JMIR Publications

ABSTRACT

Background:

The prevalence of depression is high and has been stable despite the increased treatment research and dissemination. There are many barriers to seeking traditional mental health services such as in person cognitive behavior therapy (CBT) or interpersonal therapy, which could be mitigated by using web-based prevention methods. Web-based methods to prevent depression have shown to be effective in the literature.

Objective:

The objective of this study was to understand what would motivate individuals to use web-based mental health programs and the perceived effectiveness of the programs in preventing depression in high risk populations.

Methods:

Participants were recruited from two randomized controlled trials (RCT). In one RCT, working male participants were randomly assigned one of three groups: Control (access to general depression information from BroMatters website); Intervention 1 (access to BroMatters and the BroHealth web-based depression prevention program); and Intervention 2 (access to BroHealth, BroMatters, and telephone sessions with a life-coach). In the other RCT, men and women 18 years or older were assigned to the control group or intervention group (access to the HardHat web-based program). Participants for the current qualitative study were recruited from any of the intervention groups in either of the two studies. Two groups were recruited from the BroMatters RCT (n = 61) and a third group from the HardHat RCT (n = 16). Semi-structured telephone interviews were conducted, audio recorded and transcribed verbatim. Content analysis was used to analyse the interviews from the 77 study participants.

Results:

Awareness, medium/ functionality, content, and coaches were all categories surrounding the perceived effectiveness of the web-based mental health programs. Motivators to use the programs included categories such as providing reminders or incentives, promotion of the programs, providing appropriate medium and functionality, and appropriate content/ perceived need. Some participants were either unsure about what would motivate them to use the programs or believed that there is no way to motivate use.

Conclusions:

Conflicting evidence was obtained regarding the perceived effectiveness of aspects of the content and functionality of web-based programs. In general, web-based mental health programs were perceived to help increase mental health awareness, especially when a live coach was involved as part of the web resource. However, results also revealed that it is difficult to motivate people to begin using web-based mental health programs and some participants even thought it was impossible to do so. Strategies that may motivate use of such programs include: effectively promoting the program, providing incentives and reminders, and improving how the program functions. Perceived personal need was also found to motivate use of web-based mental health programs.