An Adjunctive Internet-Based Intervention to Enhance Treatment for Depression in Adults: Randomized Controlled Trial

J Carola Pérez, Olga Fernández, Cristián Cáceres, Álvaro E Carrasco, Markus Moessner, Stephanie Bauer, Daniel Espinosa-Duque, Sergio Gloger, Mariane Krause, J Carola Pérez, Olga Fernández, Cristián Cáceres, Álvaro E Carrasco, Markus Moessner, Stephanie Bauer, Daniel Espinosa-Duque, Sergio Gloger, Mariane Krause

Abstract

Background: Internet-based interventions promise to enhance the accessibility of mental health care for a greater number of people and in more remote places. Their effectiveness has been shown for the prevention and treatment of various mental disorders. However, their potential when delivered as add-on to conventional treatment (ie, blended care) is less clear.

Objective: The aim of this study is to study the effectiveness of an internet intervention (ASCENSO) implemented in addition to face-to-face treatment as usual (TAU) for depression.

Methods: A 2-arm, parallel-group, randomized controlled trial was conducted in an outpatient private mental health care center in Chile. In all, 167 adults, diagnosed with major depressive disorder, without severe comorbidities, and with internet access, were included. Eighty-four participants were assigned to the intervention group and received medical and psychological TAU from the mental health center plus access to the ASCENSO online platform. The control group (n=83) received only TAU. The ASCENSO platform includes psycho-educational information, depressive symptom monitoring and feedback, and managing emergencies based on the principles of cognitive behavioral therapy. Emergency management was mental health provider-assisted. TAU includes access to primary care physicians and psychiatrists, to a brief individual psychotherapy, and to medication when needed. The baseline questionnaires were administered in person, and 6- and 9-months assessments were conducted online. Depression symptoms and quality of life were measured by self-administered questionnaires, and treatment adherence was determined via the Mental Health Center's internal records. The usage of ASCENSO was assessed by server logs. Reduction on depressive symptomatology was considered as the primary outcome of the intervention and quality of life as a secondary outcome.

Results: Of the 84 participants in the intervention group, 5 participants (6%) never accessed the online platform. Of the remaining 79 participants who accessed ASCENSO, 1 (1%, 1/79) did not answer any of the symptom questionnaire, and most participants (72/79, 91%) answered the monitoring questionnaires irregularly. The ASCENSO intervention implemented in addition to face-to-face care did not improve the outcome of the usual care delivered at the mental health center, either in terms of reduction of depressive symptoms (F2,6087= 0.48; P=.62) or in the improvement of quality of life (EQ-5D-3L: F2,7678=0.24; P=.79 and EQ-VAS: F2,6670= 0.13; P=.88). In contrast, for the primary (F2,850=78.25; P<.001) and secondary outcomes (EQ-5D-3L: F2,1067=37.87; EQ-VAS: F2,4390= 51.69; P<.001) in both groups, there was an improvement from baseline to 6 months (P<.001), but there was no change at 9 months. In addition, no effects on adherence to or use of TAU were found. Finally, the dropout rate for the face-to-face treatment component was 54% (45/84) for the intervention group versus 39% (32/83) for the control group (P=.07).

Conclusions: The fact that the adjunctive access to ASCENSO did not improve outcome could be due to both the rather high effectiveness of TAU and to patients' limited use of the online platform.

Trial registration: ClinicalTrials.gov NCT03093467; https://ichgcp.net/clinical-trials-registry/NCT03093467.

Keywords: blended care; depression; e-mental health; internet.

Conflict of interest statement

Conflicts of Interest: Intellectual property of the content of ASCENSO platform belongs to “Fundación para la Investigación en Depresión y Personalidad, Chile,” this paper’s authors (AEC, CC, SB, MM, DED, and MK), and other researchers (Jorge Olivares and Graciela Rojas). The Center for Psychotherapy Research, University Hospital Heidelberg, owns the copyright of the computer source code and software that support the ASCENSO platform. The authors have no other financial or nonfinancial conflicts of interest to declare.

©J Carola Pérez, Olga Fernández, Cristián Cáceres, Álvaro E Carrasco, Markus Moessner, Stephanie Bauer, Daniel Espinosa-Duque, Sergio Gloger, Mariane Krause. Originally published in JMIR Mental Health (https://mental.jmir.org), 16.12.2021.

Figures

Figure 1
Figure 1
ASCENSO platform functioning. PHQ: Patient Health Questionnaire.
Figure 2
Figure 2
Consolidated Standards of Reporting Trials (CONSORT) diagram (patient flow). CG: control group; IG: intervention group; ITT: intention to treat; TAU: treatment as usual.

References

    1. GBD 2017 DiseaseInjury IncidencePrevalence Collaborators Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018 Nov 10;392(10159):1789–1858. doi: 10.1016/S0140-6736(18)32279-7. S0140-6736(18)32279-7
    1. Ministerio de Salud (MINSAL), Chile. Encuesta Nacional de Salud ENS 2016-2017 Segundo entrega de resultados. 2018. [2021-06-07]. .
    1. Becerra NA, Prati BZ, Martínez MR. Significados de la experiencia de enfermedad en mujeres con diagnóstico de depresión y abandono tratamiento. Rev Chil Med Fam. 2017;12(1):8–13.
    1. Collins. Westra Henny A, Dozois David J A, Burns David D. Gaps in accessing treatment for anxiety and depression: challenges for the delivery of care. Clin Psychol Rev. 2004 Sep;24(5):583–616. doi: 10.1016/j.cpr.2004.06.001. doi: 10.1016/j.cpr.2004.06.001.S0272735804000492
    1. Wang. Aguilar-Gaxiola S, Alonso J, Angermeyer Mc, Borges G, Bromet Ej, Bruffaerts R, de Girolamo G, de Graaf R, Gureje O, Haro Jm, Karam Eg, Kessler Rc, Kovess V, Lane Mc, Lee S, Levinson D, Ono Y, Petukhova M, Posada-Villa J, Seedat S, Wells Je. Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. The Lancet. 2007 Sep;370(9590):841–850. doi: 10.1016/S0140-6736(07)61414-7. doi: 10.1016/s0140-6736(07)61414-7.
    1. Behn A, Herpertz SC, Krause M. The interaction between depression and personality dysfunction: state of the art, current challenges, and future directions. Introduction to the special section. Psykhe (Santiago) 2018 Nov 05;:1–12. doi: 10.7764/psykhe.27.2.1501.
    1. Badamgarav E, Weingarten. Henning. Knight K, Hasselblad V, Gano A, Ofman Joshua J. Effectiveness of disease management programs in depression: a systematic review. Am J Psychiatry. 2003 Dec;160(12):2080–90. doi: 10.1176/appi.ajp.160.12.2080. doi: 10.1176/appi.ajp.160.12.2080.
    1. Fritsch R, Araya R, Solís J, Montt E, Pilowsky D, Rojas G. Un ensayo clínico aleatorizado de farmacoterapia con monitorización telefónica para mejorar el tratamiento de la depresión en la atención primaria en Santiago, Chile. Rev. méd. Chile. 2007 May;135(5):587–595. doi: 10.4067/S0034-98872007000500006.
    1. Haddad M, Tylee A. The chronic disease management model for depression in primary care. Clin Neuropsychiatry. 2011;8(4):252–259.
    1. Neumeyer-Gromen A, Lampert T, Stark K, Kallischnigg G. Disease management programs for depression: a systematic review and meta-analysis of randomized controlled trials. Med Care. 2004 Dec;42(12):1211–21. doi: 10.1097/00005650-200412000-00008. doi: 10.1097/00005650-200412000-00008.00005650-200412000-00008
    1. Collins P, Patel Vikram, Joestl Sarah S, March Dana, Insel Thomas R, Daar Abdallah S, Scientific Advisory Boardthe Executive Committee of the Grand Challenges on Global Mental Health. Anderson Warwick, Dhansay Muhammad A, Phillips Anthony, Shurin Susan, Walport Mark, Ewart Wendy, Savill Sir John, Bordin Isabel A, Costello E Jane, Durkin Maureen, Fairburn Christopher, Glass Roger I, Hall Wayne, Huang Yueqin, Hyman Steven E, Jamison Kay, Kaaya Sylvia, Kapur Shitij, Kleinman Arthur, Ogunniyi Adesola, Otero-Ojeda Angel, Poo Mu-Ming, Ravindranath Vijayalakshmi, Sahakian Barbara J, Saxena Shekhar, Singer Peter A, Stein Dan J. Grand challenges in global mental health. Nature. 2011 Jul 06;475(7354):27–30. doi: 10.1038/475027a. 475027a
    1. Proudfoot Judith G. Computer-based treatment for anxiety and depression: Is it feasible? Is it effective? Neurosci Biobehav Rev. 2004 May;28(3):353–63. doi: 10.1016/j.neubiorev.2004.03.008. doi: 10.1016/j.neubiorev.2004.03.008.S0149763404000375
    1. Fairburn C, Patel Vikram. The impact of digital technology on psychological treatments and their dissemination. Behav Res Ther. 2017 Jan;88:19–25. doi: 10.1016/j.brat.2016.08.012. S0005-7967(16)30137-1
    1. Andrews G, Basu A, Cuijpers P, Craske. McEvoy P, English C L, Newby J M. Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis. J Anxiety Disord. 2018 Apr;55:70–78. doi: 10.1016/j.janxdis.2018.01.001. S0887-6185(17)30447-4
    1. Josephine Königbauer, Josefine Letsch, Philipp Doebler, David Ebert, Harald Baumeister. Internet- and mobile-based depression interventions for people with diagnosed depression: A systematic review and meta-analysis. J Affect Disord. 2017 Dec 01;223:28–40. doi: 10.1016/j.jad.2017.07.021. doi: 10.1016/j.jad.2017.07.021.S0165-0327(17)30725-5
    1. Garrido S, Millington C, Cheers D, Boydell K, Schubert E, Meade T, Nguyen What works and what doesn't work? A systematic review of digital mental health interventions for depression and anxiety in young people. Front Psychiatry. 2019;10:759. doi: 10.3389/fpsyt.2019.00759. doi: 10.3389/fpsyt.2019.00759.
    1. Andersson G, Hesser H, Veilord A, Svedling L, Andersson F, Sleman O, Mauritzson L, Sarkohi A, Claesson E, Zetterqvist V, Lamminen M, Eriksson T, Carlbring P. Randomised controlled non-inferiority trial with 3-year follow-up of internet-delivered versus face-to-face group cognitive behavioural therapy for depression. J Affect Disord. 2013 Dec;151(3):986–94. doi: 10.1016/j.jad.2013.08.022. doi: 10.1016/j.jad.2013.08.022.S0165-0327(13)00656-3
    1. Carlbring P, Andersson G, Cuijpers P, Riper H, Hedman-Lagerlöf Erik. Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis. Cogn Behav Ther. 2018 Jan;47(1):1–18. doi: 10.1080/16506073.2017.1401115. doi: 10.1080/16506073.2017.1401115.
    1. Wagner B, Horn. Maercker Andreas. Internet-based versus face-to-face cognitive-behavioral intervention for depression: a randomized controlled non-inferiority trial. J Affect Disord. 2014 Jan;152-154:113–21. doi: 10.1016/j.jad.2013.06.032. doi: 10.1016/j.jad.2013.06.032.S0165-0327(13)00512-0
    1. Wentzel J, van der Vaart Rosalie, Bohlmeijer Ernst T, van Gemert-Pijnen Julia E W C. Mixing online and face-to-face therapy: how to benefit from blended care in mental health care. JMIR Ment Health. 2016 Feb 09;3(1):e9. doi: 10.2196/mental.4534. v3i1e9
    1. Kooistra. Wiersma Je, Ruwaard J, van Oppen P, Smit F, Lokkerbol J, Cuijpers P, Riper H. Blended vs. face-to-face cognitive behavioural treatment for major depression in specialized mental health care: study protocol of a randomized controlled cost-effectiveness trial. BMC Psychiatry. 2014 Oct 18;14(1):290. doi: 10.1186/s12888-014-0290-z. doi: 10.1186/s12888-014-0290-z.
    1. van der Vaart Rosalie, Witting M, Riper H, Kooistra L, Bohlmeijer. van Gemert-Pijnen Lisette J E W C. Blending online therapy into regular face-to-face therapy for depression: content, ratio and preconditions according to patients and therapists using a Delphi study. BMC Psychiatry. 2014 Dec 14;14:355. doi: 10.1186/s12888-014-0355-z. s12888-014-0355-z
    1. Zwerenz R, Baumgarten C, Becker J, Tibubos A, Siepmann M, Knickenberg. Beutel Manfred E. Improving the course of depressive symptoms after inpatient psychotherapy using adjunct web-based self-help: follow-up results of a randomized controlled trial. J Med Internet Res. 2019 Oct 24;21(10):e13655. doi: 10.2196/13655. v21i10e13655
    1. Berger T, Krieger T, Sude K, Meyer B, Maercker A. Evaluating an e-mental health program ("deprexis") as adjunctive treatment tool in psychotherapy for depression: Results of a pragmatic randomized controlled trial. J Affect Disord. 2018 Feb;227:455–462. doi: 10.1016/j.jad.2017.11.021. doi: 10.1016/j.jad.2017.11.021.S0165-0327(17)31255-7
    1. Gilbody S, Littlewood E, Hewitt C, Brierley G, Tharmanathan P, Araya R, Barkham M, Bower P, Cooper C, Gask L, Kessler D, Lester H, Lovell K, Parry G, Richards DA, Andersen P, Brabyn S, Knowles S, Shepherd C, Tallon D, White D, REEACT Team Computerised cognitive behaviour therapy (cCBT) as treatment for depression in primary care (REEACT trial): large scale pragmatic randomised controlled trial. BMJ. 2015 Nov 11;351:h5627. doi: 10.1136/bmj.h5627.
    1. Löbner Margrit, Pabst A, Stein J, Dorow M, Matschinger H, Luppa M, Maroß Astrid, Kersting A, König Hans-Helmut, Riedel-Heller Steffi G. Computerized cognitive behavior therapy for patients with mild to moderately severe depression in primary care: A pragmatic cluster randomized controlled trial (@ktiv) J Affect Disord. 2018 Oct 01;238:317–326. doi: 10.1016/j.jad.2018.06.008. doi: 10.1016/j.jad.2018.06.008.S0165-0327(18)30515-9
    1. Kenter. van de Ven Pm, Cuijpers P, Koole G, Niamat S, Gerrits Rs, Willems M, van Straten A. Costs and effects of internet cognitive behavioral treatment blended with face-to-face treatment: results from a naturalistic study. Internet Interventions. 2015 Mar;2(1):77–83. doi: 10.1016/j.invent.2015.01.001. doi: 10.1016/j.invent.2015.01.001.
    1. Jiménez-Molina Álvaro, Franco Pamela, Martínez Vania, Martínez Pablo, Rojas Graciela, Araya Ricardo. Internet-based interventions for the prevention and treatment of mental disorders in Latin America: a scoping review. Front Psychiatry. 2019;10:664. doi: 10.3389/fpsyt.2019.00664. doi: 10.3389/fpsyt.2019.00664.
    1. Martínez Pablo, Rojas G, Martínez Vania, Lara. Pérez J Carola. Internet-based interventions for the prevention and treatment of depression in people living in developing countries: A systematic review. J Affect Disord. 2018 Jul;234:193–200. doi: 10.1016/j.jad.2018.02.079. doi: 10.1016/j.jad.2018.02.079.S0165-0327(17)32567-3
    1. Espinosa. Carrasco Álvaro, Moessner Markus, Cáceres Cristian, Gloger Sergio, Rojas Graciela, Perez J Carola, Vanegas Jorge, Bauer Stephanie, Krause Mariane. Acceptability study of "ASCENSO": an online program for monitoring and supporting patients with depression in Chile. Telemed J E Health. 2016 Jul;22(7):577–83. doi: 10.1089/tmj.2015.0124. doi: 10.1089/tmj.2015.0124.
    1. Sheehan D, Lecrubier Y, Sheehan K H, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar G C. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22–33;quiz 34.
    1. Ministerio de Salud (MINSAL), Chile. Guía Clínica Depresión en personas de 15 años y más, segunda edición. Santiago: MINSAL; 2013. [2021-06-07]. .
    1. Saldivia S, Aslan J, Cova F, Vicente B, Inostroza C, Rincón Paulina. [Psychometric characteristics of the Patient Health Questionnaire (PHQ-9)] Rev Med Chil. 2019;147(1):53–60. doi: 10.4067/S0034-98872019000100053. S0034-98872019000100053
    1. Sheehan D, Lecrubier Y, Sheehan K, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar G C. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22–33;quiz 34.
    1. Loranger AW, Sartorius N, Andreoli A, Berger P, Buchheim P, Channabasavanna S M, Coid B, Dahl A, Diekstra R F, Ferguson B. The International Personality Disorder Examination. The World Health Organization/Alcohol, Drug Abuse, and Mental Health Administration international pilot study of personality disorders. Arch Gen Psychiatry. 1994 Mar 01;51(3):215–24. doi: 10.1001/archpsyc.1994.03950030051005.
    1. Organización Mundial de la Salud . Examen Internacional de los Trastornos de la Personalidad (IPDE) Madrid: Meditor; 1996.
    1. Valdés Camila, Morales-Reyes I, Pérez J Carola, Medellín Adriana, Rojas G, Krause M. [Psychometric properties of a spanish version of the Beck depression inventory IA] Rev Med Chil. 2017 Aug;145(8):1005–1012. doi: 10.4067/s0034-98872017000801005. S0034-98872017000801005
    1. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–571. doi: 10.1001/archpsyc.1961.01710120031004.
    1. EuroQol RF. EQ-5D-3L user guide Version 6. 2018. [2021-06-07].
    1. Zarate V, Kind P, Valenzuela P, Vignau A, Olivares-Tirado P, Munoz A. Social valuation of EQ-5D health states: the Chilean case. Value Health. 2011 Dec;14(8):1135–41. doi: 10.1016/j.jval.2011.09.002. S1098-3015(11)03497-8
    1. Faul F, Erdfelder E, Lang. Buchner Axel. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175–91. doi: 10.3758/BF03193146. doi: 10.3758/bf03193146.
    1. Andrews G, Cuijpers Pim, Craske Michelle G, McEvoy Peter, Titov Nickolai. Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS One. 2010 Oct 13;5(10):e13196. doi: 10.1371/journal.pone.0013196.
    1. Andersson G, Cuijpers Pim. Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cogn Behav Ther. 2009;38(4):196–205. doi: 10.1080/16506070903318960. doi: 10.1080/16506070903318960.917833314
    1. Cavanagh K, Shapiro David A. Computer treatment for common mental health problems. J Clin Psychol. 2004 Mar;60(3):239–51. doi: 10.1002/jclp.10261. doi: 10.1002/jclp.10261.
    1. Pérez Ewert Jc, Bustamante C, Alcayaga C, Medina M, Sánchez H, Campos S, Beltrán A, Urrutia M, Lange I. Evaluación del Modelo Multi-componente de Telecuidado de apoyo a Personas con Pre-diabetes en Chile. AP. 2016 Dec 05;30(121):103–107. doi: 10.15517/ap.v30i121.24370. doi: 10.15517/ap.v30i121.24370.
    1. Yuan Y. Multiple imputation using SAS software. J Stat Softw; 45. 2011:1–25. doi: 10.18637/jss.v045.i06.
    1. Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol. 2013 Nov 26;4:863. doi: 10.3389/fpsyg.2013.00863. doi: 10.3389/fpsyg.2013.00863.
    1. Andersson G, Titov N. Advantages and limitations of Internet-based interventions for common mental disorders. World Psychiatry. 2014 Feb;13(1):4–11. doi: 10.1002/wps.20083. doi: 10.1002/wps.20083.
    1. Cerga-Pashoja A, Doukani A, Gega L, Walke J, Araya R. Added value or added burden? A qualitative investigation of blending internet self-help with face-to-face cognitive behaviour therapy for depression. Psychother Res. 2020 Nov;30(8):998–1010. doi: 10.1080/10503307.2020.1720932. doi: 10.1080/10503307.2020.1720932.
    1. Schuster Raphael, Topooco Naira, Keller Antonia, Radvogin Ella, Laireiter Anton-Rupert. Advantages and disadvantages of online and blended therapy: Replication and extension of findings on psychotherapists' appraisals. Internet Interv. 2020 Sep;21:100326. doi: 10.1016/j.invent.2020.100326. S2214-7829(20)30015-4
    1. Kleiboer. Smit Jan, Bosmans Judith, Ruwaard Jeroen, Andersson Gerhard, Topooco Naira, Berger Thomas, Krieger Tobias, Botella Cristina, Baños Rosa, Chevreul Karine, Araya Ricardo, Cerga-Pashoja Arlinda, Cieślak Roman, Rogala Anna, Vis Christiaan, Draisma Stasja, van Schaik Anneke, Kemmeren Lise, Ebert David, Berking Matthias, Funk Burkhardt, Cuijpers Pim, Riper Heleen. European COMPARative Effectiveness research on blended Depression treatment versus treatment-as-usual (E-COMPARED): study protocol for a randomized controlled, non-inferiority trial in eight European countries. Trials. 2016 Aug 03;17(1):387. doi: 10.1186/s13063-016-1511-1. 10.1186/s13063-016-1511-1
    1. Cowpertwait L, Clarke D. Effectiveness of web-based psychological interventions for depression: a meta-analysis. Int J Ment Health Addiction. 2013 Jan 18;11(2):247–268. doi: 10.1007/s11469-012-9416-z. doi: 10.1007/s11469-012-9416-z.
    1. Furukawa T A, Noma H, Caldwell D M, Honyashiki M, Shinohara K, Imai H, Chen P, Hunot V, Churchill R. Waiting list may be a nocebo condition in psychotherapy trials: a contribution from network meta-analysis. Acta Psychiatr Scand. 2014 Sep;130(3):181–92. doi: 10.1111/acps.12275. doi: 10.1111/acps.12275.
    1. Christensen H, Griffiths. Farrer Louise. Adherence in internet interventions for anxiety and depression. J Med Internet Res. 2009 Apr 24;11(2):e13. doi: 10.2196/jmir.1194. v11i2e13
    1. Eysenbach G. The law of attrition. J Med Internet Res. 2005 Mar 31;7(1):e11. doi: 10.2196/jmir.7.1.e11. v7e11
    1. Johansson O, Michel T, Andersson G, Paxling B. Experiences of non-adherence to Internet-delivered cognitive behavior therapy: A qualitative study. Internet Interventions. 2015 May;2(2):137–142. doi: 10.1016/j.invent.2015.02.006. doi: 10.1016/j.invent.2015.02.006.
    1. Devilly GJ, Borkovec TD. Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry. 2000 Jun;31(2):73–86. doi: 10.1016/s0005-7916(00)00012-4.
    1. Constantino M, Arnkoff Diane B, Glass C, Ametrano R, Smith J. Expectations. J Clin Psychol. 2011 Feb;67(2):184–92. doi: 10.1002/jclp.20754. doi: 10.1002/jclp.20754.
    1. Constantino M, Coyne Alice E, Boswell James F, Iles Brittany R, Vîslă Andreea. A meta-analysis of the association between patients' early perception of treatment credibility and their posttreatment outcomes. Psychotherapy (Chic) 2018 Dec;55(4):486–495. doi: 10.1037/pst0000168. doi: 10.1037/pst0000168.2018-51673-013
    1. Doss. Feinberg Leah K, Rothman Karen, Roddy McKenzie K, Comer Jonathan S. Using technology to enhance and expand interventions for couples and families: Conceptual and methodological considerations. J Fam Psychol. 2017 Dec;31(8):983–993. doi: 10.1037/fam0000349. 2018-00265-003
    1. Yardley L, Morrison L, Bradbury K, Muller I. The person-based approach to intervention development: application to digital health-related behavior change interventions. J Med Internet Res. 2015 Jan 30;17(1):e30. doi: 10.2196/jmir.4055. v17i1e30
    1. Parada F, Martínez Vania, Espinosa. Bauer Stephanie, Moessner Markus. Using persuasive systems design model to evaluate "Cuida tu Ánimo": an internet-based pilot program for prevention and early intervention of adolescent depression. Telemed J E Health. 2020 Feb;26(2):251–254. doi: 10.1089/tmj.2018.0272.
    1. Alpay L, Doms Rob, Bijwaard Harmen. Embedding persuasive design for self-health management systems in Dutch healthcare informatics education: Application of a theory-based method. Health Informatics J. 2019 Dec;25(4):1631–1646. doi: 10.1177/1460458218796642.
    1. Hetrick SE, Robinson J, Burge E, Blandon R, Mobilio B, Rice SM, Simmons MB, Alvarez-Jimenez M, Goodrich S, Davey CG. Youth codesign of a mobile phone app to facilitate self-monitoring and management of mood symptoms in young people with major depression, suicidal ideation, and self-harm. JMIR Ment Health. 2018 Jan 23;5(1):e9. doi: 10.2196/mental.9041. v5i1e9
    1. Kelders S, Kok Robin N, Ossebaard Hans C, Van Gemert-Pijnen Julia E W C. Persuasive system design does matter: a systematic review of adherence to web-based interventions. J Med Internet Res. 2012 Nov 14;14(6):e152. doi: 10.2196/jmir.2104. v14i6e152
    1. Vandekerckhove P, de Mul M, Bramer WM, de Bont AA. Generative participatory design methodology to develop electronic health interventions: systematic literature review. J Med Internet Res. 2020 Apr 27;22(4):e13780. doi: 10.2196/13780. v22i4e13780
    1. HHS Office of Adolescent Health Evaluation technical assistance brief for OAH teenage pregnancy prevention grantees. 2017. Jul, [2021-06-07]. .
    1. Andrade C. Internal, external, and ecological validity in research design, conduct, and evaluation. Indian Journal of Psychological Medicine. 2018 Sep 01;40(5):498–499. doi: 10.4103/IJPSYM.IJPSYM_334_18. doi: 10.4103/ijpsym.ijpsym_334_18.
    1. Glasgow R, Lichtenstein Edward, Marcus Alfred C. Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. Am J Public Health. 2003 Aug;93(8):1261–7. doi: 10.2105/ajph.93.8.1261. doi: 10.2105/ajph.93.8.1261.
    1. Kordy H, Backenstrass Matthias, Hüsing Johannes, Wolf Markus, Aulich Kai, Bürgy Martin, Puschner Bernd, Rummel-Kluge Christine, Vedder Helmut. Supportive monitoring and disease management through the internet: an internet-delivered intervention strategy for recurrent depression. Contemp Clin Trials. 2013 Nov;36(2):327–37. doi: 10.1016/j.cct.2013.08.005. doi: 10.1016/j.cct.2013.08.005.S1551-7144(13)00129-8
    1. Ministerio de Transporte y Telecomunicaciones, Chile. Informe Semestral del Sector Telecomunicaciones – Primer Semestre 2021. 2021. [2021-06-07].
    1. Ministerio de Salud (MINSAL), Chile. Plan Nacional de Salud Mental 2017 -2025. Ministerio de Salud; 2017. [2021-06-07]. .
    1. Dagnino P, Anguita Verónica, Escobar Katherine, Cifuentes Sofía. Psychological effects of social isolation due to quarantine in Chile: an exploratory study. Front Psychiatry. 2020;11:591142. doi: 10.3389/fpsyt.2020.591142. doi: 10.3389/fpsyt.2020.591142.
    1. Donkin L, Glozier Nick. Motivators and motivations to persist with online psychological interventions: a qualitative study of treatment completers. J Med Internet Res. 2012 Jun 22;14(3):e91. doi: 10.2196/jmir.2100. v14i3e91

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner