Consumer-Guided Development of an Engagement-Facilitation Intervention for Increasing Uptake and Adherence for Self-Guided Web-Based Mental Health Programs: Focus Groups and Online Evaluation Survey

Amelia Gulliver; Alison L Calear; Matthew Sunderland; Frances Kay-Lambkin; Louise M Farrer; Michelle Banfield; Philip J Batterham

doi:10.2196/22528

Consumer-Guided Development of an Engagement-Facilitation Intervention for Increasing Uptake and Adherence for Self-Guided Web-Based Mental Health Programs: Focus Groups and Online Evaluation Survey

JMIR Form Res. 2020 Oct 29;4(10):e22528. doi: 10.2196/22528.

Authors

Amelia Gulliver¹, Alison L Calear¹, Matthew Sunderland², Frances Kay-Lambkin³, Louise M Farrer¹, Michelle Banfield¹, Philip J Batterham¹

Affiliations

¹ Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia.
² The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia.
³ Priority Research Centre for Brain and Mental Health, University of Newcastle, Newcastle, Australia.

PMID: 33118939
PMCID: PMC7661236
DOI: 10.2196/22528

Abstract

Background: Self-guided web-based mental health programs are effective in treating and preventing mental health problems. However, current engagement with these programs in the community is suboptimal, and there is limited evidence indicating how to increase the use of existing evidence-based programs.

Objective: This study aims to investigate the views of people with lived experience of depression and anxiety on factors influencing their engagement with self-guided web-based mental health (e-mental health) programs and to use these perspectives to develop an engagement-facilitation intervention (EFI) to increase engagement (defined as both uptake and adherence) with these programs.

Methods: A total of 24 community members (female=21; male=3) with lived experience of depression and anxiety or depression or anxiety alone participated in 1 of 4 focus groups discussing the factors influencing their engagement with self-guided e-mental health programs and the appearance, delivery mode, and functionality of content for the proposed EFI. A subsequent evaluation survey of the focus group participants (n=14) was conducted to evaluate the resultant draft EFI. Data were thematically analyzed using both inductive and deductive qualitative methods.

Results: Participants suggested that the critical component of an EFI was information that would challenge personal barriers to engagement, including receiving personalized symptom feedback, information regarding the program's content or effectiveness and data security, and normalization of using e-mental health programs (eg, testimonials). Reminders, rewards, feedback about progress, and coaching were all mentioned as facilitating adherence.

Conclusions: EFIs have the potential to improve community uptake of e-mental health programs. They should focus on providing information on the content and effectiveness of e-mental health programs and normalizing their use. Given that the sample comprised predominantly young females, this study may not be generalizable to other population groups. There is a strong value in involving people with a lived experience in the design and development of EFIs to maximize their effectiveness.

Keywords: anxiety; depression; internet; mental health; technology; treatment adherence and compliance.

©Amelia Gulliver, Alison L Calear, Matthew Sunderland, Frances Kay-Lambkin, Louise M Farrer, Michelle Banfield, Philip J Batterham. Originally published in JMIR Formative Research (http://formative.jmir.org), 29.10.2020.