scholarly journals Trajectories of Suicidal Ideation in People Seeking Web-Based Help for Suicidality: Secondary Analysis of a Dutch Randomized Controlled Trial

2016 ◽  
Vol 18 (6) ◽  
pp. e178 ◽  
Author(s):  
Trine Madsen ◽  
Bregje van Spijker ◽  
Karen-Inge Karstoft ◽  
Merete Nordentoft ◽  
Ad JFM Kerkhof
Keyword(s):  
Randomized Controlled Trial ◽  
Suicidal Ideation ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Web Based ◽  
Randomized Controlled

scholarly journals Predictors of Self-Determined Module Choice in a Web-Based Computer-Tailored Diet and Physical Activity Intervention: Secondary Analysis of Data From a Randomized Controlled Trial

10.2196/15024 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e15024
Author(s):  
Juul M J Coumans ◽  
Catherine A W Bolman ◽  
Anke Oenema ◽  
Lilian Lechner
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Physical Activity Intervention ◽  
Multinomial Logistic Regression ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Motivation To Change ◽  
Web Based ◽  
Multinomial Logistic Regression Analysis ◽  
Randomized Controlled

Background Tailoring an online intervention to participant preferences (eg, by giving participants a choice which modules to follow) may increase engagement in the intervention, motivation for behavioral change, and possibly intervention effects. So far, little is known about what characteristics predict these module choices. Filling this knowledge gap is useful for optimizing program engagement. Objective We investigated participant choice for a dietary and/or physical activity (PA) promotion module in our web-based computer-tailored intervention based on self-determination theory (SDT) and motivational interviewing (MI). Furthermore, we investigated which demographic characteristics, current behavior, psychosocial constructs and constructs from SDT and MI, and program-related variables such as advice on which module to follow were associated with these choices. Methods Observational data were used from the randomized controlled trial MyLifestyleCoach of participants who were randomized into the intervention condition, completed the baseline questionnaire, and made a module choice in the opening session of the intervention. Here, they received advice on their own dietary and PA behavior. At the session’s end, they chose which lifestyle modules they would like to follow (both, diet, PA, or no module). Measurements included demographic information; self-reported diet and PA; and several psychosocial, SDT, and MI constructs. In total, data from 619 Dutch adults (59.6% women; mean age was 51.9 [SD 13.5] years) were analyzed. A stepwise multinomial logistic regression analysis was conducted to investigate which characteristics are related to module choice; the diet module served as reference category as almost everyone was advised to follow this module. Results Of this sample, 54.8% (339/619) chose to do both the diet and PA module, 25.4% (157/619) chose to follow the diet module, 17.8% (110/619) preferred to follow no module, and 2.1% (13/619) chose to do the PA module only. Furthermore, it was found that older people, those who consumed more fruit, and those who scored lower on importance to change their current diet were more likely to choose no module compared to the diet module. People who had more motivation to change their current PA and those who received strong advice compared with slight advice to follow the diet module were more likely to choose both modules compared with the diet module only. Conclusions The results show that more than half of the sample was interested in following both the diet and PA module in this online lifestyle intervention. Several characteristics were found to be related to module choice. A future challenge is to examine how this knowledge can be used to improve future interventions, such as tailoring (messages or content) on specific groups or examining where and how MI could be used to motivate people to make a certain module choice. Trial Registration Netherlands Trial Register NL7333; https://www.trialregister.nl/trial/7333

scholarly journals A Mixed-Methods Evaluation of Usability and Acceptability of Web-Based Relapse Prevention and Self-Monitoring Program: Secondary Analysis of a Pilot Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Ayumi Takano ◽  
Toshihiko Matsumoto
Keyword(s):  
Randomized Controlled Trial ◽  
Relapse Prevention ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Monitoring Program ◽  
Self Monitoring ◽  
Web Based ◽  
Randomized Controlled ◽  
Pilot Randomized Controlled Trial ◽  
The Web

This secondary analysis of a pilot randomized controlled trial assessed the usability and acceptability of a web-based relapse prevention and self-monitoring program, which was newly developed for Japanese drug users. We analyzed quantitative and qualitative data using a mixed-method approach among 43 study participants. We assessed the usability of the programs using the Web Usability Scale (WUS) and satisfaction and acceptance using the Client Satisfaction Questionnaire 8-item version (CSQ-8). We also collected qualitative feedback using semi-structured open-ended questions. The results of WUS indicated that the usability of the programs was sufficient. According to the CSQ-8 results, the self-monitoring program had less satisfaction, while the web-based relapse prevention program met satisfaction. Some possible improvements for a future version of the web-based programs were suggested based on participants' feedback.

scholarly journals Web-Based Eye Movement Desensitization and Reprocessing for Adults With Suicidal Ideation: Protocol for a Randomized Controlled Trial

10.2196/30711 ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. e30711
Author(s):  
Olga Winkler ◽  
Raman Dhaliwal ◽  
Andrew Greenshaw ◽  
Katie O'Shea ◽  
Adam Abba-Aji ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Suicidal Ideation ◽  
Eye Movement ◽  
Controlled Trial ◽  
Suicidal Thoughts ◽  
Treatment As Usual ◽  
Web Based ◽  
Randomized Controlled ◽  
Suicidal Thoughts And Behaviors ◽  
The Impact

Background Adversity and traumatic experiences increase the likelihood of suicidal thoughts and behaviors. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based, trauma-focused psychotherapy that desensitizes painful memories, so that reminders in the present no longer provoke overwhelming emotional responses. Preliminary evidence suggests that EMDR can be used as an acute intervention in suicidal patients, including those with major depressive disorder. In addition, because of social distancing restrictions during the COVID-19 pandemic, clinicians have been using EMDR on the web and, in the absence of formal evaluations of web-based EMDR, informal reports indicate good results. Objective The primary aim of this randomized controlled trial is to investigate whether remotely delivered EMDR (targeting experiences associated with suicidal thinking) reduces suicidal thoughts. Secondary aims include examining the impact of remotely delivered EMDR on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation. We will also report on adverse events in the EMDR group to explore whether targeting suicidal ideation with EMDR is safe. Finally, we will compare dropout rates between the treatment groups. Methods In this randomized controlled trial, 80 adults who express suicidal ideation and meet the study criteria will receive either 12 sessions of twice weekly EMDR plus treatment as usual or treatment as usual alone. EMDR sessions will focus on the most distressing and intrusive memories associated with suicidal ideation. Data for primary and secondary objectives will be collected at baseline, 2 months, and 4 months after enrollment. A subsequent longer-term analysis, beyond the scope of this protocol, will examine differences between the groups with respect to the number of posttreatment emergency room visits, hospitalizations, and overall health care use in the year before and after therapy. Results The protocol was approved by the University of Alberta Research Health Ethics Board (protocol ID Pro00090989). Funding for this study was provided by the Mental Health Foundation (grant RES0048906). Recruitment started in May 2021, with a projected completion date of March 2023. Conclusions The results of this trial will contribute to knowledge on whether web-based delivery of EMDR is a safe and effective treatment for reducing suicidal ideation and potentially reducing the incidence of suicide attempts in this patient population. Trial Registration ClinicalTrials.gov NCT04181047; https://clinicaltrials.gov/ct2/show/NCT04181047 International Registered Report Identifier (IRRID) DERR1-10.2196/30711

scholarly journals Web-Based Eye Movement Desensitization and Reprocessing for Adults With Suicidal Ideation: Protocol for a Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Olga Winkler ◽  
Raman Dhaliwal ◽  
Andrew Greenshaw ◽  
Katie O'Shea ◽  
Adam Abba-Aji ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Suicidal Ideation ◽  
Eye Movement ◽  
Controlled Trial ◽  
Suicidal Thoughts ◽  
Treatment As Usual ◽  
Web Based ◽  
Randomized Controlled ◽  
Suicidal Thoughts And Behaviors ◽  
The Impact

BACKGROUND Adversity and traumatic experiences increase the likelihood of suicidal thoughts and behaviors. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based, trauma-focused psychotherapy that desensitizes painful memories, so that reminders in the present no longer provoke overwhelming emotional responses. Preliminary evidence suggests that EMDR can be used as an acute intervention in suicidal patients, including those with major depressive disorder. In addition, because of social distancing restrictions during the COVID-19 pandemic, clinicians have been using EMDR on the web and, in the absence of formal evaluations of web-based EMDR, informal reports indicate good results. OBJECTIVE The primary aim of this randomized controlled trial is to investigate whether remotely delivered EMDR (targeting experiences associated with suicidal thinking) reduces suicidal thoughts. Secondary aims include examining the impact of remotely delivered EMDR on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation. We will also report on adverse events in the EMDR group to explore whether targeting suicidal ideation with EMDR is safe. Finally, we will compare dropout rates between the treatment groups. METHODS In this randomized controlled trial, 80 adults who express suicidal ideation and meet the study criteria will receive either 12 sessions of twice weekly EMDR plus treatment as usual or treatment as usual alone. EMDR sessions will focus on the most distressing and intrusive memories associated with suicidal ideation. Data for primary and secondary objectives will be collected at baseline, 2 months, and 4 months after enrollment. A subsequent longer-term analysis, beyond the scope of this protocol, will examine differences between the groups with respect to the number of posttreatment emergency room visits, hospitalizations, and overall health care use in the year before and after therapy. RESULTS The protocol was approved by the University of Alberta Research Health Ethics Board (protocol ID Pro00090989). Funding for this study was provided by the Mental Health Foundation (grant RES0048906). Recruitment started in May 2021, with a projected completion date of March 2023. CONCLUSIONS The results of this trial will contribute to knowledge on whether web-based delivery of EMDR is a safe and effective treatment for reducing suicidal ideation and potentially reducing the incidence of suicide attempts in this patient population. CLINICALTRIAL ClinicalTrials.gov NCT04181047; https://clinicaltrials.gov/ct2/show/NCT04181047 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/30711

scholarly journals A Comparison of Users and Nonusers of a Web-Based Intervention for Carers of Older Persons With Alzheimer Disease and Related Dementias: Mixed Methods Secondary Analysis

10.2196/14254 ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. e14254 ◽  
Author(s):  
Wendy Duggleby ◽  
Jenny Ploeg ◽  
Carrie McAiney ◽  
Kathryn Fisher ◽  
Kathya Jovel Ruiz ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Mixed Methods ◽  
Self Efficacy ◽  
Computer Literacy ◽  
Controlled Trial ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Web Based ◽  
Telephone Interviews ◽  
Randomized Controlled

Background A self-administered Web-based intervention was developed to help carers of persons with Alzheimer disease and related dementias (ADRD) and multiple chronic conditions (MCC) deal with the significant transitions they experience. The intervention, My Tools 4 Care (MT4C), was evaluated during a pragmatic mixed methods randomized controlled trial with 199 carers. Those in the intervention group received free, password-protected access to MT4C for three months. MT4C was found to increase hope in participants at three months compared with the control group. However, in the intervention group, 22% (20/92) did not use MT4C at all during the three-month period. Objective This mixed methods secondary analysis aimed to (1) examine differences at three months in the outcomes of hope, self-efficacy, and health-related quality of life (HRQOL) scores in users (ie, those who used MT4C at least once during the three-month period) compared with nonusers and (2) identify reasons for nonuse. Methods Data from the treatment group of a pragmatic mixed methods randomized controlled trial were used. Through audiotaped telephone interviews, trained research assistants collected data on participants’ hope (Herth Hope Index; HHI), self-efficacy (General Self-Efficacy Scale; GSES), and HRQOL (Short-Form 12-item health survey version 2; SF-12v2) at baseline, one month, and three months. Treatment group participants also provided feedback on MT4C through qualitative telephone interviews at one month and three months. Analysis of covariance was used to determine differences at three months, and generalized estimating equations were used to determine significant differences in HHI, GSES, and SF-12v2 between users and nonusers of MT4C from baseline to three months. Interview data were analyzed using content analysis and integrated with quantitative data at the result stage. Results Of the 101 participants at baseline, 9 (9%) withdrew from the study, leaving 92 participants at three months of which 72 (78%) used MT4C at least once; 20 (22%) participants did not use it at all. At baseline, there were no statistically significant differences in demographic characteristics and in outcome variables (HHI, GSES, and SF-12v2 mental component score and physical component score) between users and nonusers. At three months, participants who used MT4C at least once during the three-month period (users) reported higher mean GSES scores (P=.003) than nonusers. Over time, users had significantly higher GSES scores than nonusers (P=.048). Reasons for nonuse of MT4C included the following: caregiving demands, problems accessing MT4C (poor connectivity, computer literacy, and navigation of MT4C), and preferences (for paper format or face-to-face interaction). Conclusions Web-based interventions, such as MT4C, have the potential to increase the self-efficacy of carers of persons with ADRD and MCC. Future research with MT4C should consider including educational programs for computer literacy and providing alternate ways to access MT4C in addition to Web-based access. Trial Registration ClinicalTrials.gov NCT02428387; https://clinicaltrials.gov/ct2/show/NCT02428387

scholarly journals Predictors of Self-Determined Module Choice in a Web-Based Computer-Tailored Diet and Physical Activity Intervention: Secondary Analysis of Data From a Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Juul MJ Coumans ◽  
Catherine AW Bolman ◽  
Anke Oenema ◽  
Lilian Lechner
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Physical Activity Intervention ◽  
Multinomial Logistic Regression ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Motivation To Change ◽  
Web Based ◽  
Multinomial Logistic Regression Analysis ◽  
Randomized Controlled

BACKGROUND Tailoring an online intervention to participant preferences (eg, by giving participants a choice which modules to follow) may increase engagement in the intervention, motivation for behavioral change, and possibly intervention effects. So far, little is known about what characteristics predict these module choices. Filling this knowledge gap is useful for optimizing program engagement. OBJECTIVE We investigated participant choice for a dietary and/or physical activity (PA) promotion module in our web-based computer-tailored intervention based on self-determination theory (SDT) and motivational interviewing (MI). Furthermore, we investigated which demographic characteristics, current behavior, psychosocial constructs and constructs from SDT and MI, and program-related variables such as advice on which module to follow were associated with these choices. METHODS Observational data were used from the randomized controlled trial MyLifestyleCoach of participants who were randomized into the intervention condition, completed the baseline questionnaire, and made a module choice in the opening session of the intervention. Here, they received advice on their own dietary and PA behavior. At the session’s end, they chose which lifestyle modules they would like to follow (both, diet, PA, or no module). Measurements included demographic information; self-reported diet and PA; and several psychosocial, SDT, and MI constructs. In total, data from 619 Dutch adults (59.6% women; mean age was 51.9 [SD 13.5] years) were analyzed. A stepwise multinomial logistic regression analysis was conducted to investigate which characteristics are related to module choice; the diet module served as reference category as almost everyone was advised to follow this module. RESULTS Of this sample, 54.8% (339/619) chose to do both the diet and PA module, 25.4% (157/619) chose to follow the diet module, 17.8% (110/619) preferred to follow no module, and 2.1% (13/619) chose to do the PA module only. Furthermore, it was found that older people, those who consumed more fruit, and those who scored lower on importance to change their current diet were more likely to choose no module compared to the diet module. People who had more motivation to change their current PA and those who received strong advice compared with slight advice to follow the diet module were more likely to choose both modules compared with the diet module only. CONCLUSIONS The results show that more than half of the sample was interested in following both the diet and PA module in this online lifestyle intervention. Several characteristics were found to be related to module choice. A future challenge is to examine how this knowledge can be used to improve future interventions, such as tailoring (messages or content) on specific groups or examining where and how MI could be used to motivate people to make a certain module choice. CLINICALTRIAL Netherlands Trial Register NL7333; https://www.trialregister.nl/trial/7333

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