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

{"title":"Are there unique facets of therapeutic alliance for users of digital mental health interventions? An examination with the eHealth Therapeutic Alliance Inventory","authors":"Ohad Ashur,&nbsp;Chen R. Saar,&nbsp;Or Brandes,&nbsp;Amit Baumel","doi":"10.1016/j.invent.2024.100783","DOIUrl":"10.1016/j.invent.2024.100783","url":null,"abstract":"<div><div>Therapeutic alliance (TA) is a well-established predictor of clinical outcomes in traditional psychotherapy. However, its association with outcomes in eHealth interventions has been inconsistent, which might be due to the absence of measurements specifically designed to capture TA in eHealth settings. The eHealth Therapeutic Alliance Inventory (ETAI) incorporates conventional as well as unique eHealth TA subscales, enabling to examine the contribution of new facets of TA beyond traditional concepts. This study investigates the predictive contribution of eHealth TA subscales compared to conventional TA subscales on clinical outcomes and evaluates the concurrent criterion validity of the ETAI. The study was conducted within the framework of a randomized controlled trial involving a 10-week digital parent training program aimed at addressing child disruptive behaviors. Parents were randomly assigned to either an enhanced-quality or a standard-quality program. Parents from 68 families completed the ETAI at five weeks' post-program initiation and at the post-intervention phase. The primary outcome was the improvement in child behavior, measured by the Eyberg Child Behavior Inventory. Positive Pearson correlations were found between all ETAI subscales covering unique eHealth TA aspects, measured at the 5-week time-point, and improvement in child behavior at post-intervention (<em>r</em>_s ≥ 0.23, <em>p</em>_s &lt; 0.03). The conventional TA subscale showed no significant Pearson correlation with improvement in child behavior. When examining the unique contributions of ETAI-subscales to explain the improvement in child behavior, only ETAI-Perceived Emotional Investment subscale was found to have a unique contribution (<em>β</em> = 0.29, <em>p</em> = 0.019). In addition, scores on most ETAI subscales were significantly higher among parents using the enhanced-quality program compared with the standard program (Cohen's <em>d</em>_s &gt; 0.48), reinforcing ETAI's criterion validity. The development of TA scales that incorporates unique eHealth TA subscales show initial promise in predicting outcomes. Further research is needed to better understand how different factors of eHealth TA relate to clinical outcomes across diverse clinical targets and programs.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100783"},"PeriodicalIF":3.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560585","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 of participant compliance with ecological momentary assessment among individuals with chronic pain who are using cannabis and opioids","authors":"Jungin Joo ,&nbsp;Janardan Devkota ,&nbsp;Bryant M. Stone ,&nbsp;Kelly E. Dunn ,&nbsp;Vadim Zipunnikov ,&nbsp;Ryan Vandrey ,&nbsp;Patrick H. Finan ,&nbsp;Johannes Thrul","doi":"10.1016/j.invent.2024.100784","DOIUrl":"10.1016/j.invent.2024.100784","url":null,"abstract":"<div><h3>Background</h3><div>Cannabis may be an alternative or adjunct to opioid therapy for chronic pain. However, there are limited data on patterns of opioid medication and medical cannabis use. The current study investigated the feasibility of using Ecological Momentary Assessment (EMA) to assess patterns of prescription opioids and medical cannabis among individuals experiencing chronic pain.</div></div><div><h3>Method</h3><div>The study included 133 participants recruited online. Participants were 42.6 (SD = 13.9) years old on average and the majority were men (57.9 %) and Non-Hispanic White (63.2 %). Participants completed a baseline assessment, followed by 30 days of EMA data collection with four randomly prompted past-hour surveys and one daily diary per day, and a follow-up survey that assessed perceived EMA burden. Simple and multivariable linear regression models were estimated to investigate participant predictors of the proportion of EMA surveys completed (past-hour surveys and daily diaries in separate models).</div></div><div><h3>Results</h3><div>Compliance rates for EMA prompts were 89.7 % for daily diaries and 63.3 % for past-hour surveys. In multivariable regression, participants holding a graduate degree completed a lower proportion of daily diaries (<em>b</em> = −0.109, <em>SE</em> = 0.052, <em>p</em> &lt; .05) and past-hour surveys (<em>b</em> = −0.148, <em>SE</em> = 0.071, <em>p</em> &lt; .05), compared to those with less than a 4-year degree. Participants completing a higher proportion of daily diaries reported greater ease of use at follow-up (<em>b</em> = 0.050, <em>SE</em> = 0.022, <em>p</em> &lt; .05) and those completing a higher proportion of past-hour surveys desired higher rewards (<em>b</em> = 0.066, <em>SE</em> = 0.033, <em>p</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Study results confirm the feasibility of using EMA methods to assess patterns of prescription opioids and medical cannabis among individuals experiencing chronic pain.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100784"},"PeriodicalIF":3.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651940","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":"Evaluating the web-based ‘Partner in Balance’ program for informal caregivers of people with Huntington's disease: A pilot study","authors":"Maud M.J. Daemen ,&nbsp;Lizzy M.M. Boots ,&nbsp;Mayke Oosterloo ,&nbsp;Marjolein E. de Vugt ,&nbsp;Annelien A. Duits","doi":"10.1016/j.invent.2024.100782","DOIUrl":"10.1016/j.invent.2024.100782","url":null,"abstract":"<div><h3>Background</h3><div>Huntington's disease (HD) poses significant challenges for both affected individuals and their informal caregivers. With the progression of HD, caregivers frequently prioritize caring for the person with HD over their own well-being. ‘Partner in Balance’ (PiB) is an 8-week online self-management program guided by a personal coach, developed to help caregivers of people with HD cope with challenging situations and develop skills to increase resilience and prevent overburdening.</div></div><div><h3>Aims</h3><div>This pilot study evaluates the feasibility and preliminary effects of the PiB-HD program.</div></div><div><h3>Methods</h3><div>The study employed a pre-post design. Perceived feasibility by HD caregivers was evaluated using both quantitative and qualitative measures. Preliminary effects were based on self-report measures of self-efficacy, mastery, mood, quality of life, and capability to function. Coaches' evaluations were conducted using a questionnaire.</div></div><div><h3>Results</h3><div>In total, 18 caregivers completed the intervention. Findings demonstrate positive responses regarding the program's usability, relevance, and acceptability. Participants found the program helpful in addressing challenges, gaining insight into their actions, and feeling better equipped with skills to face future challenges. Descriptive statistics suggest that the PiB-HD program shows potential for reducing stress and anxiety. Additionally, coaches (<em>n</em> = 9) viewed the program positively for its usability, integration potential into their work, flexibility, and time efficiency.</div></div><div><h3>Conclusions</h3><div>The PiB-HD program proved to be feasible, usable and acceptable for caregivers of people with HD. These results provide directions for further research into the effectiveness of PiB-HD, and can already be utilized to advise on the deployment of eHealth in the provision of HD care.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100782"},"PeriodicalIF":3.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528220","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":"Effectiveness and prediction of treatment adherence to guided internet-based cognitive behavioral therapy for health anxiety: A cohort study in routine psychiatric care","authors":"Susanna Österman ,&nbsp;Erland Axelsson ,&nbsp;Erik Forsell ,&nbsp;Cecilia Svanborg ,&nbsp;Nils Lindefors ,&nbsp;Erik Hedman-Lagerlöf ,&nbsp;Volen Z. Ivanov","doi":"10.1016/j.invent.2024.100780","DOIUrl":"10.1016/j.invent.2024.100780","url":null,"abstract":"<div><h3>Objective</h3><div>Health anxiety, also known as hypochondriasis, is a common psychiatric disorder which leads to considerable distress and is associated with high societal costs. Internet-based cognitive behavioural therapy (ICBT) for health anxiety has demonstrated efficacy in randomized controlled trials (RCTs), but there is limited knowledge regarding its effectiveness in real-world settings. This study aimed to evaluate the clinical effectiveness of guided ICBT for health anxiety in routine psychiatric care, including symptom change, treatment adherence, and potential negative effects. Additionally, we explored predictors of treatment adherence.</div></div><div><h3>Method</h3><div>A longitudinal cohort study of 447 patients enrolled in 12 weeks of ICBT for health anxiety between 2018 and 2020 in an outpatient psychiatric clinic specializing in ICBT. Primary outcome measure was the 14-item Short Health Anxiety Inventory (SHAI-14) and a within-group design with repeated measures was utilized for the primary analysis.</div></div><div><h3>Results</h3><div>Participants showed significant improvements from pre- to post-treatment (<em>d</em> = 1.61). At post-treatment, 60 % (95 % CI 58–62) demonstrated statistically reliable change (RCI), and 44 % (95 % CI 42–46) were in remission. On average, participants completed 7 (SD = 4) out of 12 treatment modules. For each additional completed module, the mean reduction was 0.31 (95 % CI 0.10 to 0.54) points on the SHAI-14.</div></div><div><h3>Conclusions</h3><div>Guided ICBT for health anxiety can be effective when delivered within the context of routine psychiatric care. The study suggests that effect sizes are comparable with those in RCTs and higher treatment adherence is associated with better outcomes in health anxiety. ICBT could be used to increase availability to effective therapy for health anxiety.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100780"},"PeriodicalIF":3.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528234","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":"Internet-based cognitive behavioural therapy for insomnia comorbid with chronic benign pain – A randomized controlled trial","authors":"K. Bothelius ,&nbsp;S. Jernelöv ,&nbsp;V. Kaldo ,&nbsp;C. Lu ,&nbsp;M.-M. Stråle ,&nbsp;M. Jansson-Fröjmark","doi":"10.1016/j.invent.2024.100781","DOIUrl":"10.1016/j.invent.2024.100781","url":null,"abstract":"<div><h3>Background</h3><div>Comorbid sleep disturbances are common among individuals with chronic pain, and Cognitive Behavioural Therapy for Insomnia (CBT-i) has proven effective for such individuals. Nonetheless, research on web-based CBT-i tailored for patients with both chronic pain and insomnia is limited. This study aimed to evaluate the feasibility and efficacy of internet-based CBT-i and to explore potential mechanisms underlying treatment outcomes.</div></div><div><h3>Methods</h3><div>In this study, 85 participants suffering from comorbid insomnia and chronic pain were randomized into two groups: Internet-based CBT for Insomnia (ICBT-i) and Internet-based Applied Relaxation (IAR). Both interventions spanned eight weeks, supported by therapeutic guidance throughout.</div></div><div><h3>Results</h3><div>Participation was modest, with an average module completion of 2.0 out of 8 for ICBT-i and 2.4 for IAR. Both interventions significantly alleviated insomnia symptoms on one of the insomnia measures post-treatment, without notable differences between them. Directly after treatment, IAR outperformed ICBT-i in reducing pain interference, anxiety, and in enhancing self-rated health, though these differences lessened at the 6-month follow-up. Potential therapeutic mechanisms may involve attenuating maladaptive sleep beliefs and augmenting sleep-related willingness.</div></div><div><h3>Conclusions</h3><div>The study encountered low engagement rates, with approximately one-third of participants not completing any module. The limited efficacy of ICBT-i may be due to low treatment involvement, with few patients completing key techniques like sleep compression and stimulus control. Despite the low adherence, both interventions yielded post-treatment improvements in insomnia symptoms, but to establish internet-based treatments for insomnia as a viable option in chronic pain management, patient engagement must be improved.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100781"},"PeriodicalIF":3.6,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528233","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 Sleep Course: An inclusive trial examining the feasibility, acceptability, and preliminary efficacy of a digital sleep intervention for adults with self-reported sleep difficulties","authors":"Amelia J. Scott,&nbsp;Taylor Hathway,&nbsp;Madelyne A. Bisby,&nbsp;Nickolai Titov,&nbsp;Blake F. Dear","doi":"10.1016/j.invent.2024.100778","DOIUrl":"10.1016/j.invent.2024.100778","url":null,"abstract":"<div><div>Cognitive Behavioural Therapy for Insomnia (CBTi) is a well-established first-line treatment for insomnia and sleep difficulties, yet numerous barriers hinder its widespread adoption. One potential criticism of the existing evidence base for CBTi is that many trials exclude participants that would commonly be seen in in primary care, such as those aged over 65, with comorbid health conditions, or prescribed sleep medication. The current pilot study therefore aimed to assess the acceptability and efficacy of a brief, digitally delivered sleep intervention, the Sleep Course, using a broad range of participants. Participants (<em>n</em> = 74) completed the 6-week, 4-lesson intervention alongside measures of sleep disturbance, sleep-related impairment, depression, anxiety and sleep-wake patterns (via sleep diary). Generalized estimating equations analysis modelled change in participants' outcomes from pre- to post-treatment and 3-month follow-up, and subgroup analyses explored the role of possible moderators (e.g., age over 65, co-morbidities, and concurrent prescription medication use). The intervention was associated with good rates of satisfaction (79 %) and lesson completion (70 %). Results showed significant and large reductions in insomnia, sleep disturbance and associated symptoms (e.g., <em>d</em> = 1.06–1.37 change in insomnia symptoms). Evidence of high acceptability and clinical improvement was found irrespective of age, physical comorbidity, and sleep medication use. However, there was evidence of less improvement among those taking medications or having tried psychological treatment in the past. These results provide strong preliminary evidence for the intervention as an acceptable, efficacious and scalable treatment for a broad range of participants with sleep difficulties. Larger randomised controlled trials are needed.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100778"},"PeriodicalIF":3.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427488","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":"Online social platform engagement by young treatment seekers in a digital vaping cessation intervention: Effects on confidence in the ability to quit vaping and vaping abstinence","authors":"Elizabeth K. Do ,&nbsp;Sarah Cha ,&nbsp;Shreya Tulsiani ,&nbsp;Giselle Edwards ,&nbsp;Linda Q. Yu ,&nbsp;Michael S. Amato ,&nbsp;Megan A. Jacobs ,&nbsp;Elizabeth C. Hair","doi":"10.1016/j.invent.2024.100779","DOIUrl":"10.1016/j.invent.2024.100779","url":null,"abstract":"<div><h3>Background</h3><div>The evidence-based vaping cessation program, This is Quitting (TIQ), has been found to be effective in promoting abstinence among young people who use e-cigarettes.</div></div><div><h3>Purpose</h3><div>To estimate acceptability and engagement with Discord among treatment seeking youth and young adults and assess the benefit of adding an online social platform via Discord to TIQ.</div></div><div><h3>Methods</h3><div>Between February and March 2023, 527 TIQ participants (aged 13–24 years) were invited to join Discord with other TIQ users (TIQ Discord). Participants completed two online surveys, at baseline and 1-month post study enrollment. Descriptive statistics were used to describe acceptability and engagement with TIQ Discord. Chi-square, Fisher's exact, and <em>t</em>-tests were used to compare changes in confidence in ability to quit and vaping abstinence across those who joined and engaged with TIQ Discord, compared to those receiving TIQ only.</div></div><div><h3>Results</h3><div>Among the <em>n</em> = 319 who were invited to TIQ Discord and provided follow-up data, 57.4 % joined. Among those who joined (<em>n</em> = 183), 61.7 % engaged with TIQ Discord by contributing at least one message or reaction. The mean number of contributed messages was 4.0 (median = 1, range = 1 to 51) and reactions was 0.31 (median = 0, range = 0 to 14). Engaging with TIQ Discord was positively associated with increased confidence in quitting at follow-up (<em>p</em>-value = 0.02), but vaping abstinence at follow-up did not differ (p-value = 0.87).</div></div><div><h3>Discussion</h3><div>Over half of participants who were invited to TIQ Discord joined – indicating high acceptability and an uptake rate that is higher than what is typically observed for online cessation communities. Engagement was positively associated with proximal outcomes, but self-selection prevents causal attribution. Pilot study results suggest acceptability of Discord for providing digital cessation support to young people in combination with a text-message cessation intervention.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100779"},"PeriodicalIF":3.6,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427489","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":"Evaluation of the impact of a digital care navigator on increasing patient registration with digital mental health interventions in routine care","authors":"Brittany Jaso-Yim ,&nbsp;Mara Eyllon ,&nbsp;Pratha Sah ,&nbsp;Mariesa Pennine ,&nbsp;George Welch ,&nbsp;Keke Schuler ,&nbsp;Laura Orth ,&nbsp;Heather O'Dea ,&nbsp;Elizabeth Rogers ,&nbsp;Lily H. Murillo ,&nbsp;J. Ben Barnes ,&nbsp;Georgia Hoyler ,&nbsp;Gabrielle Peloquin ,&nbsp;Kevin Jarama ,&nbsp;Samuel S. Nordberg ,&nbsp;Soo Jeong Youn","doi":"10.1016/j.invent.2024.100777","DOIUrl":"10.1016/j.invent.2024.100777","url":null,"abstract":"<div><h3>Background</h3><div>Less than half of adults with mental health disorders in the United States receive appropriate or timely care. Digital Mental Health Interventions (DMHIs) have the potential to bridge this gap. However, real-world adoption of DMHIs is impeded by patient and provider-level technological barriers. Care navigators have the potential to address these challenges by providing technical support and enhancing patients' experience with DMHIs.</div></div><div><h3>Objective</h3><div>This study explores the effect of a digital care navigator (DCN) on patient registration latency and rates of DMHIs implemented as part of a digital-first behavioral health care model integrated within routine care at a large multispecialty group medical practice.</div></div><div><h3>Methods</h3><div>Data were collected from electronic medical records and DMHI registration data were obtained from the DMHI vendors. Descriptive statistics were used to describe the DCN's efforts to help patients register with their DMHIs. Moods median tests evaluated differences in registration latency and weekly registration rate pre- and post- DCN implementation. Change in registration likelihood as a function of DCN outreach latency was investigated using a Kaplan-Meier plot.</div></div><div><h3>Results</h3><div>During the first eight months, the DCN made 1306 phone calls to 680 unique patients, successfully connecting with 66 %. DCN implementation also increased the median registration rate from 61.9 % to 76.9 %. Results showed that the expediency by which the DCN outreached patients directly impacted registration rate such that of those who were outreached by the DCN on the day of their referral to a DMHI, 96.86 % registered. This number was reduced to 76.15 % if the DCN reached them 1-day following referral, and 41.39 % 5-days after their referral.</div></div><div><h3>Conclusions</h3><div>Use of a DCN shows promise for enhancing patient registration rates with DMHIs in routine healthcare settings.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100777"},"PeriodicalIF":3.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357075","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 effects of digital nature and actual nature on stress reduction: A meta-analysis and systematic review","authors":"Luyao Fan,&nbsp;Mohamad Rizal Baharum","doi":"10.1016/j.invent.2024.100772","DOIUrl":"10.1016/j.invent.2024.100772","url":null,"abstract":"<div><h3>Objectives</h3><p>The study aims to conduct a systematic literature review and meta-analysis to assess the effects of digital nature and actual nature on stress reduction.</p></div><div><h3>Methods</h3><p>In August 2023, Web of Science, Scopus, ProQuest, PubMed, and EBSCOhost databases were used, and ten articles were in the analysis, with a total sample size of 886 participants. Studies within- or between-subjects design conducted in either a randomized controlled trial or a quasi-experimental design were included. No restriction was put on the year of publication or geographical region. Conference papers and dissertations were also included whereas, book chapters were excluded. Participants included those who were exposed to at least one form of digital nature exposure, such as static images, videos, 360° pictures, and 360° videos. The risk of bias determined through Review Manager 5.4 was used to assess the quality of the studies. STATA software package version 16 was used for visual analysis of funnel plots. For the assessment of potential publication bias, Egger's test was implemented.</p></div><div><h3>Results</h3><p>Digital natural environments had the same level of stress recovery compared to actual environmental exposures with the same intervention content (SMD = −0.01; 95% CI: −0.15, 0.12). Subgroup analyses and meta-regression indicated that subjective or physiological stress measures, level of immersion, and data extraction method were not associated with pooled effect stress recovery. All subgroups showed comparable stress levels in both conditions. In addition, all included studies had different levels of risk of bias (low, moderate, and high).</p></div><div><h3>Conclusions</h3><p>The present study concludes that previous research has generally shown that stress levels are reduced in both digital and actual natural environments. The results of the meta-analysis support this conclusion with no significant differences between the two modes of stress recovery through nature viewing.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100772"},"PeriodicalIF":3.6,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214782924000654/pdfft?md5=c483d226c71812e6aed8d31e749459a7&pid=1-s2.0-S2214782924000654-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240619","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 centered design of AI-powered Digital Therapeutics for stress prevention: Perspectives from multi-stakeholders' workshops about the SHIVA solution","authors":"Marco Bolpagni ,&nbsp;Susanna Pardini ,&nbsp;Silvia Gabrielli","doi":"10.1016/j.invent.2024.100775","DOIUrl":"10.1016/j.invent.2024.100775","url":null,"abstract":"<div><h3>Background</h3><p>AI-powered Digital Therapeutics (DTx) hold potential for enhancing stress prevention by promoting the scalability of P5 Medicine, which may offer users coping skills and improved self-management of mental wellbeing. However, adoption rates remain low, often due to insufficient user and stakeholder involvement during the design phases.</p></div><div><h3>Objective</h3><p>This study explores the human-centered design potentials of SHIVA, a DTx integrating virtual reality and AI with the SelfHelp+ intervention, aiming to understand stakeholder views and expectations that could influence its adoption.</p></div><div><h3>Methods</h3><p>Using the SHIVA example, we detail design opportunities involving AI techniques for stress prevention across modeling, personalization, monitoring, and simulation dimensions. Workshops with 12 stakeholders—including target users, digital health designers, and mental health experts—addressed four key adoption aspects through peer interviews: AI data processing, wearable device roles, deployment scenarios, and the model's transparency, explainability, and accuracy.</p></div><div><h3>Results</h3><p>Stakeholders perceived AI-based data processing as beneficial for personalized treatment in a secure, privacy-preserving environment. While wearables were deemed essential, concerns about compulsory use and VR headset costs were noted. Initial human facilitation was favored to enhance engagement and prevent dropouts. Transparency, explainability, and accuracy were highlighted as crucial for the stress detection model.</p></div><div><h3>Conclusion</h3><p>Stakeholders recognized AI-driven opportunities as crucial for SHIVA's adoption, facilitating personalized solutions tailored to user needs. Nonetheless, challenges persist in developing a transparent, explainable, and accurate stress detection model to ensure user engagement, adherence, and trust.</p></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"38 ","pages":"Article 100775"},"PeriodicalIF":3.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221478292400068X/pdfft?md5=5966cd183f03cb84438a0e6b81125694&pid=1-s2.0-S221478292400068X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230189","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}