Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
Human Development and Family Studies, Michigan State University, East Lansing.
J Adolesc Health. 2020 Aug;67(2):232-238. doi: 10.1016/j.jadohealth.2020.01.025. Epub 2020 Mar 10.
Although Internet-based electronic health (eHealth) interventions could potentially reduce mental health disparities, especially in college students in under-resourced countries, little is known about the relative acceptability of eHealth versus in-person treatment modalities and the treatment barriers associated with a preference for one type over the other.
Participants were from the 2018-2019 cohort of the University Project for Healthy Students (PUERTAS), a Web-based survey of incoming first-year students in Mexico and part of the World Mental Health International College Student Survey initiative. A total of 7,849 first-year students, 54.73% female, from five Mexican universities participated. We estimated correlates of preference for eHealth delivery over in-person modalities with a multivariate logistic regression.
Thirty-eight percent of students prefer in-person services, 36% showed no preference for in-person over eHealth, 19% prefer not to use services of any kind, and 7% preferred eHealth over in-person treatment delivery. Being embarrassed, worried about harm to one's academic career, wanting to handle problems on one's own, beliefs about treatment efficacy, having depression, and having attention-deficient hyperactivity disorder were associated with a clear preference for eHealth delivery methods with odds ratios ranging from 1.47 to 2.59.
Although more students preferred in-person services over eHealth, those reporting attitudinal barriers (i.e., embarrassment, stigma, wanting to handle problems on one's own, and beliefs about treatment efficacy) and with depression or attention-deficit hyperactivity disorder had a greater preference for eHealth interventions suggesting these are students to whom eHealth interventions could be targeted to alleviate symptoms and/or as a bridge to future in-person treatment.
虽然基于互联网的电子健康(eHealth)干预措施有可能减少心理健康方面的差距,尤其是在资源匮乏国家的大学生中,但对于 eHealth 与面对面治疗方式的相对可接受性,以及与偏好一种方式而不是另一种方式相关的治疗障碍知之甚少。
参与者来自 2018-2019 年的大学生健康项目(PUERTAS),这是一项针对墨西哥新入学一年级学生的基于网络的调查,也是世界心理健康国际大学生调查倡议的一部分。共有来自五所墨西哥大学的 7849 名一年级学生参与了这项调查,其中 54.73%为女性。我们使用多变量逻辑回归估计了对 eHealth 与面对面治疗方式的偏好相关因素。
38%的学生更喜欢面对面服务,36%的学生对面对面服务和 eHealth 没有偏好,19%的学生不想使用任何类型的服务,7%的学生更喜欢 eHealth 而不是面对面治疗。感到尴尬、担心对学业造成伤害、希望自己处理问题、对治疗效果的信念、患有抑郁症和患有注意力缺陷多动障碍,与明确偏好 eHealth 治疗方法相关,优势比为 1.47 至 2.59。
尽管有更多的学生更喜欢面对面服务而不是 eHealth,但那些报告存在态度障碍(即尴尬、耻辱感、希望自己处理问题,以及对治疗效果的信念),且患有抑郁症或注意力缺陷多动障碍的学生更倾向于接受 eHealth 干预措施,这表明这些学生是 eHealth 干预措施的目标人群,可以减轻症状和/或作为未来面对面治疗的桥梁。