Abstract
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 (η2 p =.014) independent of usage time, whereas a negative attitude (perceived lack of personal contact) was associated with reduced efficacy (η2 p =.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 (η2 p =.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.
| Original language | English |
|---|---|
| Journal | Depression and Anxiety |
| Volume | 35 |
| Issue number | 5 |
| Pages (from-to) | 421-430 |
| Number of pages | 10 |
| ISSN | 1091-4269 |
| DOIs | |
| Publication status | Published - 05.2018 |
Funding
The EVIDENT trial, which underlay this study, was funded by the German Federal Ministry of Health (II A 5–2512 FSB 052). The funding body had no role in the design of the study, data collection, analysis, or interpretation of the data. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. The trial was approved by the ethics committee of the German Psychological Association (Deutsche Gesellschaft für Psychologie; DGPs) and conducted in compliance with the Declaration of Helsinki (registration number NCT01636752 at clinicaltrials.gov). The authors wish to thank GAIA AG (Hamburg, Germany), which gave technical support and made the Internet intervention (deprexis) available at no cost to the participants in the trial. The full EVIDENT trial team consists of the following: Sandra Nolte, Matthias Rose (local principal investigator), Anna Paulitschek, Leonie Gmöhling, and Leonie Schickedanz (Berlin); Thomas Berger (Bern); Viola Gräfe, and Wolfgang Greiner (local principal investigator; Bielefeld); Mirja Behrens, Cecile Hörmann, Anna Katharina Jahns, Thies Lüdtke, Björn Meyer, Steffen Moritz (local principal investigator), Johanna Schröder, Amit Gulati, and Eik Vettorazzi (Hamburg); Carla Gamon, Fritz Hohagen (principal investigator), Philipp Klein (local principal investigator), Antje Roniger, and Christina Späth (Lübeck); Alice Arndt, Liv Glindemann, Wolfgang Lutz (local principal investigator), David Rosenbaum, and Kathinka Wolter (Trier), and Flora Bach, Elisabeth Beck, Kristina Fuhr, Martin Hautzinger (local principal investigator), Katharina Krisch, and Melanie Wahl (Tübingen).
Research Areas and Centers
- Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)
