Accepted for/Published in: JMIR Formative Research
Date Submitted: Jul 15, 2020
Date Accepted: Oct 2, 2020
An engagement-facilitation intervention (EFI) for increasing uptake and adherence for self-guided e-mental health programs: Consumer-guided development
ABSTRACT
Background:
Self-guided online mental health programs are effective in treating and preventing mental health problems. However, current engagement with these programs in the community is suboptimal, and there is limited evidence indicating how to increase the use of existing evidence-based programs.
Objective:
To investigate the views of people with lived experience of depression and anxiety on factors influencing their engagement with self-guided online mental health (e-mental health) interventions and to use these perspectives to develop an engagement-facilitation intervention (EFI) to increase engagement (defined as both uptake and adherence) with these interventions.
Methods:
A total of 24 community members (female = 21; male = 3) with lived experience of depression and/or anxiety participated in one of four focus groups discussing: 1) factors influencing their engagement with self-guided e-mental health programs, and 2) the appearance, delivery mode, and functionality of content for the proposed EFI. A subsequent evaluation survey of the focus group participants (n = 14) was conducted to evaluate the resultant draft EFI. Data were thematically analysed using both inductive and deductive qualitative methods.
Results:
Participants suggested that the critical component of an EFI was information that would challenge personal barriers to engagement including receiving personalised symptom feedback, information regarding the program’s content/effectiveness and data security, and normalisation of using e-mental health programs (e.g., testimonials). Reminders, rewards, feedback about progress, and coaching were all mentioned as facilitating adherence.
Conclusions:
EFIs have potential to improve community uptake of e-mental health programs. They should focus on providing information on the content and effectiveness of e-mental health programs, and normalising their use. There is strong value in involving people with a lived experience in the design and development of EFIs to maximise their effectiveness.
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