Impact and change of attitudes toward Internet interventions within a randomized controlled trial on individuals with depression symptoms

TY - JOUR

T1 - Impact and change of attitudes toward Internet interventions within a randomized controlled trial on individuals with depression symptoms

AU - Schröder, Johanna

AU - Berger, Thomas

AU - Meyer, Björn

AU - Lutz, Wolfgang

AU - Späth, Christina

AU - Michel, Pia

AU - Rose, Matthias

AU - Hautzinger, Martin

AU - Hohagen, Fritz

AU - Klein, Jan Philipp

AU - Moritz, Steffen

N1 - © 2018 Wiley Periodicals, Inc.

PY - 2018/5

Y1 - 2018/5

N2 - BACKGROUND: Most individuals with depression do not receive adequate treatment. Internet interventions may help to bridge this gap. Research on attitudes toward Internet interventions might facilitate the dissemination of such interventions by identifying factors that help or hinder uptake and implementation, and by clarifying who is likely to benefit. This study examined whether attitudes toward Internet interventions moderate the effects of a depression-focused Internet intervention, and how attitudes change over the course of treatment among those who do or do not benefit.METHODS: We recruited 1,004 adults with mild-to-moderate depression symptoms and investigated how attitudes toward Internet interventions are associated with the efficacy of the program deprexis, and how attitudes in the intervention group change from pre to post over a 3 months intervention period, compared to a control group (care as usual). This study consists of a subgroup analysis of the randomized controlled EVIDENT trial.RESULTS: Positive initial attitudes toward Internet interventions were associated with greater efficacy (η2p = .014) independent of usage time, whereas a negative attitude (perceived lack of personal contact) was associated with reduced efficacy (η2p = .012). Users' attitudes changed during the trial, and both the magnitude and direction of attitude change were associated with the efficacy of the program over time (η2p = .030).CONCLUSIONS: Internet interventions may be the most beneficial for individuals with positive attitudes toward them. Informing potential users about evidence-based Internet interventions might instill positive attitudes and thereby optimize the benefits such interventions can provide. Assessing attitudes prior to treatment might help identify suitable users.

AB - BACKGROUND: Most individuals with depression do not receive adequate treatment. Internet interventions may help to bridge this gap. Research on attitudes toward Internet interventions might facilitate the dissemination of such interventions by identifying factors that help or hinder uptake and implementation, and by clarifying who is likely to benefit. This study examined whether attitudes toward Internet interventions moderate the effects of a depression-focused Internet intervention, and how attitudes change over the course of treatment among those who do or do not benefit.METHODS: We recruited 1,004 adults with mild-to-moderate depression symptoms and investigated how attitudes toward Internet interventions are associated with the efficacy of the program deprexis, and how attitudes in the intervention group change from pre to post over a 3 months intervention period, compared to a control group (care as usual). This study consists of a subgroup analysis of the randomized controlled EVIDENT trial.RESULTS: Positive initial attitudes toward Internet interventions were associated with greater efficacy (η2p = .014) independent of usage time, whereas a negative attitude (perceived lack of personal contact) was associated with reduced efficacy (η2p = .012). Users' attitudes changed during the trial, and both the magnitude and direction of attitude change were associated with the efficacy of the program over time (η2p = .030).CONCLUSIONS: Internet interventions may be the most beneficial for individuals with positive attitudes toward them. Informing potential users about evidence-based Internet interventions might instill positive attitudes and thereby optimize the benefits such interventions can provide. Assessing attitudes prior to treatment might help identify suitable users.

KW - Adult

KW - Cognitive Behavioral Therapy

KW - Depression

KW - Depressive Disorder

KW - Female

KW - Follow-Up Studies

KW - Health Knowledge, Attitudes, Practice

KW - Humans

KW - Internet

KW - Male

KW - Middle Aged

KW - Patient Acceptance of Health Care

KW - Young Adult

KW - Journal Article

KW - Multicenter Study

KW - Randomized Controlled Trial

KW - Research Support, Non-U.S. Gov't

U2 - 10.1002/da.22727

DO - 10.1002/da.22727

M3 - SCORING: Journal article

C2 - 29489038

VL - 35

SP - 421

EP - 430

JO - DEPRESS ANXIETY

JF - DEPRESS ANXIETY

SN - 1091-4269

IS - 5

ER -