Pilot Implementation of Computerized Cognitive Behavioral Therapy in a University Health Setting

Santucci, Lauren C.; McHugh, R. Kathryn; Elkins, R. Meredith; Schechter, Brandon M.; Ross, Margaret S.; Landa, Carrie; Eisen, Susan V.; Barlow, David H.

doi:10.1007/s10488-013-0488-2

Cited by 21 publications

(39 citation statements)

References 24 publications

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“…One study had 7 arms assessing the effect of different timing and content of strategies [ 44 ]. The remaining 4 studies were RCTs with 2 arms [ 38 , 45 - 47 ].…”

Section: Resultsmentioning

confidence: 99%

“…All of the studies were conducted online and some studies specifically mentioned the location of the participants: the Netherlands [ 44 , 46 ], Australia [ 36 , 43 , 47 ], the United States [ 11 , 35 , 37 , 38 , 41 ], and Switzerland and Germany [ 40 ]. Six of the studies aimed to evaluate the effect of adding the strategy on the effectiveness of the DIs [ 35 , 39 - 42 , 47 ], 3 of the studies aimed to evaluate the effect of the technology-based strategies on promoting engagement with the DI [ 37 , 45 , 46 ], and 2 studies aimed to evaluate the effect of the strategy on digital intervention outcomes and engagement [ 36 , 43 ]. One study evaluated the effect of different timing and content of strategies on engagement [ 44 ], one study evaluated the effect of adding online peer coaching on increasing participation with a DI [ 38 ], and the final study explored the qualities of engagement with a DI [ 11 ].…”

Section: Resultsmentioning

confidence: 99%

“…The digital interventions targeted different health behaviors and conditions. Eight DIs were designed to target different mental health conditions, including social phobia [ 39 , 47 ], depression [ 35 , 36 , 40 , 45 ], anxiety [ 45 ], and bipolar disorder [ 38 , 43 ]. The rest of the DIs promoted a variety of health behaviors, including smoking cessation (n=4), decreasing alcohol consumption (n=2), self-monitoring of healthy behaviors (n=1), physical activity (n=2), and healthy diet (n=3) [ 11 , 37 , 41 , 42 , 44 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…Strategies were used either for the duration of the DI [ 11 , 36 , 38 - 40 , 42 , 43 , 45 , 47 ] or at specific times [ 35 , 37 , 41 , 44 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…Most of the studies reported using engagement strategies on a regular basis. Six studies used the strategy at least once per week [ 36 , 37 , 39 , 40 , 45 , 47 ], one used it for 2 weeks [ 41 ], one used it three times [ 35 ], and one used it to encourage users to complete sessions with up to 4 email prompts for each session [ 11 ]. Three studies reported variable frequencies [ 38 , 42 , 43 ] and 2 studies used a strategy once only [ 44 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

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The Effectiveness of Prompts to Promote Engagement With Digital Interventions: A Systematic Review

Alkhaldi¹,

Hamilton²,

Lau³

et al. 2016

J Med Internet Res

262

206

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BackgroundDigital interventions have been effective in improving numerous health outcomes and health behaviors; furthermore, they are increasingly being used in different health care areas, including self-management of long-term conditions, mental health, and health promotion. The full potential of digital interventions is hindered by a lack of user engagement. There is an urgent need to develop effective strategies that can promote users’ engagement with digital interventions. One potential method is the use of technology-based reminders or prompts.ObjectiveTo evaluate the effectiveness of technology-based strategies for promoting engagement with digital interventions.MethodsCochrane Collaboration guidelines on systematic review methodology were followed. The search strategy was executed across 7 electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science, the Education Resources Information Center (ERIC), PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Databases were searched from inception to September 13, 2013, with no language or publication type restrictions, using three concepts: randomized controlled trials, digital interventions, and engagement. Gray literature and reference lists of included studies were also searched. Titles and abstracts were independently screened by 2 authors, then the full texts of potentially eligible papers were obtained and double-screened. Data from eligible papers were extracted by one author and checked for accuracy by another author. Bias was assessed using the Cochrane risk of bias assessment tool. Narrative synthesis was performed on all included studies and, where appropriate, data were pooled using meta-analysis. All findings were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.ResultsA total of 14 studies were included in the review with 8774 participants. Of the 14 studies, 9 had sufficient data to be included in the meta-analyses. The meta-analyses suggested that technology-based strategies can potentially promote engagement compared to no strategy for dichotomous outcomes (relative risk [RR] 1.27, 95% CI 1.01-1.60, I2=71%), but due to considerable heterogeneity and the small sample sizes in most studies, this result should be treated with caution. No studies reported adverse or economic outcomes. Only one study with a small sample size compared different characteristics; the study found that strategies promoting new digital intervention content and those sent to users shortly after they started using the digital intervention were more likely to engage users.ConclusionsOverall, studies reported borderline positive effects of technology-based strategies on engagement compared to no strategy. However, the results have to be interpreted with caution. More research is needed to replicate findings and understand which characteristics of the strategies are effective in promoting engagement and how cost-effective they are.

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“…One study had 7 arms assessing the effect of different timing and content of strategies [ 44 ]. The remaining 4 studies were RCTs with 2 arms [ 38 , 45 - 47 ].…”

Section: Resultsmentioning

confidence: 99%