Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 3, 2023
Date Accepted: Nov 12, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Non-use of guided internet-based cognitive behavioral therapy for alcohol use disorder: a qualitative study on barriers experienced by patients in choosing iCBT
ABSTRACT
Background:
Digital health research focus on the digital divide between individuals who are using technology and those who do not. In Denmark, 91 percent have a computer and 97 out of 100 families have internet access. Therefore, the reason for non-use is mainly not due to lack of access to technology. Several studies have found the socio-economic status (SES) to have an impact on health literacy. The higher SES, the more health literacy, and the fewer barriers do they have to digital health interventions. A series of studies have focused on patient perspectives of using internet-based treatment for Alcohol Use Disorder (AUD), but no studies have investigated the barriers to engaging in digital treatment for AUD among the treatment seeking population.
Objective:
The aim of this study is to investigate non-use of guided internet-based cognitive behavioral therapy (iCBT) for AUD in a blended format. More specifically, to explore patient barriers to using iCBT for AUD and their reasons for choosing not to receive treatment via this format.
Methods:
Patients in the Blend-A study who had not used internet-based treatment were asked for an interview about reasons not to choose internet-based treatment. The participants were recruited among patients in the Blend-A study, and three of them were women. A total of 11 patients aged 29-78 years (mean 59, SD 16) with AUD were included in semi-structured individual qualitative cellphone interviews. The interviews were transcribed and analyzed using thematic analysis.
Results:
Under the heading reasons for choosing treatment face-to-face, we found five themes: patients need for attending sessions in person, preferring verbal communication, want immediate feedback, felt more empowered and motivated with face-to-face sessions, and lack of digital health literacy.
Conclusions:
This study indicates that most of the patients choose not to use iCBT for AUD because they perceive such treatment format as impersonal. They prefer direct communication with the therapist and thereby the possibility for both to express and comprehend facial expressions and body language. Clinical Trial: Clinicaltrials.gov.: NCT04535258
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