JMIR Publications

ABSTRACT

Background:

The expansion of e-mental health services offers diverse treatment options, as well as possibilities for individuals to make informed decisions about their care.

Objective:

This study evaluates the effects of a decision aid (DA) for users in choosing between guided Internet-based psychological interventions and in-person psychotherapy.

Methods:

A web based RCT was conducted with 148 Chinese-speaking participants from Hong Kong above the clinical threshold. Participants were randomly assigned to either the DA intervention group or the attention control group. The DA group underwent a brief interactive self-directed web-based DA. The attention control involved an unguided web search on mental health information. The primary outcome measures included decision conflict, and secondary outcome measures included stage of decision making, and satisfaction with the decision, attitudes, and likelihood of utilizing the mentioned services.

Results:

A time-by-intervention interaction in ANOVA, F (1,136) =9.56, p < 0.002, 95% CI = [0.0086,0.16]) indicated that decisional conflict reduced more significantly in DA group than control as measure by decision conflict scale. In addition, participants who used the DA, preferred (OR: 2.26, p=0.024, 95% CI: 1.11,4.60) and were more likely to use (OR: 2.53, p=0.006, 95% CI: 1.13,4.92) guided Internet-based psychotherapy than participants who searched mental health information on the web by themselves.

Conclusions:

This study demonstrates the potential impact and value of DA in assisting individuals with depressive symptoms in making informed choices related to e-mental health. Coordinated investment in DA may facilitate uptake of digital mental health services. Future research should explore the behavioral and long-term impact and generalizability of decision aids in applied settings. Clinical Trial: ChiCTR2300077323