Accepted for/Published in: JMIR Formative Research
Date Submitted: Apr 25, 2022
Date Accepted: Jun 8, 2022
Single-Session Interventions Embedded Within Tumblr: A Test of Acceptability and Utility
ABSTRACT
Background:
Existing mental health treatments are insufficient for addressing mental health needs at scale, particularly for teenagers; many teens now seek mental health information and support online. Single-session interventions (SSIs) may be particularly well-suited for dissemination as embedded, online support options that are easily-accessible within popular social platforms.
Objective:
Evaluate the acceptability, usability, and effectiveness of three, 5 to 8-minute SSIs (ABC Project, Project SAVE, and REFRAME)—embedded as Koko “minicourses” on Tumblr—to improve three key mental health outcomes: hopelessness, self-hate, and desire to stop self-harm behavior.
Methods:
Qualitative (i.e., written text responses) and quantitative data (i.e., star ratings, SSI completion rates) evaluated acceptability and usability of all three SSIs. Paired t-tests assessed changes in hopelessness, self-hate, and desire to stop future self-harm, from pre- to post-SSI. Where demographic information was available, analyses were restricted to teenagers (13-19 years).
Results:
Between March 2021 and February 2022, the SSIs were completed 6,179 times. All three SSIs generated high star ratings (>4 out of 5 stars), with high completion rates (~25-57%) relative to real-world completion rates among other digital self-help interventions. Qualitative feedback indicated many people found the SSIs to be helpful. Paired t-tests detected significant pre-post reductions in hopelessness for those who completed ABC Project (P < .0001, dz = -.81, 95% CI [-.85, -.77]) and REFRAME (P < .0001, dz = -.88, 95% CI [-.96, -.80]). Self-hate significantly decreased (P < .0001, dz = -.67, 95% CI [-.74, -.60]), and desire to stop self-harm significantly increased (P < .0001, dz = .40, 95% CI [.33, .47]), from pre- to post-completion of Project SAVE. Results remained consistent across sensitivity analyses and after correcting for multiple tests.
Conclusions:
Very brief SSIs, when embedded within popular social platforms, are one promising and acceptable method for providing free, scalable, and potentially helpful mental health support online. Considering unique barriers to mental health treatment access that many teenagers face, this approach may be especially useful for teens without access to other mental health supports. Clinical Trial: N/A (not randomized trial research)
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