Currently accepted at: JMIR Mental Health
Date Submitted: Jan 25, 2019
Open Peer Review Period: Jan 28, 2019 - Feb 14, 2019
Date Accepted: Feb 22, 2019
(closed for review but you can still tweet)
If You Build It, Will They Come? A Mixed-Methods Study of Knowledge Translation Strategies to Support Bipolar Disorder Self-Management
Self-management is increasingly recognised as an important method through which individuals with bipolar disorder (BD) may cope with symptoms and improve quality of life (QoL). Digital health technologies have strong potential as a method to support application of evidence-informed self-management strategies in BD. Little is known, however, about how to most effectively maximise user engagement with digital platforms.
The aims of the present study were to a) create an innovative online Bipolar Wellness Centre, and b) to conduct a mixed-methods (i.e., quantitative and qualitative) evaluation to assess the impact of different sorts of engagement (i.e., ‘knowledge translation’ [KT]) for self-management strategies for BD.
The project was implemented in two phases. In phase one, Community Based Participatory Research and user-centered design methods were used to develop a website (Bipolar Wellness Centre) housing evidence-informed tools and strategies for self-management in BD. In phase two, a mixed-methods evaluation was conducted on the impact of and engagement with four KT strategies (online webinars, online videos, online one-to-one ‘Living Library’ peer support, and in-person workshops,). Quantitative assessments occurred at two time points: pre-intervention and three weeks post-intervention. Purposive sampling was used to recruit a sub-sample of participants for the qualitative interviews, ensuring each KT modality was represented, and interviews occurred approximately three weeks post-intervention.
Ninety-four participants were included in the quantitative analysis. Responses to evaluative questions about engagement were broadly positive. When averaged across the four KT strategies, significant improvements were observed on the Bipolar Recovery Questionnaire (p = .018) and QoL.BD (p = .005). Non-significant improvements in positive affect and negative affect were also observed. The sole difference that emerged between KT strategies related to the Chronic Disease Self-Efficacy measure, which decreased after participation in the webinar and video arms, but increased after the Living Library and workshop arms. A sub-sample of 43 participants were included in the qualitative analyses, with the majority of participants describing positive experiences with the four KT strategies; peer contact was emphasised as a benefit across all strategies. Infrequent negative experiences were reported in relation to the webinar and video strategies, and included technical difficulties, the academic tone of webinars, and feeling unable to relate to the actor in the videos.
The present study adds to a growing literature that suggests digital health technologies can provide effective support for self-management for people with BD. The finding that KT strategies could differentially impact chronic disease self-efficacy (hypothesised as being a product of differences in degree of peer contact) warrants further exploration. Implications of the findings for the development of evidence-informed apps for BD are discussed.
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