Borsutzky Swantje, Gehlenborg Josefine, Rolvien Lara, Moritz Steffen
Department of Psychosocial Medicine, University Hospital Hamburg-Eppendorf, Clinic for Psychiatry and Psychotherapy, Hamburg, Germany.
JMIR Form Res. 2025 Jun 24;9:e65478. doi: 10.2196/65478.
Mental health disorders affect 1 in 8 people worldwide, yet many face barriers to accessing care. E-mental health interventions, including self-guided internet-based programs, offer promising solutions. However, the mechanisms driving knowledge gain in such programs remain poorly understood. The role of medium, topic, sequence, and confidence and their interaction in learning outcomes need further investigation. Additionally, the influence of knowledge gaps on the outcome of psychoeducational intervention is not well understood (eg, whether psychoeducation requires an existing knowledge gap to be effective).
This randomized controlled trial investigated the role of medium, topic, sequence, and participants' initial knowledge levels on knowledge gain and confidence in fully automated self-guided e-mental health psychoeducation.
A total of 158 adults (mean age 34, SD 12.4 years; n=118, 74.7% female) were randomized to 8 experimental conditions (receiving video, texts, or both containing psychoeducational content on sleep or social competence; n=142) or a control group (neutral video; n=16). The fully automated interventions (videos) were developed for use in web-based e-mental health interventions. They address transdiagnostic symptoms and hence are relevant across various disorders. To assess the added value of video production for knowledge gain, text-based scripts corresponding to the video content were created and compared. All interventions and outcome assessments were delivered on the web via Qualtrics without face-to-face components. Pre- and postintervention knowledge was assessed using a validated 30-item knowledge test (true/false). Confidence in responses was rated on a 0% to 100% scale. Statistical analyses included 3-way ANOVA and multivariate ANOVA.
Knowledge significantly increased across experimental groups (F=17.272; P<.001; η=0.10). Participants with social competence deficits had significantly lower baseline knowledge (P=.04; d=0.41). For sleep deficits, a nonsignificant trend emerged (P=.09; d=0.28). Participants with social competence deficits demonstrated greater knowledge improvement (t=7.12; P<.001; d=0.60). Participants with sleep deficits showed smaller but significant gains (t=2.43; P=.02; d=0.20). No significant differences in knowledge gain were found between video and text formats. Confidence in correct answers increased significantly in the experimental group (mean 42.82, 95% CI 41.15-44.50 to mean 51.67, 95% CI 49.28-54.04), with larger gains for social competence than sleep. Confidence in the control group remained unchanged.
Both video and text formats effectively facilitated knowledge gain in e-mental health interventions, with no clear advantage of one medium over the other. Participants with prior deficits learned more in areas where they initially lacked knowledge. Confidence in correct answers increased alongside knowledge, highlighting psychoeducation's role in promoting self-efficacy. Future research should explore multimedia integration to enhance adherence and symptom improvement.
German Clinical Trials Register DRKS00026722; https://drks.de/search/en/trial/DRKS00026722.
心理健康障碍影响着全球八分之一的人口，但许多人在获得护理方面面临障碍。电子心理健康干预措施，包括基于互联网的自助式项目，提供了有前景的解决方案。然而，此类项目中推动知识获取的机制仍知之甚少。媒介、主题、顺序、信心及其在学习成果中的相互作用需要进一步研究。此外，知识差距对心理教育干预结果的影响也未得到充分理解（例如，心理教育是否需要存在知识差距才能有效）。
这项随机对照试验研究了媒介、主题、顺序以及参与者的初始知识水平对全自动自助式电子心理健康心理教育中知识获取和信心的作用。
共有158名成年人（平均年龄34岁，标准差12.4岁；n = 118，74.7%为女性）被随机分配到8种实验条件（接收关于睡眠或社交能力的视频、文本或两者，均包含心理教育内容；n = 142）或一个对照组（中性视频；n = 16）。全自动干预措施（视频）专为基于网络的电子心理健康干预而开发。它们解决跨诊断症状，因此与各种障碍相关。为了评估视频制作对知识获取的附加价值，创建并比较了与视频内容对应的文本脚本。所有干预措施和结果评估均通过Qualtrics在网络上进行，无需面对面环节。干预前后的知识通过经过验证的30项知识测试（是非题）进行评估。对回答的信心以0%至100%的量表进行评分。统计分析包括三因素方差分析和多因素方差分析。
各实验组的知识均显著增加（F = 17.272；P <.001；η = 0.10）。社交能力存在缺陷的参与者基线知识显著更低（P =.04；d = 0.41）。对于睡眠缺陷，出现了不显著的趋势（P =.09；d = 0.28）。社交能力存在缺陷的参与者知识改善更大（t = 7.12；P <.001；d = 0.60）。睡眠存在缺陷的参与者虽增益较小但显著（t = 2.43；P =.02；d = 0.20）。视频和文本格式在知识获取方面未发现显著差异。实验组中对正确答案的信心显著增加（平均42.82，95%置信区间41.15 - 44.5（此处原文有误，应为44.50）至平均51.67，95%置信区间49.28 - 54.04），社交能力方面的增益大于睡眠方面。对照组的信心保持不变。
视频和文本格式在电子心理健康干预中均有效地促进了知识获取，一种媒介相对于另一种媒介没有明显优势。先前存在缺陷的参与者在他们最初缺乏知识的领域中学到了更多。对正确答案的信心随着知识的增加而增强，突出了心理教育在促进自我效能方面的作用。未来的研究应探索多媒体整合以提高依从性和症状改善情况。
德国临床试验注册中心DRKS00026722；https://drks.de/search/en/trial/DRKS00026722 。
