Dataset Information

The Cost-Effectiveness of an Internet Intervention to Facilitate Mental Health Help-Seeking by Young Adults: Randomized Controlled Trial.

ABSTRACT:

Background

Little empirical evidence is available to support the effectiveness and cost-effectiveness of internet interventions to increase help-seeking behavior for mental health in young adults.

Objective

The aim of this study was to evaluate the cost-effectiveness of a Web-based mental health help-seeking navigation tool (Link) in comparison with usual help-seeking strategies.

Methods

A cost-utility analysis alongside the main randomized trial of Link was conducted from the Australian health care sector perspective. Young adults aged 18 to 25 years were randomized to the Link intervention (n=205) or usual care (n=208) with 1- and 3-month follow-ups. The primary outcome of this study was quality-adjusted life years (QALYs) measured by the assessment of quality of life-4D. Costs were calculated based on the self-reported resource use questionnaire and were reported in 2015 Australian dollars. Primary analyses were conducted as intention-to-treat and reported as incremental cost-effectiveness ratios. Completer analyses were conducted in a sensitivity analysis.

Results

Significantly more QALYs were gained in the intervention group than the control group (0.15 vs 0.14; P<.001). The intervention was associated with significantly lower health professional consultation costs at 1-month follow-up (mean costs Aus $98 vs Aus $162; P<.05). Costs of hospital services were lower at 3 months in the intervention arm (mean costs Aus $47 vs Aus $101); however, there was insufficient sample size to detect a significant difference between the groups. There were no statistically significant differences in the total costs between the 2 arms. Relative to the control group, those who received the intervention experienced 0.01 more QALYs (0.00-0.02) and had lower total health sector costs of Aus -$81 (Aus -$348 to Aus $186) over 3 months. The intervention was found to be more effective and less costly compared with usual help-seeking strategies. The intervention was 100% likely to be cost-effective below a willingness-to-pay value-for-money threshold of Aus $28,033 per QALY. Results were robust in the sensitivity analysis.

Conclusions

Our study found that the online youth mental health help-seeking Web service is a cost-effective intervention for young people aged 18 to 25 years compared with usual search strategies. Further research is required to confirm these results.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12614001223628; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?id=366731.

SUBMITTER: Le LK

PROVIDER: S-EPMC6681639 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The Cost-Effectiveness of an Internet Intervention to Facilitate Mental Health Help-Seeking by Young Adults: Randomized Controlled Trial.

Le Long Khanh-Dao LK Sanci Lena L Chatterton Mary Lou ML Kauer Sylvia S Buhagiar Kerrie K Mihalopoulos Cathrine C

Journal of medical Internet research 20190722 7

<h4>Background</h4>Little empirical evidence is available to support the effectiveness and cost-effectiveness of internet interventions to increase help-seeking behavior for mental health in young adults.<h4>Objective</h4>The aim of this study was to evaluate the cost-effectiveness of a Web-based mental health help-seeking navigation tool (Link) in comparison with usual help-seeking strategies.<h4>Methods</h4>A cost-utility analysis alongside the main randomized trial of Link was conducted from ...[more]

PMID: 31333199

Similar Datasets

Project description:ObjectiveTo explore the feasibility of a dedicated online youth mental health help-seeking intervention and to evaluate using a randomised controlled trial (RCT) study design in order to identify any modifications needed before commencement of the full-scale RCT.DesignA pilot RCT with 1:1 randomisation to either the intervention or comparison arm.SettingAn online study conducted Australia-wide.Participants18-25?year olds living in Australia were recruited via social media.InterventionLink is a dedicated online mental health help-seeking navigation tool that matches user's mental health issues, severity and service-type preferences (online, phone and face-to-face) with appropriate youth-friendly services. The comparison arm was usual help-seeking strategies with a link to Google.com.Main outcome measuresThe primary outcome was the number of acceptability and feasibility criteria successfully met. Intervention and study design acceptability and feasibility were assessed by nine criteria. Secondary outcomes, via online surveys (at baseline, 1?week and 1?month) measured service use, help-seeking intentions, psychological distress, barriers to help-seeking, attitudes towards mental health help-seeking, mental health literacy, satisfaction and trust.ResultsFifty-one participants were randomised (intervention: n=24; comparison: n=27). Three out of four of the intervention and two out of five of the study design criteria were met. Unmet criteria could be addressed by modifications to the study design. Qualitative analysis demonstrated that Link was useful to participants and may have increased their positive experiences towards help-seeking. There were no observable differences between arms in any outcome measures and no harms were detected.ConclusionGenerally, the Link intervention and study design were acceptable and feasible with modifications suggested for the four out of nine unmet criteria. The main trial will hence have shorter surveys and a simpler recruitment process, use positive affect as the primary outcome and will not link to Google.com for the comparison arm.Trial registration numberAustralian New Zealand Clinical Trials Registry, ACTRN12614000386639.

Project description:BackgroundYoung people frequently make use of the internet as part of their day-to-day activities, and this has extended to their help-seeking behavior. Offline help-seeking is known to be impeded by a number of barriers including stigma and a preference for self-reliance. Online help-seeking may offer an additional domain where young people can seek help for mental health difficulties without being encumbered by these same barriers.ObjectiveThe objective of this systematic literature review was to examine young peoples' online help-seeking behaviors for mental health concerns. It aimed to summarize young peoples' experiences and identify benefits and limitations of online help-seeking for this age group. It also examined the theoretical perspectives that have been applied to understand online help-seeking.MethodsA systematic review of peer-reviewed research papers from the following major electronic databases was conducted: PsycINFO, Cumulative Index of Nursing and Allied Health Literature, PubMed, Cochrane Library, Association for Computing Machinery Digital Library, and Institute of Electrical and Electronics Engineers Xplore. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The search was conducted in August 2017. The narrative synthesis approach to reviews was used to analyze the existing evidence to answer the review questions.ResultsOverall, 28 studies were included. The most common method of data collection was through the use of surveys. Study quality was moderate to strong. Text-based query via an internet search engine was the most commonly identified help-seeking approach. Social media, government or charity websites, live chat, instant messaging, and online communities were also used. Key benefits included anonymity and privacy, immediacy, ease of access, inclusivity, the ability to connect with others and share experiences, and a greater sense of control over the help-seeking journey. Online help-seeking has the potential to meet the needs of those with a preference for self-reliance or act as a gateway to further help-seeking. Barriers to help-seeking included a lack of mental health literacy, concerns about privacy and confidentiality, and uncertainty about the trustworthiness of online resources. Until now, there has been limited development and use of theoretical models to guide research on online help-seeking.ConclusionsApproaches to improving help-seeking by young people should consider the role of the internet and online resources as an adjunct to offline help-seeking. This review identifies opportunities and challenges in this space. It highlights the limited use of theoretical frameworks to help conceptualize online help-seeking. Self-determination theory and the help-seeking model provide promising starting points for the development of online help-seeking theories. This review discusses the use of these theories to conceptualize online help-seeking and identify key motivations and tensions that may arise when young people seek help online.

Project description:BackgroundYoung people are particularly vulnerable to experiencing mental health difficulties, but very few seek treatment or help during this time. Online help-seeking may offer an additional domain where young people can seek aid for mental health difficulties, yet our current understanding of how young people seek help online is limited.ObjectiveThis was an exploratory study which aimed to investigate the online help-seeking behaviors and preferences of young people.MethodsThis study made use of an anonymous online survey. Young people aged 18-25, living in Ireland, were recruited through social media ads on Twitter and Facebook and participated in the survey.ResultsA total of 1308 respondents completed the survey. Many of the respondents (80.66%; 1055/1308) indicated that they would use their mobile phone to look online for help for a personal or emotional concern. When looking for help online, 82.57% (1080/1308) of participants made use of an Internet search, while 57.03% (746/1308) made use of a health website. When asked about their satisfaction with these resources, 36.94% (399/1080) indicated that they were satisfied or very satisfied with an Internet search while 49.33% (368/746) indicated that they were satisfied or very satisfied with a health website. When asked about credibility, health websites were found to be the most trustworthy, with 39.45% (516/1308) indicating that they found them to be trustworthy or very trustworthy. Most of the respondents (82.95%; 1085/1308) indicated that a health service logo was an important indicator of credibility, as was an endorsement by schools and colleges (54.97%; 719/1308). Important facilitators of online help-seeking included the anonymity and confidentiality offered by the Internet, with 80% (1046/1308) of the sample indicating that it influenced their decision a lot or quite a lot. A noted barrier was being uncertain whether information on an online resource was reliable, with 55.96% (732/1308) of the respondents indicating that this influenced their decision a lot or quite a lot.ConclusionsFindings from this survey suggest that young people are engaging with web-based mental health resources to assist them with their mental health concerns. However, levels of satisfaction with the available resources vary. Young people are engaging in strategies to assign credibility to web-based resources, however, uncertainty around their reliability is a significant barrier to online help-seeking.

Project description:BackgroundLGBTQ+ community's higher susceptibility to worse mental health outcomes and more help-seeking barriers compared to the cis-heterosexual population. Despite the LGBTQ+ population facing higher mental health risks, there has been a dearth of research focusing on developing tailored interventions targeting them. This study aimed to assess the effectiveness of a digital multicomponent intervention in promoting help-seeking for mental health issues in LGBTQ+ young adults.Methods and findingsWe recruited LGBTQ+ young adults aged between 18 and 29 who scored moderate or above on at least 1 dimension of the Depression Anxiety Stress Scale 21 and did not have help-seeking experiences in the past 12 months. Participants (n = 144) were stratified by gender assigned at birth (male/female) and randomly allocated (1:1 ratio) to the intervention or active control parallel condition by generating a random number table, so they were blinded to the intervention condition. All participants received online psychoeducational videos, online facilitator-led group discussions, and electronic brochures in December 2021 and January 2022, with the final follow-up in April 2022. The contents of the video, discussion, and brochure are help-seeking for the intervention group and general mental health knowledge for the control group. The primary outcomes were help-seeking intentions for emotional problems and suicidal ideation and attitudes toward seeking help from mental health professionals at the 1-month follow-up. The analysis was performed by including all participants based on their randomized group regardless of adherence to the protocol. A linear mixed model (LMM) was used for analysis. All models were adjusted for baseline scores. Chinese Clinical Trial Registry: ChiCTR2100053248. A total of 137 (95.1%) participants completed a 3-month follow-up, and 4 participants from the intervention condition and 3 from the control condition did not complete the final survey. Compared with the control group (n = 72), a significant improvement was found in help-seeking intentions for suicidal ideation in the intervention group (n = 70) at post-discussion (mean difference = 0.22, 95% CI [0.09, 0.36], p = 0.005), 1-month (mean difference = 0.19, 95% CI [0.06, 0.33], p = 0.018), and 3-month follow-ups (mean difference = 0.25, 95% CI [0.11, 0.38], p = 0.001). There was also a significant improvement in the intervention condition on the help-seeking intention for emotional problems at 1-month (mean difference = 0.17, 95% CI [0.05, 0.28], p = 0.013) and 3-month follow-ups (mean difference = 0.16, 95% CI [0.04, 0.27], p = 0.022) compared with the control group. Participants' depression and anxiety literacy and help-seeking encouragement related knowledge in intervention conditions showed significant improvements. There were no significant improvements in actual help-seeking behaviors, self-stigma toward seeking professional assistance, depression, and anxiety symptoms. No adverse events or side effects were observed. However, the follow-up time point was limited to 3 months which might not be long enough for drastic mindset and behavioral changes in help-seeking to occur.ConclusionsThe current intervention was an effective approach in promoting help-seeking intentions, mental health literacy, and help-seeking encouragement-related knowledge. Its brief yet integrated intervention format could also be utilized in treating other imminent concerns confronted by LGBTQ+ young adults.Trial registrationChictr.org.cn, ChiCTR2100053248.

Dataset Information

The Cost-Effectiveness of an Internet Intervention to Facilitate Mental Health Help-Seeking by Young Adults: Randomized Controlled Trial.

Background

Objective

Methods

Results

Conclusions

Trial registration

Publications

The Cost-Effectiveness of an Internet Intervention to Facilitate Mental Health Help-Seeking by Young Adults: Randomized Controlled Trial.

Similar Datasets

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