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A vast amount of studies show that online interventions are suitable to reduce symptoms of mental illness as for instance depression or anxiety. However, participants who use online interventions are more likely to drop out of treatment compared to face-to-face interventions. It is important to enhance adherence to online interventions so that participants engage longer in the programs. Also, as online interventions are useful to reduce the burden of mental illness, it is of interest to further improve outcomes of such interventions. Therefore, it will be investigated in this study whether or not four different factors have an impact in fostering adherence to and improving outcome of an internet-based self-help intervention based on problem-solving therapy. A multifactorial design will be used for this study to screen simultaneously whether or not i) a diagnostic telephone interview and, ii) an educational module based on motivational interviewing prior to the intervention and iii) guidance by the study team, and iv) automated e-mail reminders during the study are active factors in enhancing adherence to and outcome of online interventions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Online-Program + factors 1,2,3,4 | Experimental | In this "arm" all four factors are set to "active" (i.e. yes):
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| Online-Program + factors 1,2,3 | Experimental | In this "arm" three factors are set to "active" (i.e. yes):
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| Online-Program + factors 1,2,4 | Experimental | In this "arm" three factors are set to "active" (i.e. yes):
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| Online-Program + factors 1,2 | Experimental | In this "arm" two factors are set to "active" (i.e. yes):
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| Online-Program + factors 1,3,4 | Experimental | In this "arm" three factors are set to "active" (i.e. yes):
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HERMES (Online Self-Help Intervention based on problem-solving therapy) | Behavioral | The Online Self-Help Intervention is an online program based on the problem-solving therapy (an evidence based approach of psychotherapy). All participants will receive the exact same intervention. However, what will be experimentally varied are the four listed interventions. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Depressive Symptoms | Assessed with Patient Health Questionnaire - Depression (PHQ-9; Kroenke, Spitzer & Williams, 2001) | Baseline |
| Change in Depressive Symptoms | Assessed with Patient Health Questionnaire - Depression (PHQ-9; Kroenke, Spitzer & Williams, 2001) | 2 weeks |
| Change in Depressive Symptoms | Assessed with Patient Health Questionnaire - Depression (PHQ-9; Kroenke, Spitzer & Williams, 2001) | 4 weeks |
| Change in Depressive Symptoms | Assessed with Patient Health Questionnaire - Depression (PHQ-9; Kroenke, Spitzer & Williams, 2001) | 10 weeks |
| Change in Depressive Symptoms | Assessed with Patient Health Questionnaire - Depression (PHQ-9; Kroenke, Spitzer & Williams, 2001) | 16 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Adherence to Intervention (1) | Assessed with the online Program. Indicator of adherence: time spent in program | through study completion, an average of 16 weeks |
| Adherence to Intervention (2) | Assessed with the online Program. Indicator of adherence: clicks |
| Measure | Description | Time Frame |
|---|---|---|
| Credibility and Expectancy | Assessed with Credibility/Expectancy Questionnaires (CEQ; Devilly & Borkovec, 2000) | Baseline, 2 weeks, 4 weeks |
| Working Alliance | Assessed with Working Alliance Inventory - for Internet Interventions (WAI-I; Gomez Penedo et al., 2019) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Thomas Berger, Prof. Dr. | University of Bern | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Bern | Bern | 3012 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39679951 | Derived | Bur OT, Berger T. Participant Adherence and Contact Behavior in a Guided Internet Intervention for Depressive Symptoms: Exploratory Study. JMIR Form Res. 2024 Dec 16;8:e46860. doi: 10.2196/46860. | |
| 35306266 | Derived | Bur OT, Krieger T, Moritz S, Klein JP, Berger T. Optimizing the context of support of web-based self-help in individuals with mild to moderate depressive symptoms: A randomized full factorial trial. Behav Res Ther. 2022 May;152:104070. doi: 10.1016/j.brat.2022.104070. Epub 2022 Mar 6. |
| Label | URL |
|---|---|
| Homepage of the study | View source |
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Data will be made available, after all planned analysis have been made by the Investigators.
Data: Begin 2022 Other information: when available
will be decided individually
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Multifactorial design (factorial trial), following the Multiphase optimisation Strategy (MOST)
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Participants only know that the delivery or the context of online interventions are to be improved and investigated. However, they don't know the exact interventions.
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| Online-Program + factors 1,3 | Experimental | In this "arm" two factors are set to "active" (i.e. yes):
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| Online-Program + factors 1,4 | Experimental | In this "arm" two factors are set to "active" (i.e. yes):
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| Online-Program + factor 1 | Experimental | In this "arm" one factor is set to "active" (i.e. yes): - diagnostic interview |
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| Online-Program + factors 2,3,4 | Experimental | In this "arm" three factors are set to "active" (i.e. yes):
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| Online-Program + factors 2,3 | Experimental | In this "arm" two factors are set to "active" (i.e. yes):
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| Online-Program + factors 2,4 | Experimental | In this "arm" two factors are set to "active" (i.e. yes):
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| Online-Program + factor 2 | Experimental | In this "arm" one factor is set to "active" (i.e. yes): - motivational module |
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| Online-Program + factors 3,4 | Experimental | In this "arm" two factors are set to "active" (i.e. yes):
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| Online-Program + factor 3 | Experimental | In this "arm" one factor is set to "active" (i.e. yes): - guidance |
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| Online-Program + factor 4 | Experimental | In this "arm" one factor is set to "active" (i.e. yes): - e-mail reminders |
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| Online-Program + no factor | Experimental | In this "arm" no factor is set to "active" (i.e. yes): |
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| through study completion, an average of 16 weeks |
| Adherence to Intervention (3) | Assessed with the online Program. Indicator of adherence: number of exercises completed | through study completion, an average of 16 weeks |
| Anxiety Symptoms | Assessed with Patient Health Questionnaire - Anxiety (GAD-7; Löwe et al., 2002) | Baseline, 10 weeks, 16 weeks |
| Stress Symptoms | Assessed with Patient Health Questionnaire - Stress (PHQ-Stress; Löwe et al., 2002) | Baseline, 10 weeks, 16 weeks |
| Health | Assessed with Short Form Health Survey (SF-12; Gandek et al., 1998) | Baseline, 10 weeks, 16 weeks |
| Suicidal Tendency | Assessed with Suicide Behaviors Questionnaire - Revised (SBQ-R; Glaesmer et al., 2017) | Baseline, 10 weeks, 16 weeks |
| Social Problem Solving | Assessed with Social Problem Solving Inventory Revised (SPSI-R; D'Zurilla et al., 1999) | Baseline, 10 weeks, 16 weeks |
| Satisfaction with treatment | Assessed with the german version of Client Satisfaction Questionnaire CSQ-8 (Attkisson & Zwick, 1982) | 10 weeks |
| Negative Effects of Psychotherapy | Assessed with "Inventory for the Assessment of Negative Effects of Psychotherapy (INEP; Ladwig, Rief, & Nestoriuc, 2014) | 10 weeks, 16 weeks |
| Usability of Intervention | Assessed with System Usability Scale (SAS; Brooke, 1996) | 10 weeks |
| Baseline, 2 weeks, 4 weeks |
| 33528377 | Derived | Bur OT, Krieger T, Moritz S, Klein JP, Berger T. Optimizing the Context of Support to Improve Outcomes of Internet-Based Self-help in Individuals With Depressive Symptoms: Protocol for a Randomized Factorial Trial. JMIR Res Protoc. 2021 Feb 2;10(2):e21207. doi: 10.2196/21207. |
| ID | Term |
|---|---|
| C101827 | RBPMS protein, human |
| D003376 | Counseling |
| ID | Term |
|---|---|
| D008605 | Mental Health Services |
| D004191 | Behavioral Disciplines and Activities |
| D003153 | Community Health Services |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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