Optimizing the context of support of web-based self-help in individuals with mild to moderate depressive symptoms: A randomized full factorial trial.

Citation metadata

Publisher: Elsevier Science Publishers
Document Type: Report; Brief article
Length: 353 words

Document controls

Main content

Abstract :

Keywords Web-based self-help program; Internet intervention; Depression; Factorial trial; Problem-solving therapy; Adherence Highlights * Randomized factorial trial of internet-based problem-solving therapy. * Direct comparison of four contextual factors within the same study. * Guided participants showed a larger reduction of depressive symptoms post-treatment. * Guided participants showed higher treatment adherence. * At follow-up, symptoms in guided and unguided participants did no longer differ. Abstract Web-based self-help programs for individuals with depressive symptoms are efficacious. Differences in effect sizes and adherence rates might be due to contextual factors. This randomized factorial trial investigated the effects of four potentially supportive contextual factors on outcome and adherence. Two factors were provided through human contact (guidance and a diagnostic interview), and two factors were provided without human contact (a motivational interviewing module and automated emails). We recruited 316 adults with mild to moderate depressive symptoms (Patient Health Questionnaire--9 score: 5--14). All participants received access to a problem-solving therapy program. Participants were randomized across the four experimental factors (present or absent), resulting in a 16-condition design. The primary outcome was depressive symptoms 10 weeks after baseline. The secondary outcome was program adherence. Overall, results showed significant symptom reduction for the primary depression measure (Cohen's d = 0.38--0.91). Guided participants showed significantly less severe symptoms of depression at post-treatment (d = 0.15) and higher treatment adherence (d = 0.53). At follow-up, these differences were no longer present. The remaining three factors did not influence primary outcome and adherence. These findings indicate that guidance leads to a faster reduction of depressive symptoms and higher treatment adherence. Author Affiliation: (a) Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland (b) Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (c) Department of Psychiatry and Psychotherapy, Luebeck University, Luebeck, Germany * Corresponding author. Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland.oliver.bur@unibe.ch Article History: Received 19 November 2021; Revised 14 February 2022; Accepted 25 February 2022 (footnote)[white star] The study was preregistered at ClinicalTrials.gov(http://ClinicalTrials.gov) (NCT04318236). Byline: Oliver Thomas Bur (a,*), Tobias Krieger (a), Steffen Moritz (b), Jan Philipp Klein (c), Thomas Berger (a)

Source Citation

Source Citation   

Gale Document Number: GALE|A699667856