Search:
Scroll to top
Tag: internet-based
07/31/2023

Preliminary Implementation Outcomes of a Free Online Toolkit to Support Exposure Therapy Implementation for Youth

Becker-Haimes EM, Wislocki K, Schriger SH, Kratz HE, Sanchez AL, Clapp D, Frank HE. Preliminary Implementation Outcomes of a Free Online Toolkit to Support Exposure Therapy Implementation for Youth. Child Youth Care Forum (2023). https://doi.org/10.1007/s10566-023-09732-1

Exposure therapy is a cognitive-behavioral treatment tool for youth anxiety but is highly underutilized in routine clinical care. This study assessed usage and clinician perspectives of an online toolkit that supports the use of exposure therapy with anxious youth, called the Resource for Exposure for Anxiety Disordered Youth (READY). READY is hosted on a freely available website and has been disseminated to clinicians. Researchers extracted web analytics from the READY platform and conducted brief, anonymous electronic surveys of site users to assess READY adoption, utility, and the association with exposure therapy use. In its first three years, READY had 13,543 page views across 1731 unique users. READY clinician users (N=49, mean age=34 years, 82.9% female, 71% White) completed the survey. Survey data suggested variability in usage and perceived utility across toolkit components. READY was perceived positively overall by users and was most commonly used to prepare for exposure therapy sessions by reviewing tips or generating exposure ideas. Open-ended responses about perceived challenges in exposure delivery with youth found common barriers to be engagement by patients, difficulties with the family system, and difficulties with generating ideas for exposure practices. Although the study engaged only a small number of READY users (14%) to complete the survey, findings suggest the READY toolkit, a free online implementation resource, could be a promising tool to support clinicians delivering exposure therapy and may augment traditional training and consultation.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ;
07/10/2023

Informing the development of the Coaching Online and Community Health (COACH) program: a qualitative study of clubhouse members living with serious mental illness

O’Neill K, Hand R, Diop B, Weiss H, Cruz Pfaeffle A, Maragatham P, Rice K, Naslund JA. Informing the development of the coaching online and community health (COACH) program: a qualitative study of clubhouse members living with serious mental illness. Transl Behav Med. 2023 May 13;13(5):343-353. doi: 10.1093/tbm/ibad001.

Clubhouse organizations for individuals with serious mental illness (SMI) are structured psychosocial rehabilitation communities, some of which have developed virtual service platforms during the COVID-19 pandemic. This qualitative study explored clubhouse members’ experiences engaging with a virtual clubhouse platform during the COVID-19 pandemic; preferences for interest in and access to digital health content was assessed, as well as suggestions for an online peer lifestyle intervention. The study was guided by a community-based participatory action research framework. Ten focus groups were conducted with 33 clubhouse members (ages 28 to 69 years old, 54.3% women). Participants expressed mixed views about use of the virtual clubhouse platform (delivered over Zoom), with some finding that meeting virtually was better for social anxiety, while others reporting it challenging to interact online and pick up on social cues. The virtual platform offered new opportunities to reach individuals with SMI during the pandemic, but participants noted the importance of having staff to help them get online and navigate the virtual platform. Focus group members highlighted that compatibility with the person facilitating the intervention content was necessary for engagement. Another reported motivation for engagement was participation in health and wellness activities that bring joy and access to community resources and involvement. Recommendations from this study will inform a future adaptation of an intervention, called Group Lifestyle Balance, to suit the needs of clubhouse members.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ;
07/03/2023

Cost-effectiveness of Internet Interventions Compared With Treatment as Usual for People With Mental Disorders: Systematic Review and Meta-analysis of Randomized Controlled Trials

Rohrbach P, Dingemans A, Evers C, Van Furth E, Spinhoven P, Aardoom J, Lähde I, Clemens F, Van den Akker-Van Marle M. Cost-effectiveness of Internet Interventions Compared With Treatment as Usual for People With Mental Disorders: Systematic Review and Meta-analysis of Randomized Controlled Trials. J Med Internet Res 2023;25:e38204. DOI: 10.2196/38204

A systematic review and meta-analysis were conducted to investigate the cost-effectiveness of internet interventions for mental disorders compared to usual care. Eligibility criteria for included studies were randomized controlled trials with participants who reported any mental health disorder or symptoms, an intervention that was phone- or internet-based, reported outcomes on both quality of life and costs, and published in English. Researchers extracted data to report risk of bias, quality of the economic evaluation, quality-adjusted life years, and costs. The incremental net monetary benefit was calculated and pooled. Thirty-seven studies met eligibility criteria. Overall, the quality of economic evaluations was rated as moderate and the risk of bias as high. Internet interventions were slightly more effective in improving quality of life than usual care (Hedges g=0.052, p=.02) but with similar cost (Hedges g=0.002, p=.96). The pooled incremental net benefit was $255 (95% CI $91 to $419), favoring internet interventions over usual care. This review is a starting point for researchers to further understand the cost-effectiveness of internet interventions for mental disorders. Future work could investigate studies with more homogenous interventions or designs. Additionally, studies from non-Western cultures or low-income countries were not included in this review. To conclude, the cost-effectiveness of internet interventions compared with usual care is likely but not guaranteed.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ;
06/20/2023

A Digital Single-Session Intervention Platform for Youth Mental Health: Cultural Adaptation, Evaluation, and Dissemination

Shroff A, Roulston C, Fassler J, Dierschke N, Todd J, Ríos-Herrera Á, Plastino K, Schleider J. A Digital Single-Session Intervention Platform for Youth Mental Health: Cultural Adaptation, Evaluation, and Dissemination. JMIR Ment Health 2023;10:e43062. DOI: 10.2196/43062

An academic-community partnership was created to culturally adapt, disseminate, and gauge the acceptability and utility of an evidence-based digital mental health platform, Project Youth Empowerment and Support (YES), among English and Spanish speaking youth in south Texas. The three digital self-guided single-session interventions (SSIs) in Project YES were culturally adapted and revised in collaboration with youth stakeholders and translated to Spanish. pre-post exploratory study investigated acceptability and efficacy of Project YES on hopelessness, agency, perceived control, and self-hate. Participants aged 11 to 17 years and residing in San Antonio, Texas and the surrounding areas were recruited via social media ads, referrals, schools, and community centers. A total of 1801 youths began and 894 (49.6%) selected and completed one 30-minute SSI within the Project YES website. Data was collected via self-reported surveys before participants started a SSI and following the completion of the SSI. Participants rated the Project YES as enjoyable, easy to understand, easy to use, helpful, and would recommend to others (mean at least 3.5 out of 5.0) for both language versions Youth in Project YES (English version) reported significant improvements in hopelessness (Cohen d=0.33, p<.001), self-hate (Cohen d=0.27, p<.001) and agency (Cohen d=0.25, p<.001) post-intervention, relative to pre-intervention. Youth in Project YES (Spanish version) reported significant improvements in self-hate (Cohen d=0.37, p=.05) from before to after the intervention. Overall, the culturally adapted Project YES demonstrated to be an acceptable, accessible, and effective mental health support for English and Spanish speaking youth. The San Antonio community partnerships fostered broad recruitment and retention rates.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ;
06/12/2023

Findings From the Step Up, Test Up Study of an Electronic Screening and Brief Intervention for Alcohol Misuse in Adolescents and Young Adults Presenting for HIV Testing: Randomized Controlled Efficacy Trial

Karnik N, Kuhns L, Hotton A, Del Vecchio N, McNulty M, Schneider J, Donenberg G, Keglovitz Baker K, Diskin R, Muldoon A, Rivera J, Summersett Williams F, Garofalo R. Findings From the Step Up, Test Up Study of an Electronic Screening and Brief Intervention for Alcohol Misuse in Adolescents and Young Adults Presenting for HIV Testing: Randomized Controlled Efficacy Trial. JMIR Ment Health 2023;10:e43653. DOI: 10.2196/43653

This study tested the efficacy of a fully automated electronic screening and brief intervention, Step Up, Test Up, to reduce alcohol misuse among adolescents and young adults in community-based HIV testing environments in Chicago. Effects on sexual risk and uptake of pre-exposure prophylaxis (PrEP) for HIV prevention were also examined. Three hundred twenty-nine participants aged 16-25 years who identified as a man or transgender woman who has sex with men and reported moderate to high alcohol use were randomly assigned to a brief single-visit intervention or attention control condition (modules of similar length on promotion of diet and nutrition). The Step Up, Test Up intervention used a motivational interviewing approach to deliver lessons on 11 topics focused on alcohol use. Data were collected at 1, 3, 6, and 12-months post intervention. There were no significant group differences in alcohol use outcomes over time. There was a significant but small reduction in condomless anal sex under the influence of alcohol and drugs at 12 months compared to 3 months among participants in the intervention group relative to the control group (incidence rate ratio=0.15, 95% CI 0.05-0.44). There were no significant group differences in sexual risk and PrEP engagement. The relative lack of effect of the intervention on alcohol misuse and associated risks may reflect a need for cultural tailoring and more dynamic and engaging components in the intervention.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ; ;
04/25/2023

Mixed methods evaluation of vaping and tobacco product use prevention interventions among youth in the Florida 4-H program

Bteddini DS, LeLaurin JH, Chi X, Hall JM, Theis RP, Gurka MJ, Lee J-H, Mobley EM, Khalil GE, Polansky CJ, Kellner AM, Fahnlander AM, Kelder SH, Fiellin LE, Gutter MS, Shenkman EA, & Salloum RG. (2023). Mixed methods evaluation of vaping and tobacco product use prevention interventions among youth in the Florida 4-H program. Addictive Behaviors, 141, 107637–107637. https://doi.org/10.1016/j.addbeh.2023.107637

This pilot study tested the delivery feasibility and outcomes of two programs, CATCH My Breath and smokeSCREEN, among youth in rural settings in Florida. Eighty-two youth participants (aged 11-17) were recruited from rural youth clubs in Florida and randomly assigned to one of three arms: CATCH My Breath, smokeSCREEN, and control (receiving educational flyers). CATCH My Breath and smokescreen are prevention interventions that focus on promoting healthy behaviors and increasing awareness of vaping and tobacco use. CATCH My Breath consists of four interactive modules on vaping prevention delivered over Zoom group sessions weekly for four w eeks. smokeSCREEN is a smoking and vaping prevention video game and was delivered individually to adolescents. Participants from both intervention arms were also invited join group Zoom discussions weekly for four weeks to discuss the game. Out of the participants in the intervention arms, 83.7% attended the majority of group Zoom sessions. After the intervention, CATCH My Breath participants showed significant improvement in tobacco knowledge (post-pre=3.3, p<.01) and risk perceptions for other flavored tobacco products (post-pre=1.6, p<.05). Post intervention, smokeSCREEN participants demonstrated significantly improved tobacco knowledge (post-pre=5.0, p<.01), e-cigarettes knowledge (post-pre=2.8, p<.01) and risk perception towards e-cigarettes (post-pre=2.8, p<.05). In the control group, only risk perception to cigarettes significantly changed (post-pre=1.1, p<.01). Findings show positive feasibility and immediate positive impact of these digital intervention games augmented by virtual group sessions. Future work is needed to differentiate the impact of digital games from that of virtual group discussions. Investigations with larger samples and a longer follow-up period to evaluate longer-term impact are needed.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ; ; ;
03/13/2023

Supporting people affected by problematic alcohol, substance use and other behaviours under pandemic conditions: A pragmatic evaluation of how SMART recovery Australia responded to COVID-19

Beck AK, Larance B, Baker AL, Deane FP, Manning V, Hides L, & Kelly PJ. (2023). Supporting people affected by problematic alcohol, substance use and other behaviours under pandemic conditions: A pragmatic evaluation of how SMART recovery Australia responded to COVID-19. Addictive Behaviors, 139, 107577–107577. https://doi.org/10.1016/j.addbeh.2022.107577

Researchers conducted a pragmatic evaluation of the scaling up of online, group-based addiction services during the COVID-19 pandemic. The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) was applied to analyze the SMART Recovery Australia (SRAU) online program for 12 months and at 2-month follow-up. SRAU is a mutual-help program based on a four-point curriculum (building motivation, coping with urges, problem solving, and lifestyle balance) and led by a trained facilitator via Zoom. Before the pandemic, there were only 6 online groups and SRAU aimed to expand this service during the pandemic by developing 100 groups. Data was collected by online self-report participant surveys, Zoom data analytics on meetings and attendees, and administrative logs of third-party providers. During the 12-month evaluation period, the number of online groups increased from 6 to 132. A total of 2786 meetings were delivered with 41,752 attendees. Participant survey results (N=1052) showed that 91% of participants were highly engaged and 92% had positive experiences with the online group meetings. Further, 91% of participants who had experienced the in-person format rated their online experience as equivalent or better. However, 21% reported technical difficulties. The average number of meetings delivered and number of attendees per month were sustained at the two-month follow-up. Overall, SRAU achieved the goal of establishing at least 100 online mutual-help groups in response to the COVID-19 pandemic. Results support the acceptability and sustainability of delivering groups online for substance use behaviors.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ; ;
01/10/2023

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.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ; ;
11/29/2022

Systematic review of economic evaluations for internet- and mobile-based interventions for mental health problems

Kählke F, Buntrock C, Smit F, Ebert DD. Systematic review of economic evaluations for internet- and mobile-based interventions for mental health problems. npj Digit. Med. 5, 175 (2022). https://doi.org/10.1038/s41746-022-00702-w

A systematic review was conducted to summarize the cost-effectiveness of internet and mobile-based interventions (IMIs) for mental health disorders and symptoms. This review also assessed methodological quality of included studies. The literature search identified studies of psychological interventions provided in an online setting to treat mental health disorders or any type of psychological symptoms regardless of participant age. Studies had to be randomized controlled trials that included a full economic evaluation. A total of 4,044 articles were identified, of which 36 articles met eligibility criteria. Sixty-five economic evaluations were conducted. The most commonly targeted mental health problem was major depressive disorder or depressive symptoms, followed by anxiety. Cost-effectiveness was determined using the threshold of at or below £30,000 per quality-adjusted life year (QALY) gained. Overall, the majority of economic evaluations of IMIs (n=56) presented evidence of cost-effectiveness. Guided IMIs (i.e., interventions that include support by a provider via email, chat, or automated feedback delivery) were likely to be cost-effective in depression and anxiety studies. Methodological quality of the cost-effectiveness analyses was mostly evaluated as good, however a few studies showed high risk of bias. Researchers found high heterogeneity across studies due to factors such as costing methods, design, comparators, and outcomes used. Overall, these findings suggest the cost-effectiveness of IMIs and include new evidence in under-researched disorders such as obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), stress, and sleep. Future research is needed to continue to target underrepresented disorders (e.g., panic disorder and specific phobias), as well as research in low- and middle-income countries.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ; ;