Engagement and outcomes for a computerised cognitive-behavioural therapy intervention for anxiety and depression in African Americans

Jonassaint, Charles R.; Gibbs, Patrice; Belnap, Bea Herbeck; Karp, Jordan F.; Abebe, Kaleab Z.; Rollman, Bruce L.

doi:10.1192/bjpo.bp.116.003657

Cited by 23 publications

(19 citation statements)

References 27 publications

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“…Psychopathology was included to account for current need for mental health treatment. Race was included due to research showing that African Americans are less likely to initiate iCBT treatment than Whites ( 42 ) and U.S. national data demonstrating that White and multiracial individuals seek mental health treatment at higher rates than other racial groups ( 43 ). Accordingly, this variable was dummy coded to compare racial identities associated with higher and lower levels of mental health service utilization (White, multiracial vs. Black/African-American, Hispanic/Latinx, Asian).…”

Section: Methodsmentioning

confidence: 99%

Improving Acceptability and Uptake Behavior for Internet-Based Cognitive-Behavioral Therapy

Molloy

Ellis

et al. 2021

Front. Digit. Health

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Internet-based cognitive behavioral therapy (iCBT) programs have the potential to improve access to mental healthcare, but they are not viewed as acceptable nor widely utilized by the general public. This study tested whether two acceptance-facilitating interventions improved acceptability and uptake-related behavior for therapist assisted and self-guided iCBT. Participants were randomly assigned to read a treatment rationale for iCBT (vs. a brief definition) and to receive a small financial incentive (or not) for seeking more information about evidence-based iCBT programs. Participants (N = 662) were a diverse group recruited from a University participant pool and the surrounding community. Participants completed standardized measures of attitudes toward and outcome expectancy for iCBT and a single question about willingness to use it and were given the opportunity to get information about accessing evidence-based iCBT programs. A series of MANCOVAs showed small, positive effects of the treatment rationale on attitudes and outcome expectancy for both self-guided and therapist-assisted iCBT, but not for willingness to use it. A hierarchical logistic regression model found no effect of the treatment rationale or financial incentive on whether participants sought additional information about how to access iCBT, although psychopathology symptoms and identifying as White or multiracial were positively associated with information-seeking. Inconsistent with past research, participants rated therapist-assisted and self-guided iCBT as equally acceptable. Participants recruited from the community reported greater willingness to use iCBT than University students. These results underscore the urgent need for further research toward improving the acceptability and uptake of iCBT so that it may better fulfill its potential to fill the gap in unmet mental health need.

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Section: Methodsmentioning

confidence: 99%

Improving Acceptability and Uptake Behavior for Internet-Based Cognitive-Behavioral Therapy

Molloy

Ellis

et al. 2021

Front. Digit. Health

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“…These analyses were hypothesis driven and based on our previously published findings. 14 As a secondary analysis, we performed intensity-adjusted analyses in order to assess "how much" of the cCBT intervention resulted in improvements on outcomes. This was operationalized by fitting the same linear mixed models mentioned above but after replacing the study arm covariate with the number of cCBT sessions (ranging from 0 to 8).…”

Section: Statistical Analysesmentioning

confidence: 99%

Racial Differences in the Effectiveness of Internet-Delivered Mental Health Care

et al. 2019

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BACKGROUND: Computerized cognitive behavioral therapy (cCBT) can improve mental health outcomes in White populations; however, it is unknown whether racial and ethnic minority populations receive clinical benefits from cCBT. OBJECTIVE: To study race differences in the impact of cCBT use on mental health outcomes among White and African American primary care patients. DESIGN: Secondary analysis of a three-arm randomized controlled clinical trial. PARTICIPANTS: Primary care physicians (PCPs) referred 2,884 patients aged 18-75; 954 met eligibility criteria (including elevated mood and/or anxiety symptoms indicated as a score ≥ 10 on Patient Health Questionnaire or Generalized Anxiety Disorder scale); 704 were randomized in 3:3:1 ratio to receive either (1) the cCBT program (cCBT-only), (2) cCBT plus access to an Internet Support Group (cCBT+ISG), or (3) their PCP's usual care (UC). After exclusions, this study analyzed 689 patients: 590 receiving cCBT, in the combined cCBT-only and cCBT+ISG groups (91 African American, 499 White), and 99 receiving UC (22 African American, 77 White). INTERVENTION(S): We used the Beating the Blues cCBT program that consisted of eight 50-min Internet-delivered interactive sessions and "homework" assignments to complete between weekly sessions. College graduatelevel care coaches provided six months of remote support. MAIN MEASURE(S): After prior analyses demonstrated no effect of the ISG program, we combined the cCBT-only and cCBT+ISG groups (cCBT) to compare to UC at 6-month follow-up. Controlling for sociodemographic factors, baseline symptoms, and treatment arm, we examined race differences for impact of cCBT versus UC on the mental health-related quality-of-life (Short-form 12 Health Survey), and Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety, and depression. RESULTS: Compared to UC, cCBT had no effect on quality of life (d = 0.10; p = 0.40), depression (d = − 0.19; p = 0.10), or anxiety (d = − 0.16; p = 0.18) for Whites. However, for African American patients, cCBT was associated with significant 6-month decrease in depression (d = − 0.47, p < 0.01) and anxiety scores (d = − 0.54, p < 0.01). CONCLUSIONS: cCBT may be an efficient and scalable first step to eliminating disparities in mental health care. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT01482806. https://www.clinicaltrials.gov/ct2/ show/NCT01482806?term=rollman&rank=4

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“…According to Berger et al (2016) one way to increase access to evidence-based psychological treatment in primary care is to provide internet-or computer-based cognitive-behavioural treatment (iCBT/cCBT). iCBT or cCBT is a low-intensity non-pharmacological intervention that includes internet-delivered psychological therapies or any downloadable software, online multimedia programme or smartphone application designed to teach users the basic concepts of cognitive behavioural therapy and the skills for managing their mental health symptoms (Jonassaint et al, 2017;Pennant et al, 2015;Marks et al, 2007). Despite the variety of iCBT interventions available on the global market, the most widely known internet-based psychotherapies used so far include the Beating the Blues, MoodGYM and Colour Your Life programmes.…”

Section: Final)mentioning

confidence: 99%

“…Despite the variety of iCBT interventions available on the global market, the most widely known internet-based psychotherapies used so far include the Beating the Blues, MoodGYM and Colour Your Life programmes. iCBT has the potential to increase access to high-quality mental health treatment for minority populations Jonassaint et al, 2017). Large-scale randomized control trials (RCTs) have investigated the high level of adherence and significant outcomes in reducing symptoms of depression considering guided therapist-assisted computerized cognitive behavioural therapies in routine clinical practice (Jonassaint et al, 2017;Richards & Richardson, 2012;Perini et al, 2009;Ruwaard et al, 2009;Andersson et al, 2005;Berger et al, 2011;Johansson et al, 2012;Knowles et al, 2014;Andersson & Cuijpers, 2009;Kay-Lambkin et al, 2011).…”

Section: Final)mentioning

confidence: 99%

A Review Article on Internet-based Psychological Interventions in Primary Care. What is the Global Experience? How Reliable are Results from RCTs? Lessons Learned from the European, US and Australian Case Studies

Sogomonjan

Kerikmäe

Ööpik

2018

Baltic Journal of European Studies

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In the context of the EU’s Digital Single Market (eHealth) Strategy, the deployment of digital tools for patients’ empowerment and person-centred care is of high demand and importance. Shifting from treatment to health promotion and disease prevention, a variety of internet-based cognitive behavioural therapy programmes have been proven to be effective for managing common mental health disorders in secondary care even hough the effectiveness and the clinical use of internet-based cognitive behavioural therapy programmes alone in primary care have not been approved yet. Additionally, such interventions are neither included in the international clinical guidelines for treating common mental health disorders nor regulated by Member States as a healthcare service. Despite that, the UK National Health Service and the Swedish National Board of Health and Welfare endorse the use of internet-based cognitive behavioural therapy as a first treatment option. The aim of this research is to investigate the global experience of internet-based cognitive behavioural therapy programmes in controlled and real-life conditions in general practice and to evaluate the reliability of the results and concomitantly their compliance with the European Commission’s eHealth Strategy. A systematic review of quantitative studies was conducted from January 2007 to December 2017. The results indicated that unsupported internet-based cognitive behavioural therapy programmes alone are less effective than combined therapy options for treatment purposes, if no additional therapy is prescribed. Guided internet-based cognitive behavioural therapy may supplement traditional treatment methods resulting in improving the control of mental disorders, but are unable to demonstrate consistent quality or replace face-to-face therapy.

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Engagement and outcomes for a computerised cognitive-behavioural therapy intervention for anxiety and depression in African Americans

Cited by 23 publications

References 27 publications

Improving Acceptability and Uptake Behavior for Internet-Based Cognitive-Behavioral Therapy

Improving Acceptability and Uptake Behavior for Internet-Based Cognitive-Behavioral Therapy

Racial Differences in the Effectiveness of Internet-Delivered Mental Health Care

A Review Article on Internet-based Psychological Interventions in Primary Care. What is the Global Experience? How Reliable are Results from RCTs? Lessons Learned from the European, US and Australian Case Studies

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