Acceptability of internet-based interventions for depression in Indonesia

Arjadi, Retha; Nauta, Maaike; Bockting, Claudi

doi:10.1016/j.invent.2018.04.004

Cited by 30 publications

(29 citation statements)

References 33 publications

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“…Second, the severity of these symptoms was related to engagement with digital interventions. In needs assessment studies, participants were more willing to use DMHIs if their symptoms were more severe [ 38 , 53 , 62 , 71 , 81 , 82 ]. However, evaluation studies have shown that more severe symptoms hamper actual engagement with digital interventions [ 51 , 56 , 83 - 101 ].…”

Section: Resultsmentioning

confidence: 99%

“…Beliefs refer to preexisting beliefs the user has about mental health help-seeking [ 88 ], their need for help [ 51 , 105 - 107 ], the acknowledgment of having mental health needs [ 88 ], and using technology for mental health treatment [ 38 , 93 , 108 , 109 ]. For example, preexisting beliefs of needing help for mental health needs and having a positive perception about mental health help-seeking facilitated participants’ engagement with an intervention.…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2021

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Background Digital mental health interventions (DMHIs), which deliver mental health support via technologies such as mobile apps, can increase access to mental health support, and many studies have demonstrated their effectiveness in improving symptoms. However, user engagement varies, with regard to a user’s uptake and sustained interactions with these interventions. Objective This systematic review aims to identify common barriers and facilitators that influence user engagement with DMHIs. Methods A systematic search was conducted in the SCOPUS, PubMed, PsycINFO, Web of Science, and Cochrane Library databases. Empirical studies that report qualitative and/or quantitative data were included. Results A total of 208 articles met the inclusion criteria. The included articles used a variety of methodologies, including interviews, surveys, focus groups, workshops, field studies, and analysis of user reviews. Factors extracted for coding were related to the end user, the program or content offered by the intervention, and the technology and implementation environment. Common barriers included severe mental health issues that hampered engagement, technical issues, and a lack of personalization. Common facilitators were social connectedness facilitated by the intervention, increased insight into health, and a feeling of being in control of one’s own health. Conclusions Although previous research suggests that DMHIs can be useful in supporting mental health, contextual factors are important determinants of whether users actually engage with these interventions. The factors identified in this review can provide guidance when evaluating DMHIs to help explain and understand user engagement and can inform the design and development of new digital interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

et al. 2021

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“…An anticipated limitation of our RCT is the self-selected sample. It is possible that people who are more open towards innovative technology in general 61 and who received support prior to the loss 32 are more likely to sign up for this study, limiting the generalisability of findings emerging from this study. Due to the absence of an active control group (eg, face-to-face CBT), we are not able to test the effects of online CBT compared with an alternative treatment.…”

Section: Discussionmentioning

confidence: 96%

Online cognitive–behavioural therapy for traumatically bereaved people: study protocol for a randomised waitlist-controlled trial

et al. 2020

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IntroductionThe traumatic death of a loved one, such as death due to a traffic accident, can precipitate persistent complex bereavement disorder (PCBD) and comorbid post-traumatic stress disorder (PTSD) and depression. Waitlist-controlled trials have shown that grief-specific cognitive–behavioural therapy (CBT) is an effective treatment for such mental health problems. This is the first study that will examine the effectiveness of online CBT (vs waitlist controls) in a sample exclusively comprised of people bereaved by a traumatic death. Our primary hypothesis is that people allocated to the online CBT condition will show larger reductions in PCBD, PTSD and depression symptom levels at post-treatment than people allocated to a waitlist. We further expect that reductions in symptom levels during treatment are associated with reductions of negative cognitions and avoidance behaviours and the experience of fewer accident-related stressors. Moreover, the effect of the quality of the therapeutic alliance on treatment effects and drop-out rates will be explored.Methods and analysisA two-arm (online CBT vs waiting list) open-label parallel randomised controlled trial will be conducted. Participants will complete questionnaires at pretreatment and 12 and 20 weeks after study enrolment. Eligible for participation are Dutch adults who lost a loved one at least 1 year earlier due to a traffic accident and report clinically relevant levels of PCBD, PTSD and/or depression. Multilevel modelling will be used.Ethics and disseminationEthics approval has been received by the Medical Ethics Review Board of the University Medical Center Groningen (METc UMCG: M20.252121). This study will provide new insights in the effectiveness of online CBT for traumatically bereaved people. If the treatment is demonstrated to be effective, it will be made publicly accessible. Findings will be disseminated among lay people (eg, through newsletters and media performances), our collaborators (eg, through presentations at support organisations), and clinicians and researchers (eg, through conference presentations and scientific journal articles).Trial registration numberNL7497.

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“…Fourth, in Indonesia, internet-based interventions for depression and anxiety are currently not available for either university students or for the general population. The first randomized control trial on internet-based behavioral activation for adult depression in Indonesia [ 25 , 26 ] showed promising results with lower symptoms at posttest assessment in favor of the intervention with minimum support by a lay counselor who did not have professional education and qualifications in mental health care. However, the intervention was tested in the general population, and thus, it remains unclear whether these interventions are also effective in university students with elevated symptoms of depression and anxiety.…”

Section: Introductionmentioning

confidence: 99%

Transdiagnostic Internet Intervention for Indonesian University Students With Depression and Anxiety: Evaluation of Feasibility and Acceptability

Rahmadiana¹,

Karyotaki²,

Schulte³

et al. 2021

JMIR Ment Health

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Background University students with depression and anxiety do not easily receive or seek treatment; therefore, internet-based interventions have been suggested to be a promising way to improve treatment accessibility and availability. However, it has not been examined whether a guided, culturally adapted, transdiagnostic, internet-based intervention is effective for treating symptoms of depression, anxiety, or both among university students in Indonesia. Objective This study aims to investigate the feasibility (acceptability and satisfaction, usability, and uptake) of a guided, culturally adapted, transdiagnostic, internet-based intervention among university students with symptoms of depression, anxiety, or both in Indonesia. Methods Students from Universitas Gadjah Mada, Yogyakarta, Indonesia, were screened for symptoms of depression, anxiety, or both, and filled online informed consent, demographic questionnaires, and a quality of life measure at pretreatment assessment (T0). Subsequently, the participants started the intervention. Seven weeks after T0, the primary outcomes of this feasibility study were analyzed at posttreatment assessment (T1) using the 8-item Client Satisfaction Questionnaire (CSQ-8) and the System Usability Scale (SUS). Mean and SDs for the CSQ-8 and SUS were calculated to examine feasibility. Within-group secondary outcomes (depression, anxiety, and quality of life) were inspected for outliers and normal distribution. Paired-sample t tests were used to investigate differences between time points of secondary outcomes. A mixed-method approach of quantitative and qualitative analyses was adopted. Both the primary and secondary outcomes were additionally explored with an individual semistructured interview and synthesized descriptively. Results A total of 50 participants completed the intervention. We found a moderate to high level of satisfaction and acceptability, a slightly below-average level of desirable usability (≥70), and an adherence rate of 52% which was higher than expected given the novelty of the intervention. Results for the secondary outcomes indicated a decrease in depression and anxiety. For depression, the overall mean difference between the 2 time points for depression was 3.92 (95% CI 2.75-5.1; Hedges g 1.15; P<.001). For anxiety, the overall mean difference between the 2 time points was 3.34 (95% CI 2.06-4.61; Hedges g 1.02; P<.001). Further, a moderate effect in improving quality of life was found (g=0.50). Overall, participants were positive about the online intervention and ECoaches (online guidance), and they found the intervention to be culturally appropriate. Conclusions A culturally adapted, transdiagnostic, internet-based intervention appears to be acceptable and feasible for reducing symptoms of depression, anxiety, or both, and increasing quality of life in university students in Indonesia. Future studies should include a randomized controlled trial to assess the effectiveness of such interventions as they may supplement existing counseling services in universities, reduce the treatment costs, and maximize treatment accessibility in low-resourced settings. International Registered Report Identifier (IRRID) RR2-10.1016/j.invent.2018.11.002

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Acceptability of internet-based interventions for depression in Indonesia

Cited by 30 publications

References 33 publications

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

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

Online cognitive–behavioural therapy for traumatically bereaved people: study protocol for a randomised waitlist-controlled trial

Transdiagnostic Internet Intervention for Indonesian University Students With Depression and Anxiety: Evaluation of Feasibility and Acceptability

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