Gulliver Amelia, Calear Alison L, Sunderland Matthew, Kay-Lambkin Frances, Farrer Louise M, Batterham Philip J
Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Rd, Acton, Canberra, ACT 2601 Australia.
The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Level 6, Jane Foss Russell Building, G02, Camperdown NSW 2006, Australia.
Internet Interv. 2021 May 5;25:100400. doi: 10.1016/j.invent.2021.100400. eCollection 2021 Sep.
Low engagement with self-guided online programs limits the potential of these programs to provide effective and low-cost treatment of mild to moderate depression and anxiety at scale. Identifying factors that increase uptake and adherence in self-guided online programs may facilitate the development of targeted implementation strategies to increase engagement with these programs in the community. Using data from a randomized controlled trial of a self-guided online program for depression and anxiety, the aim of this study was to identify predictors of the acceptability of internet-based psychological programs, and engagement (uptake and adherence) with the online program tested in the trial.
A total of 556 community members with elevated symptoms of depression or anxiety were recruited via social media into the two active conditions of a three-arm randomized controlled trial. This trial tested the effectiveness of a 7-week self-guided online program for depression and anxiety called , delivered with or without an Engagement-Facilitation Intervention. Predictors of uptake (accessing at least one therapeutic module of the program), adherence (modules completed), and acceptability of internet-based psychological programs (Unified Theory of Acceptance and Use of Technology, UTAUT scale) were examined, including demographics, mental health status, help-seeking attitudes, stigma, acceptability of internet programs, and personality factors.
Logistic regression demonstrated that higher levels of conscientiousness ( = 1.06, = .026, 95% CI =1.01-1.12), and acceptability of internet-based psychological programs ( = 1.09, = .005, 95% CI =1.03-1.16) predicted greater uptake, and that failing to complete a module was predicted by lower levels of acceptability ( = 0.88, = .027, 95% CI =0.78-0.99). Linear regression showed that higher levels of agreeableness = 4.66, < .001), lower levels of stigma = -2.28, = .023) and more positive help-seeking attitudes = 2.05, = .041) predicted higher acceptability attitudes.
Acceptability of internet-based psychological programs was identified as a factor that increased both uptake and adherence to the program. Efforts to increase the acceptability of these programs may improve engagement with these programs in the community. It may also be useful to consider personality traits and clinical profiles when considering the appropriate audience for self-guided internet interventions.
对自助式在线项目的低参与度限制了这些项目大规模提供有效且低成本的轻至中度抑郁和焦虑治疗的潜力。识别能提高自助式在线项目参与度和依从性的因素，可能有助于制定有针对性的实施策略，以提高社区对这些项目的参与度。本研究利用一项针对抑郁和焦虑的自助式在线项目的随机对照试验数据，旨在识别基于互联网的心理项目的可接受性预测因素，以及在该试验中测试的在线项目的参与度（采用率和依从性）。
通过社交媒体招募了556名抑郁或焦虑症状加重的社区成员，纳入一项三臂随机对照试验的两个有效组。该试验测试了一个名为的为期7周的抑郁和焦虑自助式在线项目的有效性，该项目在有或没有参与促进干预的情况下提供。研究了采用率（访问该项目至少一个治疗模块）、依从性（完成的模块）以及基于互联网的心理项目的可接受性（技术接受与使用统一理论，UTAUT量表）的预测因素，包括人口统计学、心理健康状况、求助态度、耻辱感、互联网项目的可接受性和人格因素。
逻辑回归表明，较高的尽责性水平（β = 1.06，P = 0.026，95%CI = 1.01 - 1.12）和基于互联网的心理项目的可接受性（β = 1.09，P = 0.005，95%CI = 1.03 - 1.16）预测了更高的采用率，而未完成一个模块则由较低的可接受性水平预测（β = 0.88，P = 0.027，95%CI = 0.78 - 0.99）。线性回归显示，较高的宜人性水平（β = 4.66，P < 0.001）、较低的耻辱感水平（β = -2.28，P = 0.023）和更积极的求助态度（β = 2.05，P = 0.041）预测了更高的可接受性态度。
基于互联网的心理项目的可接受性被确定为增加对该项目的采用率和依从性的一个因素。提高这些项目可接受性的努力可能会改善社区对这些项目的参与度。在考虑自助式互联网干预的合适受众时，考虑人格特质和临床特征也可能是有用的。
