Lifestyle Medicine and Health Research Centre, Avondale University College, Cooranbong, NSW, Australia.
J Med Internet Res. 2021 Apr 14;23(4):e25358. doi: 10.2196/25358.
Digital mental health promotion interventions (MHPIs) present a scalable opportunity to attenuate the risk of mental health distress among nonclinical cohorts. However, adherence is frequently suboptimal, and little is known about participants' perspectives concerning facilitators and barriers to adherence in community-based settings.
This study aimed to examine participants' perceptions of facilitators and barriers to adherence in a web- and mobile app-based MHPI for a nonclinical cohort.
This qualitative study used inductive, reflexive thematic analysis to explore free-text responses in a postintervention evaluation of a 10-week digital MHPI. The intervention was administered using a web and mobile app from September to December 2018. Participants (N=320) were Australian and New Zealand members of a faith-based organization who self-selected into the study, owned a mobile phone with messaging capability, had an email address and internet access, were fluent in English, provided informed consent, and gave permission for their data to be used for research. The postintervention questionnaire elicited participants' perceptions of facilitators and barriers to adherence during the intervention period.
Key factors that facilitated adherence were engaging content, time availability and management, ease of accessibility, easy or enjoyable practical challenges, high perceived value, and personal motivation to complete the intervention. The primary perceived barrier to adherence was the participants' lack of time. Other barriers included completing and recording practical activities, length of video content, technical difficulties, and a combination of personal factors.
Time scarcity was the foremost issue for the nonclinical cohort engaged in this digital MHPI. Program developers should streamline digital interventions to minimize the time investment for participants. This may include condensed content, optimization of intuitive web and app design, simplified recording of activities, and greater participant autonomy in choosing optional features. Nonetheless, participants identified a multiplicity of other interindividual factors that facilitated or inhibited adherence.
数字心理健康促进干预（MHPIs）为减轻非临床人群心理健康困扰的风险提供了一个可扩展的机会。然而，依从性通常不理想，对于社区环境中参与者对依从性的促进因素和障碍的看法知之甚少。
本研究旨在探讨基于网络和移动应用的非临床人群 MHPIs 中参与者对依从性的促进因素和障碍的看法。
这项定性研究使用归纳、反思性主题分析方法，探索了一项为期 10 周的数字 MHPIs 干预后评估中的自由文本回复。该干预于 2018 年 9 月至 12 月通过网络和移动应用进行。参与者（N=320）是一个基于信仰的组织的澳大利亚和新西兰成员，他们自行选择参加该研究，拥有具有消息功能的移动电话，拥有电子邮件地址和互联网访问权限，英语流利，并提供了知情同意书，并允许将其数据用于研究。干预后问卷征集了参与者在干预期间对依从性的促进因素和障碍的看法。
促进依从性的关键因素包括引人入胜的内容、时间的可用性和管理、易于访问、易于处理或愉快的实际挑战、高感知价值和个人完成干预的动机。主要的依从性障碍是参与者缺乏时间。其他障碍包括完成和记录实际活动、视频内容的长度、技术困难以及个人因素的组合。
时间紧张是参与这项数字 MHPIs 的非临床人群的首要问题。项目开发者应精简数字干预措施，以减少参与者的时间投入。这可能包括压缩内容、优化直观的网络和应用程序设计、简化活动记录以及更大程度地让参与者自主选择可选功能。然而，参与者确定了许多其他个体因素，这些因素促进或阻碍了依从性。
