Preferences Regarding Information Strategies for Digital Mental Health Interventions Among Medical Students: Discrete Choice Experiment (Preprint)

Abstract

BACKGROUND The impact of digital mental health interventions (DMHIs) in the prevention and therapy of common mental disorders (CMDs) on healthcare has been debated in view of the currently low utilization rates. Potential reasons may include lacking awareness or familiarity with DMHIs as well as concerns about their quality, trusted sources and the evidence base, which calls for context-sensitive information campaigns. Medical students represent a suitable user case to develop information strategies as they were previously shown to have a comparatively high risk for CMDs themselves. Further, in their role as future physicians, they will prescribe DMHIs. Yet, little is known about medical students´ information preferences regarding DMHIs. OBJECTIVE The aim of the study was to explore information preferences for DMHIs among medical students in Germany for personal use. METHODS A discrete choice experiment (DCE) was conducted, which was developed using an exploratory sequential mixed-methods research approach. Five attributes (i.e., source, delivery mode, timing, recommendation, and quality criteria) each with 3-4 levels were identified using formative research. Twenty-four choice sets each with two alternatives were divided into three versions of the DCE, each with eight different choice sets, to which participants were randomly assigned. DCE data were analyzed employing logistic regression models to estimate preference weights and relative importance of attributes. To identify subgroups of students varying in information preferences, we additionally performed a latent class analysis (LCA). RESULTS Out of N=309 eligible participants data, n=231 were included in the main analysis due to reliable data (70.1% women, age: M=24.1 years, SD=4.0 years). Overall, medical students preferred to receive information about DMHIs from the student council and favored being informed via social media early (i.e., during their pre-clinic phase or their freshman week). Recommendations from other students or health professionals were preferred over recommendations from other users or no recommendation at all. Information about the scientific evidence base were the preferred quality criterion. Overall, timing of the provision of information was the most relevant attribute (32.6%). LCA revealed two distinct subgroups. Class 1 preferred to receive extensive information about DMHIs in a seminar, while class 2 wanted to be informed digitally (via e-mail or social media) and as early as possible in their studies. CONCLUSIONS Medical students have specific needs and preferences regarding DMHI information. Timing of information (early in medical education) was considered more important than information source or delivery mode, which should be prioritized by decision makers (e.g., members of faculties of medicine, university, ministry of education). This DCE provides novel insights into what is important when informing medical students about DMHIs and how complex and potentially well-accepted information strategies can be deduced by considering the preferences of the target group. CLINICALTRIAL The DCE was pre-registered at the Open Science Framework (OSF) in October 2022: https://osf.io/2s9u8.