Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Department of Educational and Counselling Psychology, and Special Education, Faculty of Education, University of British Columbia, Vancouver, BC, Canada.
J Med Internet Res. 2021 Jan 21;23(1):e20557. doi: 10.2196/20557.
There is a growing body of evidence regarding eHealth interventions that target substance use disorders. Development and funding decisions in this area have been challenging, due to a lack of understanding of what parts of an intervention work in which context.
We conducted a realist review of the literature on electronic cognitive behavioral therapy (eCBT) programs for substance use with the goal of answering the following realist question: "How do different eCBT interventions for substance use interact with different contexts to produce certain outcomes?"
A literature search of published and gray literature on eHealth programs targeting substance use was conducted. After data extraction, in order to conduct a feasible realist review in a timely manner, the scope had to be refined further and, ultimately, only included literature focusing on eCBT programs targeting substance use. We synthesized the available evidence from the literature into Context-Mechanism-Outcome configurations (CMOcs) in order to better understand when and how programs work.
A total of 54 papers reporting on 24 programs were reviewed. Our final results identified eight CMOcs from five unique programs that met criteria for relevance and rigor.
Five strategies that may be applied to future eCBT programs for substance use are discussed; these strategies may contribute to a better understanding of mechanisms and, ultimately, may help design more effective solutions in the future. Future research on eCBT programs should try to understand the mechanisms of program strategies and how they lead to outcomes in different contexts.
针对物质使用障碍的电子健康干预措施的证据越来越多。由于缺乏对干预措施中哪些部分在哪些情况下起作用的理解，该领域的开发和资金决策一直具有挑战性。
我们对电子认知行为疗法（eCBT）治疗物质使用的相关文献进行了真实主义综述，旨在回答以下真实主义问题：“不同的电子认知行为疗法干预措施如何在不同的背景下相互作用，从而产生特定的结果？”
对针对物质使用的电子健康计划的已发表和灰色文献进行了文献检索。在数据提取之后，为了及时进行可行的真实主义综述，范围必须进一步细化，最终仅包括针对物质使用的电子认知行为疗法计划的文献。我们将文献中的可用证据综合为情境-机制-结果配置（CMOcs），以便更好地了解程序在何时以及如何发挥作用。
共审查了 54 篇报告了 24 个计划的论文。我们的最终结果从符合相关性和严谨性标准的五个独特计划中确定了八个 CMOcs。
讨论了可能应用于未来物质使用的电子认知行为疗法计划的五种策略；这些策略可能有助于更好地理解机制，并最终可能有助于未来设计更有效的解决方案。未来关于电子认知行为疗法计划的研究应尝试理解计划策略的机制以及它们如何在不同的背景下导致结果。
