Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia.
Black Dog Institute, University of New South Wales, Sydney, Australia.
J Affect Disord. 2020 Mar 15;265:402-409. doi: 10.1016/j.jad.2020.01.044. Epub 2020 Jan 13.
The effectiveness of internet-based self-help programs for mental health may be limited by low engagement. Identifying factors associated with engagement in online interventions assists in developing strategies to improve efficacy through greater engagement. The aim of the current study was to identify factors associated with engagement among people with suicidal thoughts who completed an online program.
418 adults with suicidal ideation were recruited online into a randomized controlled trial of a 6-week internet-based self-help program. Program usage for the intervention and active control conditions was measured as the number of logins and modules accessed. Predictors of program usage and between-group differences were examined, including sociodemographic variables, user preferences and mental health status.
Both the control group and the intervention group accessed approximately three modules (M = 3.1, SD = 2.0 v. M = 2.8, SD = 2.1, respectively), although participants in the intervention group had a significantly higher number of logins (17.3 vs 9.7, p < 0.001). Across both conditions, individuals with more severe suicidal thoughts had better engagement with their respective program. More logins for both programs were also associated with being female, married or in a de-facto relationship, not employed, less severe depression and less willingness to seek help from informal sources.
Metrics of adherence may not directly reflect engagement with the program. There may be additional unmeasured factors associated with engagement.
The findings suggest that different engagement strategies may be required depending on sociodemographic and clinical characteristics. Tailoring interventions to at-risk subgroups may optimise health and functional outcomes.
基于互联网的自助心理健康项目的有效性可能受到参与度低的限制。确定与在线干预参与相关的因素有助于通过提高参与度来制定提高疗效的策略。本研究的目的是确定完成在线项目的有自杀念头的人参与度的相关因素。
418 名有自杀意念的成年人在线参加了一项为期 6 周的基于互联网的自助在线项目的随机对照试验。干预组和主动对照组的程序使用情况是通过登录次数和访问模块数来衡量的。检查了程序使用情况和组间差异的预测因素，包括社会人口统计学变量、用户偏好和心理健康状况。
对照组和干预组都访问了大约三个模块（干预组 M=3.1，SD=2.0；对照组 M=2.8，SD=2.1），尽管干预组的登录次数明显更高（17.3 次比 9.7 次，p<0.001）。在两种情况下，自杀念头更严重的个体对各自的项目参与度更好。两个程序的更多登录次数也与女性、已婚或事实婚姻、无业、抑郁程度较轻和不太愿意寻求非正式来源的帮助有关。
依从性指标可能不能直接反映对项目的参与度。可能还有其他未测量的与参与度相关的因素。
研究结果表明，根据社会人口统计学和临床特征，可能需要不同的参与策略。针对高危亚组的干预措施可能会优化健康和功能结果。
