Moskalenko Maryna Y, Hadjistavropoulos Heather D, Katapally Tarun R
Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, Canada.
Department of Psychology, University of Regina, Regina, Canada.
J Ment Health. 2022 Dec;31(6):738-747. doi: 10.1080/09638237.2020.1793125. Epub 2020 Jul 25.
Internet-delivered cognitive behavioral therapy (ICBT) provides critical remote access to mental health care to at-risk populations. However, to our knowledge, no investigation has been conducted to understand complex pathways through which barriers to care (i.e. structural, attitudinal and technological) correlate with patient interest in ICBT.
The objective of this study is to develop and test a pathway analysis framework using structural equation modeling to understand direct and mediating associations of barriers to care with interest in ICBT.
This cross-sectional observational study was conducted among adult (>18 years) urban and rural residents ( = 200) in Saskatchewan, Canada. An online survey assessed interest in ICBT, barriers to ICBT, demographics, and depression and anxiety symptoms. Utilizing structural equation modeling, a path analysis framework was developed.
Path analysis results showed how associations between complex barriers and demographic variables correlate with interest in ICBT. For instance, the negative association of perceived financial concerns and life chaos on interest in ICBT was mediated by perceived access to care.
The findings identify specific barriers that could be addressed through targeted population health interventions to improve uptake of ICBT.
互联网认知行为疗法（ICBT）为高危人群提供了至关重要的远程心理健康护理途径。然而，据我们所知，尚未开展任何调查来了解护理障碍（即结构、态度和技术方面）与患者对ICBT的兴趣相关的复杂途径。
本研究的目的是使用结构方程模型开发并测试一个路径分析框架，以了解护理障碍与对ICBT的兴趣之间的直接和中介关联。
这项横断面观察性研究在加拿大萨斯喀彻温省的成年（>18岁）城乡居民（n = 200）中进行。一项在线调查评估了对ICBT的兴趣、ICBT的障碍、人口统计学以及抑郁和焦虑症状。利用结构方程模型，开发了一个路径分析框架。
路径分析结果显示了复杂障碍与人口统计学变量之间的关联如何与对ICBT的兴趣相关。例如，感知到的经济担忧和生活混乱与对ICBT的兴趣之间的负相关是通过感知到的护理可及性介导的。
研究结果确定了可以通过有针对性的人群健康干预来解决的特定障碍，以提高ICBT的采用率。
