J. Med. Internet Res. - Participants, usage, and use patterns of a web-based intervention for the prevention of depression within a randomized controlled trial.

Tópicos

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Resumo

CKGROUND: Although Web-based interventions have been shown to be effective, they are not widely implemented in regular care. Nonadherence (ie, participants not following the intervention protocol) is an issue. By studying the way Web-based interventions are used and whether there are differences between adherers (ie, participants that started all 9 lessons) and nonadherers, more insight can be gained into the process of adherence.OBJECTIVE: The aims of this study were to (1) describe the characteristics of participants and investigate their relationship with adherence, (2) investigate the utilization of the different features of the intervention and possible differences between adherers and nonadherers, and (3) identify what use patterns emerge and whether there are differences between adherers and nonadherers.METHODS: Data were used from 206 participants that used the Web-based intervention Living to the full, a Web-based intervention for the prevention of depression employing both a fully automated and human-supported format. Demographic and baseline characteristics of participants were collected by using an online survey. Log data were collected within the Web-based intervention itself. Both quantitative and qualitative analyses were performed.RESULTS: In all, 118 participants fully adhered to the intervention (ie, started all 9 lessons). Participants with an ethnicity other than Dutch were more often adherers (?1=5.5, P=.02), and nonadherers used the Internet more hours per day on average (F1,203=3.918, P=.049). A logistic regression showed that being female (OR 2.02, 95% CI 1.01-4.04; P=.046) and having a higher need for cognition (OR 1.02; 95% CI 1.00-1.05; P=.02) increased the odds of adhering to the intervention. Overall, participants logged in an average of 4 times per lesson, but adherers logged in significantly more times per lesson than nonadherers (F1,204=20.710; P<.001). For use patterns, we saw that early nonadherers seemed to use fewer sessions and spend less time than late nonadherers and adherers, and fewer sessions to complete the lesson than adherers. Furthermore, late nonadherers seemed to have a shorter total duration of sessions than adherers.CONCLUSIONS: By using log data combined with baseline characteristics of participants, we extracted valuable lessons for redesign of this intervention and the design of Web-based interventions in general. First, although characteristics of respondents can significantly predict adherence, their predictive value is small. Second, it is important to design Web-based interventions to foster adherence and usage of all features in an intervention.TRIAL REGISTRATION: Dutch Trial Register Number: NTR3007; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3007 (Archived by WebCite at http://www.webcitation.org/6ILhI3rd8).

Resumo Limpo

ckground although webbas intervent shown effect wide implement regular care nonadher ie particip follow intervent protocol issu studi way webbas intervent use whether differ adher ie particip start lesson nonadher insight can gain process adherenceobject aim studi describ characterist particip investig relationship adher investig util differ featur intervent possibl differ adher nonadher identifi use pattern emerg whether differ adher nonadherersmethod data use particip use webbas intervent live full webbas intervent prevent depress employ fulli autom humansupport format demograph baselin characterist particip collect use onlin survey log data collect within webbas intervent quantit qualit analys performedresult particip fulli adher intervent ie start lesson particip ethnic dutch often adher p nonadher use internet hour per day averag f p logist regress show femal ci p higher need cognit ci p increas odd adher intervent overal particip log averag time per lesson adher log signific time per lesson nonadher f p use pattern saw earli nonadher seem use fewer session spend less time late nonadher adher fewer session complet lesson adher furthermor late nonadher seem shorter total durat session adherersconclus use log data combin baselin characterist particip extract valuabl lesson redesign intervent design webbas intervent general first although characterist respond can signific predict adher predict valu small second import design webbas intervent foster adher usag featur interventiontri registr dutch trial regist number ntr httpwwwtrialregisternltrialregadminrctviewasptc archiv webcit httpwwwwebcitationorgilhird

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