将指导性互联网干预措施转变为简化和自我指导的数字工具——来自最近三个项目的经验

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Pub Date : 2023-11-23 DOI:10.1016/j.invent.2023.100693

Martin Kraepelien , Amira Hentati , Dorian Kern , Christopher Sundström , Susanna Jernelöv , Nils Lindefors

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引用次数: 0

摘要

由治疗师指导的网络干预通常比无指导的更有效。然而，指导本身需要临床医生的时间，一些研究表明，自我指导的干预可能同样有效。提出了数字心理自我保健的概念，即基于使用数字工具并在结构化临床过程中提供的自我指导的互联网干预。方法开发了三种新的自我保健干预措施，即基于睡眠日记的失眠干预措施，基于酒精日记的问题性酒精使用干预措施，以及针对特应性皮炎(湿疹)的暴露和正念工具干预措施。新开发的数字自我保健干预措施与早期治疗师指导的干预措施进行了比较，使用了三项可行性试验(n's = 30、36和21)和三项随机试验(n's = 148、166和102)的公开结果。比较包括内容类型、持续时间、书面材料长度和组内效应大小。结果与指导性干预相比，新干预大大减少了临床时间，受试者的阅读量也大大减少。数字自我保健工具也显示出与更全面的指导性互联网干预相同的组内效应大小和反应率。初步结果表明，一些指导性互联网干预措施可以转化为自我引导的数字工具。这三个例子表明，如果在干预前后提供电话访谈，数字心理自我保健可以成为更全面的指导性互联网干预的可行替代方案。虽然这些例子很有希望，但需要进一步的研究，包括随机实验，来比较治疗效果，并确定哪些患者群体可能需要更全面的有指导的互联网干预。

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Transforming guided internet interventions into simplified and self-guided digital tools – Experiences from three recent projects

Introduction

Therapist-guided internet interventions are often more efficacious than unguided ones. However, the guidance itself requires clinician time, and some research suggests that self-guided interventions could potentially be equally effective. The concept of digital psychological self-care, self-guided internet interventions based on the use of digital tools and provided within a structured clinical process, is presented.

Methods

Three new self-care interventions, a sleep diary-based intervention for insomnia, an alcohol diary-based intervention for problematic alcohol use and an intervention with exposure and mindfulness tools for atopic dermatitis (eczema), were developed. Newly developed digital self-care interventions were compared to the earlier therapist-guided interventions they were based on, using published results from three feasibility trials (n's = 30, 36 and 21) and three randomized trials (n's = 148, 166 and 102). The comparison included type of content, duration, length of written material and within-group effect-sizes.

Results

In comparison to the guided interventions, clinician time was greatly reduced and the new interventions involved much less reading for participants. The digital self-care tools also showed within-group effect sizes and response rates on par with the more comprehensive guided internet interventions.

Discussion

Preliminary results suggest that some guided internet interventions can be transformed into self-guided digital tools. These three examples show that digital psychological self-care, if provided with telephone interviews before and after the intervention, can be viable alternatives to more comprehensive guided internet interventions. Although these examples are promising, further studies, including randomized experiments, are needed to compare treatment efficacies, and to identify which groups of patients may need more comprehensive guided internet interventions.

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来源期刊

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Medicine-Health Informatics

CiteScore

6.50

自引率

9.30%

发文量

审稿时长

6 weeks

期刊介绍： Official Journal of the European Society for Research on Internet Interventions (ESRII) and the International Society for Research on Internet Interventions (ISRII). The aim of Internet Interventions is to publish scientific, peer-reviewed, high-impact research on Internet interventions and related areas. Internet Interventions welcomes papers on the following subjects: • Intervention studies targeting the promotion of mental health and featuring the Internet and/or technologies using the Internet as an underlying technology, e.g. computers, smartphone devices, tablets, sensors • Implementation and dissemination of Internet interventions • Integration of Internet interventions into existing systems of care • Descriptions of development and deployment infrastructures • Internet intervention methodology and theory papers • Internet-based epidemiology • Descriptions of new Internet-based technologies and experiments with clinical applications • Economics of internet interventions (cost-effectiveness) • Health care policy and Internet interventions • The role of culture in Internet intervention • Internet psychometrics • Ethical issues pertaining to Internet interventions and measurements • Human-computer interaction and usability research with clinical implications • Systematic reviews and meta-analysis on Internet interventions