Perceived Effectiveness and Motivations for the Use of Web-Based Mental Health Programs: Qualitative Study

Eccles, Heidi; Nannarone, Molly; Lashewicz, Bonnie; Attridge, Mark; Marchand, Alain; Aiken, Alice; Ho, Kendall; Wang, JianLi

doi:10.2196/16961

Cited by 10 publications

(12 citation statements)

References 62 publications

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“…Other program functionality issues were also evident, highlighting the importance of a user-friendly design and interface. In addition, many HardHat participants did not receive the reminder emails that were sent, thus limiting their effectiveness [ 8 ]. The qualitative results also shed light on the importance of program personalization and balancing text and video and audio content, and these findings should be taken into consideration in the design of future digital mental health programs.…”

Section: Discussionmentioning

confidence: 99%

“…Web-based mental health programs can play an important role in the prevention of depression by increasing accessibility, confidentiality, and sustainability [ 6 ], and those based on cognitive behavioral therapy (CBT) have been shown to be effective at decreasing stress [ 7 ]. A recent study found that web-based mental health programs were perceived by users to increase both individual and societal mental health awareness [ 8 ]. However, the rates of use and adherence to such programs can be low and inconsistent, with completion rates in randomized controlled trials (RCTs) ranging from 14% to 90% [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Barriers to the Use of Web-Based Mental Health Programs for Preventing Depression: Qualitative Study

Eccles¹,

Nannarone²,

Lashewicz³

et al. 2021

JMIR Form Res

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Background Depression has a profound impact on population health. Although using web-based mental health programs to prevent depression has been found to be effective in decreasing depression incidence, there are obstacles preventing their use, as reflected by the low rates of use and adherence. Objective The aims of the study are to understand the barriers to using web-based mental health programs for the prevention of depression and the possible dangers or concerns regarding the use of such programs. Methods BroMatters and HardHat were two randomized controlled trials (RCTs) that evaluated the effectiveness of e–mental health programs for preventing workplace depression. In the BroMatters RCT, only working men who were at high risk of having a major depressive episode were included. The participants were assigned to either the control group or 1 of 2 intervention groups. The control participants had access to the general depression information on the BroMatters website. Intervention group 1 had access to BroMatters and BroHealth—the depression prevention program. Intervention group 2 had access to BroMatters and BroHealth along with weekly access to a qualified coach through telephone calls. The HardHat trial targeted both men and women at high risk of having a major depressive episode. The participants in the intervention group were given access to the HardHat depression prevention program (which included a web-based coach), whereas HardHat access was only granted to the control group once the study was completed. This qualitative study recruited male participants from the intervention groups of the two RCTs. A total of 2 groups of participants were recruited from the BroMatters study (after a baseline interview: n=41; 1 month after the RCT: n=20; 61/744, 8.2%), and 1 group was recruited from the HardHat RCT 1 month after the initial quantitative interview (9/103, 8.7%). Semistructured interviews were performed with the participants (70/847, 8.3%) and analyzed using content analysis. Results There were both personal and program-level barriers to program use. The three personal barriers included time, stress level, and the perception of depression prevention. Content, functionality, and dangers were the program-level barriers to the use of web-based mental health programs. Large amounts of text and functionality issues within the programs decreased participants’ engagement. The dangers associated with web-based mental health programs included privacy breaches and inadequate help for severe symptoms. Conclusions There are personal and program-level barriers to the use of web-based mental health programs. The stigmatization of help seeking for depression symptoms affects the time spent on the program, as does the public perception of depression. Certain barriers may be mitigated by program updates, whereas others may require a complete shift in the perception of depression prevention.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Barriers to the Use of Web-Based Mental Health Programs for Preventing Depression: Qualitative Study

Eccles¹,

Nannarone²,

Lashewicz³

et al. 2021

JMIR Form Res

Self Cite

View full text Add to dashboard Cite

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“…A study of 93 mobile mental health apps showed that the overall user retention is very low, with a 15-day retention rate of 3.9% and a 30-day retention rate of 3.3% [ 16 ]. Another study with 77 participants in two randomized controlled trials demonstrated how difficult it is to motivate people to begin using an e-mental health solution [ 17 ]. Any digital health trial will see a significant proportion of users drop out or cease using the app before completion.…”

Section: Introductionmentioning

confidence: 99%

Human-Centered Design Approaches in Digital Mental Health Interventions: Exploratory Mapping Review

Vial¹,

Boudhraâ²,

Dumont³

2022

JMIR Ment Health

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Background Digital mental health interventions have a great potential to alleviate mental illness and increase access to care. However, these technologies face significant challenges, especially in terms of user engagement and adoption. It has been suggested that this issue stems from a lack of user perspective in the development process; accordingly, several human-centered design approaches have been developed over the years to consider this important aspect. Yet, few human-centered design approaches to digital solutions exist in the field of mental health, and rarely are end users involved in their development. Objective The main objective of this literature review is to understand how human-centered design is considered in e-mental health intervention research. Methods An exploratory mapping review was conducted of mental health journals with the explicit scope of covering e-mental health technology. The human-centered design approaches reported and the core elements of design activity (ie, object, context, design process, and actors involved) were examined among the eligible studies. Results A total of 30 studies met the inclusion criteria, of which 22 mentioned using human-centered design approaches or specific design methods in the development of an e-mental health solution. Reported approaches were classified as participatory design (11/27, 41%), codesign (6/27, 22%), user-centered design (5/27, 19%), or a specific design method (5/27, 19%). Just over half (15/27, 56%) of the approaches mentioned were supported by references. End users were involved in each study to some extent but not necessarily in designing. About 27% (8/30) of all the included studies explicitly mentioned the presence of designers on their team. Conclusions Our results show that some attempts have indeed been made to integrate human-centered design approaches into digital mental health technology development. However, these attempts rely very little on designers and design research. Researchers from other domains and technology developers would be wise to learn the underpinnings of human-centered design methods before selecting one over another. Inviting designers for assistance when implementing a particular approach would also be beneficial. To further motivate interest in and use of human-centered design principles in the world of e-mental health, we make nine suggestions for better reporting of human-centered design approaches in future research.

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“…Preliminary research suggests music therapy via telehealth improves access to care and community music engagement [14,15]. Research also suggests web-based services are promising avenues to increase mental health awareness and treatment options [16,17]. For those practicing via mediated technologies, there are several freely available and fee-based platforms to choose from, including Doxy.me (Doxy.me LLC, Rochester, NY), Microsoft Teams (Microsoft Corporation, Redmond, WA), Skype for Business (Microsoft Corporation), WebEx (Webex by Cisco, Milpitas, CA), and Zoom (Zoom Video Communications Inc, San Jose, CA).…”

Section: Introductionmentioning

confidence: 99%

Copyright as a Barrier to Music Therapy Telehealth Interventions: Qualitative Interview Study

Reid¹,

Kresovich²

2021

JMIR Form Res

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Background Music therapy is a multifaceted discipline that harnesses the power of music to treat a wide range of patient populations. A therapist who plays music in a private room for a patient is not subject to copyright restrictions on public performances. However, in the wake of the COVID-19 pandemic, music therapy is no longer strictly confined to the face-to-face setting. This study explores music therapists’ perceptions of copyright law with respect to their ability to provide mediated services to their clients. Objective The objectives of our study were two-fold. The first was to investigate whether concerns about copyright law are hampering the diffusion of telehealth innovations, and the second was whether these concerns are causing music therapists to avoid therapeutically beneficial telehealth interventions. Methods Semistructured interviews were conducted with credentialed music therapists (n=18) in the United States between May 2020 and June 2020. With participants’ consent, we used video conference technology to record and transcribe the in-depth interviews. The median interview length was 45 (SD 16.37) minutes. This theoretically informed study employed thematic analysis of the interview data. Results The COVID-19 pandemic accelerated the adoption of telehealth interventions to facilitate therapy outside of private face-to-face environments: environments where music therapy practices are largely shielded from copyright infringement concerns. Five main themes emerged, including therapists’ uncertainty about permissible uses of music and therapists’ erring on the side of caution causing lost opportunities for care. Our interview data suggest music therapists have altered telehealth interventions in suboptimal ways to avoid copyright liability in a physically distanced environment. Conclusions Some music therapists “drag their feet” on offering therapeutically appropriate telehealth services to clients because of copyright concerns. Our findings suggest innovative mediated therapies were shied away from or abandoned. These findings offer a novel contribution to the public health literature by highlighting copyright law as an unexpected and unwelcome barrier to the diffusion of music therapy practices in technology-mediated settings.

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Perceived Effectiveness and Motivations for the Use of Web-Based Mental Health Programs: Qualitative Study

Cited by 10 publications

References 62 publications

Barriers to the Use of Web-Based Mental Health Programs for Preventing Depression: Qualitative Study

Barriers to the Use of Web-Based Mental Health Programs for Preventing Depression: Qualitative Study

Human-Centered Design Approaches in Digital Mental Health Interventions: Exploratory Mapping Review

Copyright as a Barrier to Music Therapy Telehealth Interventions: Qualitative Interview Study

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