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Tag: engagement

Challenges in Recruiting University Students for Web-Based Indicated Prevention of Depression and Anxiety: Results From a Randomized Controlled Trial (ICare Prevent)

Bolinski F, Kleiboer A, Neijenhuijs K, Karyotaki E, Wiers R, de Koning L, Jacobi C, Zarski A, Weisel K, Cuijpers P, Riper H. Challenges in Recruiting University Students for Web-Based Indicated Prevention of Depression and Anxiety: Results From a Randomized Controlled Trial (ICare Prevent). J Med Internet Res 2022;24(12):e40892. DOI: 10.2196/40892

This study described recruitment challenges for a transdiagnostic, web-based prevention program and presented initial analysis on the intervention’s effectiveness on depression and anxiety symptoms. The study was a 3-arm randomized controlled trial with students (at least 16 years old) with subclinical symptoms of depression and anxiety to compare individually guided and automatically guided versions of ICare Prevent versus care as usual. ICare Prevent is a web-based and mobile-supported intervention for prevention of depression and anxiety. ICare Prevent is a 7-session web-based program (45-60 minutes each) and participants were instructed to complete 1-2 sessions weekly. ICare Prevent also provides elective modules and diaries that target factors common to mood and anxiety problems (i.e., sleep, alcohol use, positive activities). The individually guided version provided structured and personalized feedback on exercises and the automatically guided version provided standard and computerized feedback after each session. The study’s original recruitment goal was 252 student participants. Various strategies of recruitment were used, including social media campaigns on Facebook and Instagram, printed advertising at universities, paid participant platform, and other collaborations. Direct recruitment using students’ email addresses via the student administration was the most effective strategy. Despite these strategies, data was available for only 35 participants (individually guided: n=14, automatically guided: n=8, care as usual: n=13). Participants provided self-reported depression and anxiety symptoms at baseline, 6-month, and 12-month follow-up. Log data from the intervention platform showed low usage, with an average of 3 out of 7 sessions completed. Results did not show sufficient evidence of intervention effects on depression and anxiety over time in any intervention arm. Overall, recruitment for this population was challenging and more research is needed to identify factors to better engage college students in research studies.


Digital Solution for Smoking Cessation Shows Positive Results in Randomized Trial

Article Excerpt: A behavioral change digital health company has announced positive results from a randomized controlled trial for its app-based digital tool for tobacco use cessation. Pivot’s tool provides evidence-based tobacco cessation interventions, an interactive breath sensor, human coaching, nicotine replacement therapy, a digital support community, as well as behavioral therapy, the company stated in a press release.

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Article Source: Healio


Building Strong Futures: The Feasibility of Using a Targeted Digital Media Campaign to Improve Knowledge About Pregnancy and Low Birthweight Among Black Women

Bonnevie E, Rosenberg SD, Goldbarg J, Ashley-West A, & Smyser J. (2021). Building Strong Futures: The Feasibility of Using a Targeted Digital Media Campaign to Improve Knowledge About Pregnancy and Low Birthweight Among Black Women. Maternal and Child Health Journal, 25(1), 127–135.

This article reports the campaign methods for a digital intervention targeting Black women in one Florida county to promote positive pregnancy-related knowledge and attitudes related to low birthweight. The Strong Beautiful Future campaign was tailored toward Black women around a reproductive empowerment lens. Content focused on emphasizing healthy pregnancy-related behaviors (prenatal care, nutrition, weight gain, and birthweight) and creating positive representations of Black women throughout the pregnancy stages, using images and videos. Content was posted 5-7 times each week on Instagram, Facebook, and Twitter for 2 years and digital ads and local social media influencers were used to promote the campaign. Researchers measured campaign engagement through digital metrics. After two years of campaign implementation, social media accounts had 1784 total followers, with most on Facebook (n=920). In the two years, on a monthly average, Facebook had the highest number of times the content was displayed, but Instagram showed highest level of engagement (number of likes, comments, shares, views and clicks). Three cross-sectional surveys were conducted online over the study period to examine Black women’s pregnancy-related knowledge, attitudes, and behaviors. Findings showed a non-significant increase in knowledge about prenatal care, weight gain, exercise, and health impacts of low birthweight. Overall, this study highlights how a targeted digital campaign to providing health information is feasible in reaching Black women in targeted locations.


Can VR Act as A Digital Therapeutic?

Article Excerpt: Our digital, two-dimensional lives leave little room for focus. Our eyes dart from screen to screen over the course of the day as notifications and messages draw our attention away from tasks, from relaxation, from the faces of our loved ones. Through all of its flatness, our digital lives are dominated by distraction—so much so that we can sometimes forget to breathe. Finding lasting inner peace from within this flattened world can be a neurological nightmare. Mindfulness and meditation apps, digital health’s answer in the last decade, use many of the same engagement methods that have propelled other consumer applications like games and fitness apps to success. Strategies like achievements and social connectivity have kept many users coming back to engage in evidence-based, clinically effective therapies. But even the most effective and engaging mindfulness apps can’t transcend the noise and distraction of our everyday lives.

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Article Source: Fast Company


Predictors of adolescent engagement and outcomes – A cross-sectional study using the Togetherall (formerly Big White Wall) digital mental health platform

Marinova N, Rogers T, and MacBeth A. “Predictors of Adolescent Engagement and Outcomes – A Cross-Sectional Study Using the Togetherall (formerly Big White Wall) Digital Mental Health Platform.” Journal of affective disorders 311 (2022): 284–293.

This study modelled predictors of engagement and symptom change in adolescent users of Togetherall anonymous digital mental health peer-support platform. Researchers conducted a retrospective analysis of longitudinal user data from 606 Togetherall users (16-18 years old) referred from mental health services in the United Kingdom. Togetherall is a membership-based digital platform that supports delivery of peer support moderated by professionals, self-help materials, guided courses, digital art, and self-monitoring of mental well-being. Usage metrics, including number of logins, session duration, usage time, and number of guided courses and self-help materials accessed were collected. Participant characteristics and anxiety and depression symptoms were used to predict engagement and participants chose when and whether to complete a symptom measure. Average number of logins was 5.11 and mean usage time 64.22 minutes. 34% of participants discontinued use after one log-in. Total usage time predicted more access of self-help materials. Females made greater use of materials and courses than males. Higher baseline depression and anxiety, longer usage time, and session duration predicted lower post intervention depression scores. Higher baseline depression and anxiety and more self-help materials accessed predicted lower post intervention anxiety scores. Findings demonstrate that adolescents with significant levels of morbidity readily engaged with an anonymous online platform for support with mental health. Togetherall may offer a supportive community for adolescents using mental health services. Future studies are needed to establish effectiveness, adherence and acceptability using robust RCTs with active comparison groups.


How Much Are Patients Actually Using Mental Health Apps? Research on Engagement Is Elusive

Article Excerpt: As companies selling health care apps struggle to prove to a skeptical system that they really deliver results, we’re about to start hearing a lot more about “engagement.” A new paper scrutinizing six clinical trials supporting four mental health apps cleared by the Food and Drug Administration argues there’s an urgent need to close the “gap between intention and real-world efficacy for digital therapeutics” — specifically, the dearth of data on how much people actually use digital treatments.

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Article Source: STAT News


The EMPOWER blended digital intervention for relapse prevention in schizophrenia: a feasibility cluster randomized controlled trial in Scotland and Australia

Gumley AI, Bradstreet S, Ainsworth J, Allan S, Alvarez-Jimenez M, Aucott L, Birchwood M, Briggs A, Bucci S, Cotton SM, Engel L, French P, Lederman R, Lewis S, Machin M, MacLennan G, McLeod H, McMeekin N, Mihalopoulos C, Gleeson J (2022). The EMPOWER blended digital intervention for relapse prevention in schizophrenia: a feasibility cluster randomised controlled trial in Scotland and Australia. The Lancet. Psychiatry, 9(6), 477–486.

The study used a randomized controlled study design to evaluate feasibility of a digital intervention for relapse prevention in schizophrenia, Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery (EMPOWER). Eight community mental health service (CMHS) sites in Glasgow and Melbourne were randomized to EMPOWER or treatment as usual. Participants older than 16 years of age, who had a schizophrenia diagnosis, had contact with CMHS, and had a relapse in the past two years, were recruited (N=73). EMPOWER is a blended peer and clinician support smartphone app that allows people to monitor their wellbeing and warning signs of schizophrenia relapse (i.e., a return to active schizophrenia symptoms) over a maximum of 12 months. The app includes messages to enhance self-management and autonomy and visual charts to observe changes in self-reported well-being over time. Researchers assessed feasibility, acceptability, usability, and safety through in-person interviews at the end of 12-months. Results demonstrated high rates of engagement with the app and participants reported using the app on a weekly to daily basis. Participants reported a moderate willingness (mean of 2.45 on scale of 1-4) to share their data with caregivers and staff. Overall, participants rated the app as interesting to use, easy to learn, and that the content was well written and credible. Fear of relapse was lower in the EMPOWER group than in the treatment as usual group (mean difference of -7.53 points (95% CI: 14.45 to 0.60). Results suggest the promise of EMPOWER and a next step to evaluate its effectiveness and cost-effectiveness in further research.


Feedback on Instagram posts for a gestational weight gain intervention

Waring ME, Pagoto SL, Moore Simas TA, Heersping G, Rudin LR, Arcangel K. Feedback on Instagram posts for a gestational weight gain intervention [published correction appears in Transl Behav Med. 2022 Apr 22;:]. Transl Behav Med. 2022;12(4):568-575. doi:10.1093/tbm/ibac001

Researchers evaluated the feasibility and acceptability of a private Instagram group and lifestyle intervention posts focused on healthy gestational weight gain. A study was conducted with pregnant women with pre-pregnancy overweight or obesity who use Instagram regularly. Eleven participants each created a private Instagram account and followed the other participants’ accounts and a moderator. The moderator, a registered dietitian, uploaded posts twice a day for 2 weeks about physical activity, healthy eating, goal setting and progress reports during pregnancy. Participants were encouraged to check the group daily and engage by liking, replying to comments, and posting their own photos. After the 2-week intervention, participants completed an online survey on acceptability of the Instagram posts developed by the researchers and participated in virtual focus group interviews via Webex. User engagement data was collected from Instagram. The results indicated all participants followed the moderator’s account and engaged with all study posts. Most participants (82%) reported feeling comfortable sharing in the group and 73% would participate in a similar group in the future. A majority of participants found the posts visually attractive and indicated that the posts provided helpful information. However, participants preferred more personalized content and felt hesitant to post their own photos because they did not feel their photos were high-quality and positive enough. Overall, the study demonstrated that creating a private Instagram group for delivery of a dietary and fitness intervention is feasible. Findings can inform next steps in development and future research developing Instagram-delivered interventions for other health behaviors or conditions.


Barriers to and Facilitators of User Engagement With Digital Mental Health Interventions: Systematic Review

Borghouts J, Eikey E, Mark G, De Leon C, Schueller SM, Schneider M, Stadnick N, Zheng K, Mukamel D, Sorkin DH. Barriers to and Facilitators of User Engagement With Digital Mental Health Interventions: Systematic Review. J Med Internet Res 2021;23(3):e24387

The purpose of this systematic review was to identify common barriers and facilitators that influence user engagement with digital mental health interventions. All empirical studies that report qualitative and/or quantitative data on a digital mental health intervention among adults were included (N=208 articles). Studies evaluated user engagement through surveys, interviews, focus groups, randomized controlled trials, field studies, analysis of app data, and user reviews. The researchers extracted data related to the user, the program or content offered by the intervention, and the technology and implementation environment. Identified barriers included: severe mental health illnesses that hampered engagement, technical issues, and a lack of personalization. Facilitators included: social connectedness, increased insight into health, and a feeling of being in control of one’s health. These factors should be considered as guidance when evaluating interventions to improve engagement. In addition, this review can help develop targeted strategies to overcome barriers and successfully implement digital mental health interventions.