heather D. Hadjistavropoulos","doi":"10.1016/j.invent.2024.100718","DOIUrl":"10.1016/j.invent.2024.100718","url":null,"abstract":"<div><h3>Background</h3><p>Within Canada, internet-delivered cognitive behavioural therapy (ICBT) has recently been tailored by PSPNET to meet the needs of public safety personnel (PSP) to help address high rates of mental health problems within this population. Perceptions and outcomes of ICBT among PSP are promising, but it remains unknown how PSPNET is perceived by PSP organizational leaders. It is important to assess this gap because these leaders have significant potential to influence the uptake of ICBT.</p></div><div><h3>Methods</h3><p>In the current study, PSP leaders (<em>n</em> = 10) were interviewed to examine their perceptions of PSPNET and opportunities to improve ICBT implementation. The RE-AIM evaluation framework was used to assess PSP leaders' perceptions of PSPNET in terms of reach, effectiveness, adoption, implementation, and maintenance.</p></div><div><h3>Results</h3><p>The results evidenced that leaders perceived PSPNET as effective in reaching and serving PSP and PSP organizations. PSP leaders reported perceiving ICBT as effectively implemented, especially for being freely offered to individual PSP and for improving PSP's access to experienced therapists specifically trained to work with PSP. Participants indicated organizations have promoted and will continue promoting PSPNET longer-term, facilitating adoption and maintenance. Factors perceived as facilitating successful service delivery included building relationships and trust with PSP organizations and general support for PSP leadership mental health initiatives. PSP leaders identified perceived areas for improving ICBT implementation (e.g., ensuring leaders have access to data on PSPNET uptake and outcomes, creating promotional videos, expanding availability of PSPNET to other provinces, offering additional options for receiving therapist support).</p></div><div><h3>Implications</h3><p>Overall, the study provides insights into PSP leaders' perceptions of the implementation of ICBT among PSP and ideas for optimizing implementation efforts.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"35 ","pages":"Article 100718"},"PeriodicalIF":4.3,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782924000113/pdfft?md5=aaf4877a11d698ae5eb7a714e79af4fb&pid=1-s2.0-S2214782924000113-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139586346","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}