J. Med. Internet Res. - Pretreatment attrition and formal withdrawal during treatment and their predictors: an exploratory study of the anxiety online data.

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Resumo

CKGROUND: Although in its infancy, the field of e-mental health interventions has been gaining popularity and afforded considerable research attention. However, there are many gaps in the research. One such gap is in the area of attrition predictors at various stages of assessment and treatment delivery.OBJECTIVE: This exploratory study applied univariate and multivariate analysis to a large dataset provided by the Anxiety Online (now called Mental Health Online) system to identify predictors of attrition in treatment commencers and in those who formally withdrew during treatment based on 24 pretreatment demographic and personal variables and one clinical measure.METHODS: Participants were assessed using a complex online algorithm that resulted in primary and secondary diagnoses in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Those who received a primary or secondary diagnosis of 1 of 5 anxiety disorders (generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and panic disorder) were offered an online 12-week disorder-specific treatment program.RESULTS: Of 9394 potential participants, a total of 3880 clients enrolled and 5514 did not enroll in one of the treatment programs following the completion of pretreatment assessment measures (pretreatment attrition rate: 58.70%). A total of 3199 individuals did not formally withdraw from the 12-week treatment cycle, whereas 142 individuals formally dropped out (formal withdrawal during treatment dropout rate of 4.25%). The treatment commencers differed significantly (P<.001-.03) from the noncommencers on several variables (reason for registering, mental health concerns, postsecondary education, where first heard about Anxiety Online, Kessler-6 score, stage of change, quality of life, relationship status, preferred method of learning, and smoking status). Those who formally withdrew during treatment differed significantly (P=.002-.03) from those who did not formally withdraw in that they were less likely to express concerns about anxiety, stress, and depression; to rate their quality of life as very poor, poor, or good; to report adequate level of social support; and to report readiness to make or were in the process of making changes.CONCLUSIONS: This exploratory study identified predictors of pretreatment attrition and formal withdrawal during treatment dropouts for the Anxiety Online program.TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG).

Resumo Limpo

ckground although infanc field ement health intervent gain popular afford consider research attent howev mani gap research one gap area attrit predictor various stage assess treatment deliveryobject exploratori studi appli univari multivari analysi larg dataset provid anxieti onlin now call mental health onlin system identifi predictor attrit treatment commenc formal withdrew treatment base pretreat demograph person variabl one clinic measuremethod particip assess use complex onlin algorithm result primari secondari diagnos accord diagnost statist manual mental disord fourth edit text revis dsmivtr receiv primari secondari diagnosi anxieti disord general anxieti disord social anxieti disord obsessivecompuls disord posttraumat stress disord panic disord offer onlin week disorderspecif treatment programresult potenti particip total client enrol enrol one treatment program follow complet pretreat assess measur pretreat attrit rate total individu formal withdraw week treatment cycl wherea individu formal drop formal withdraw treatment dropout rate treatment commenc differ signific p noncommenc sever variabl reason regist mental health concern postsecondari educ first heard anxieti onlin kessler score stage chang qualiti life relationship status prefer method learn smoke status formal withdrew treatment differ signific p formal withdraw less like express concern anxieti stress depress rate qualiti life poor poor good report adequ level social support report readi make process make changesconclus exploratori studi identifi predictor pretreat attrit formal withdraw treatment dropout anxieti onlin programtri registr australian new zealand clinic trial registri actrn httpwwwanzctrorgautrialviewaspxid archiv webcit httpwwwwebcitationorgrwvog

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