Background

Low engagement with self-guided online programs limits the potential of these programs to provide effective and low-cost treatment of mild to moderate depression and anxiety at scale. Identifying factors that increase uptake and adherence in self-guided online programs may facilitate the development of targeted implementation strategies to increase engagement with these programs in the community. Using data from a randomized controlled trial of a self-guided online program for depression and anxiety, the aim of this study was to identify predictors of the acceptability of internet-based psychological programs, and engagement (uptake and adherence) with the online program tested in the trial.

Methods

A total of 556 community members with elevated symptoms of depression or anxiety were recruited via social media into the two active conditions of a three-arm randomized controlled trial. This trial tested the effectiveness of a 7-week self-guided online program for depression and anxiety called myCompass 2, delivered with or without an Engagement-Facilitation Intervention. Predictors of uptake (accessing at least one therapeutic module of the program), adherence (modules completed), and acceptability of internet-based psychological programs (Unified Theory of Acceptance and Use of Technology, UTAUT scale) were examined, including demographics, mental health status, help-seeking attitudes, stigma, acceptability of internet programs, and personality factors.

Results

Logistic regression demonstrated that higher levels of conscientiousness (OR = 1.06, p = .026, 95% CI =1.01–1.12), and acceptability of internet-based psychological programs (OR = 1.09, p = .005, 95% CI =1.03–1.16) predicted greater uptake, and that failing to complete a module was predicted by lower levels of acceptability (OR = 0.88, p = .027, 95% CI =0.78–0.99). Linear regression showed that higher levels of agreeableness (t = 4.66, p < .001), lower levels of stigma (t = −2.28, p = .023) and more positive help-seeking attitudes (t = 2.05, p = .041) predicted higher acceptability attitudes.

Discussion

Acceptability of internet-based psychological programs was identified as a factor that increased both uptake and adherence to the myCompass 2 program. Efforts to increase the acceptability of these programs may improve engagement with these programs in the community. It may also be useful to consider personality traits and clinical profiles when considering the appropriate audience for self-guided internet interventions.

中文翻译：

---

抑郁症和焦虑症自我指导在线计划的可接受性和参与度的预测因子

背景

在线自导项目参与度低，限制了这些项目大规模提供有效和低成本治疗轻度至中度抑郁症和焦虑症的潜力。确定增加自我指导在线计划的吸收和坚持的因素可能有助于制定有针对性的实施策略，以增加社区对这些计划的参与。使用来自针对抑郁症和焦虑症的自我指导在线计划的随机对照试验的数据，本研究的目的是确定基于互联网的心理计划的可接受性以及与测试的在线计划的参与度（吸收和依从性）的预测因子在审判中。

方法

共有 556 名抑郁或焦虑症状加重的社区成员通过社交媒体被招募到三臂随机对照试验的两个活跃条件中。该试验测试了名为myCompass 2的为期 7 周的针对抑郁和焦虑的自我指导在线计划的有效性，该计划在有或没有参与促进干预的情况下提供。对基于互联网的心理项目（接受和使用技术的统一理论，UTAUT 量表）的吸收预测因素（访问该项目的至少一个治疗模块）、依从性（模块已完成）和可接受性进行了检查，包括人口统计、心理健康地位、寻求帮助的态度、耻辱感、互联网程序的可接受性和人格因素。

结果

Logistic 回归表明，更高水平的尽责性 ( OR  = 1.06, p  = .026, 95% CI =1.01–1.12) 和基于互联网的心理项目的可接受性 ( OR  = 1.09, p  = .005, 95% CI =1.03 –1.16) 预测更大的吸收，而未能完成一个模块的预测是较低的可接受性水平 ( OR  = 0.88, p  = .027, 95% CI =0.78–0.99)。线性回归表明，更高水平的宜人性（t  = 4.66，p  < .001），更低水平的污名（t  = -2.28，p  = .023）和更积极的求助态度（t  = 2.05，p  = .041）预测更高的可接受态度。

讨论

基于互联网的心理计划的可接受性被确定为增加对myCompass 2计划的吸收和坚持的一个因素。努力提高这些项目的可接受性可能会提高社区对这些项目的参与度。在为自我引导的互联网干预考虑合适的受众时，考虑人格特征和临床概况也可能是有用的。