Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 7, 2020
Date Accepted: Aug 3, 2020
The influence of three modes of human support (automated emails, short message service and videoconferencing) on attrition and adherence to a Web- and mobile app-based mental health promotion intervention for a nonclinical cohort: randomized comparative study.
ABSTRACT
Background:
The escalating prevalence of mental health disorders necessitates a greater focus on mental health promotion for nonclinical cohorts. However, knowledge is scant regarding both the influence of human support on adherence and participant preferences for support when applying Web- and mobile app-based mental health promotion interventions amongst nonclinical groups.
Objective:
This study compared the influence of three modes of human support on adherence to a Web- and mobile app-based mental health promotion intervention for a nonclinical cohort. It evaluated user preferences for human support and assessed whether adherence and outcomes were enhanced when participants received their preferred mode of human support.
Methods:
Subjects participated in a 10-week, digitally-delivered mental health promotion intervention and were randomized into three groups, differentiated by support mode: Group 1 (n=201), standard –automated emails (S); Group 2 (n=202), standard plus personalized short message service (S+pSMS); Group 3 (n=202), standard plus weekly videoconferencing support (S+VCS). Adherence to the intervention was measured by the number of video lessons viewed, points achieved for weekly experiential challenge activities and the total number of weeks that participants recorded a score for challenges. In the postquestionnaire, participants ranked their preferred human support mode from 1 to 4 (S, S+pSMS, S+VCS, S+pSMS & VCS combined) and stratified analysis was conducted for those who received their first preference. A prequestionnaire and postquestionnaire assessed wellbeing measures (ie, mental health, vitality, depression, anxiety, stress, life satisfaction, and flourishing).
Results:
A total of 320 out of 458 (69.9%) registered participants (S, n=103; S+pSMS, n=114; S+VCS, n=103) completed pre and postquestionnaires. No significant between-group differences were observed in adherence, as measured by mean number of videos watched (P=.42), mean challenge scores (P=.71) or the number of weeks that scores were logged (P=.66). Fifty-six participants (17.5%, 56/320) received their first preference in human support (S, n=22; S+pSMS, n=26; S+VCS, n=8). No differences were observed, between those who received their first preference and those who did not, for video adherence (P=.91), challenge score adherence (P=.27) or any wellbeing measures: mental health (P=.86), vitality (P=.98), depression (P=.09), anxiety (P=.64), stress (P=.55), life satisfaction (P=.50) and flourishing (P=.47).
Conclusions:
The mode of human support did not impact adherence to the Web and mobile app-based mental health promotion intervention among the nonclinical cohort. Receiving preferred support mode did not result in greater adherence or better outcomes. Clinical Trial: Australian New Zealand Clinical Trials Registry (ANZCTR): 12619001009101; http://www.anzctr.org.au/ACTRN12619001009101.aspx
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