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User Experience and Effects of an Individually Tailored Transdiagnostic Internet-Based and Mobile-Supported Intervention for Anxiety Disorders: Mixed-Methods Study.

ABSTRACT: BACKGROUND:Internet interventions have been shown to be effective in treating anxiety disorders. Most interventions to date focus on single disorders and disregard potential comorbidities. OBJECTIVE:The aim of this mixed-methods study was to investigate feasibility, user experience, and effects of a newly developed individually tailored transdiagnostic guided internet intervention for anxiety disorders. METHODS:This study is an uncontrolled, within-group, baseline, postintervention pilot trial with an embedded qualitative and quantitative process and effect evaluation. In total, 49 adults with anxiety disorders (generalized anxiety disorder n=20, social phobia n=19, agoraphobia without panic n=12, panic with agoraphobia n=6, panic without agoraphobia n=4, subclinical depression n=41) received access to the 7-session intervention. We examined motivation and expectations, intervention use, user experience, impact, and modification requests. Qualitative data were assessed using semistructured interviews and analyzed by qualitative content analysis. Quantitative outcomes included symptom severity of anxiety and depression (Hamilton Anxiety Rating Scale [HAM-A], Quick Item Inventory of Depressive Symptomatology clinician rating [QIDS-C]), diagnostic status in clinical interviews (Mini International Neuropsychiatric Interview [MINI]), and web-based self-reports (Generalized Anxiety Disorder-7 [GAD-7], Center for Epidemiological Studies Depression Scale [CES-D], Beck Anxiety Inventory [BAI], Panic and Agoraphobia Scale [PAS], Social Phobia Scale [SPS], Patient Health Questionnaire-9 [PHQ-9]) at baseline and postassessment. Quantitative data was analyzed by comparing within-group means expressed as Cohen d. RESULTS:Anxiety symptom severity (HAM-A d=1.19) and depressive symptoms (QIDS-C d=0.42) improved significantly, and 54% (21/39) no longer were diagnosed as having any anxiety disorder. The main positive effects were the general improvement of disease burden and attentiveness to feelings and risk situations while the main negative effects experienced were lack of change in disease burden and symptom deterioration. The most prevalent reasons for participation were the advantages of online treatment, symptom burden, and openness toward online treatment. Helpful factors included support, psychoeducation and practicing strategies in daily life; the main hindering factors were too little individualization and being overwhelmed by the content and pace. CONCLUSIONS:The intervention was found to be feasible and results show preliminary data indicating potential efficacy for improving anxiety and depression. The next step should be the evaluation within a randomized controlled trial. Concerning intervention development, it was found that future interventions should emphasize individualization even more in order to further improve the fit to individual characteristics, preferences, and needs.

SUBMITTER: Weisel KK

PROVIDER: S-EPMC7527916 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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User Experience and Effects of an Individually Tailored Transdiagnostic Internet-Based and Mobile-Supported Intervention for Anxiety Disorders: Mixed-Methods Study.

Weisel Kiona K KK Zarski Anna-Carlotta AC Berger Thomas T Krieger Tobias T Moser Christian T CT Schaub Michael P MP Görlich Dennis D Berking Matthias M Ebert David D DD

Journal of medical Internet research 20200916 9

<h4>Background</h4>Internet interventions have been shown to be effective in treating anxiety disorders. Most interventions to date focus on single disorders and disregard potential comorbidities.<h4>Objective</h4>The aim of this mixed-methods study was to investigate feasibility, user experience, and effects of a newly developed individually tailored transdiagnostic guided internet intervention for anxiety disorders.<h4>Methods</h4>This study is an uncontrolled, within-group, baseline, postinte ...[more]

PMID: 32936085

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Project description:BACKGROUND:Depression and anxiety are common and co-morbid disorders that affect a significant proportion of students. Innovative prevention strategies targeting both conditions are needed to reduce their health burden and costs. ICare Prevent is such an innovative strategy and contains a transdiagnostic individually tailored Internet-based and mobile-supported intervention. It addresses common risk factors of depression and anxiety as part of a large EU-funded multi-country project* (ICare). Little is known about the clinical and cost-effectiveness of this type of intervention compared to care as usual (CAU) for college students. We hypothesize that ICare Prevent will be more (cost-)effective than CAU in the reduction of symptoms of depression and anxiety. METHODS:A three-arm, parallel, randomized controlled superiority trial will be conducted comparing a guided and an unguided version of ICare Prevent with a control group receiving CAU. The trial will be open-label but outcome assessors will be blinded. A total of 252 college students (age???16 years) with subclinical symptoms of depression defined as a score???16 on the Center for Epidemiological Studies Depression Scale (CES-D), and/or anxiety, defined as a score???5 on the Generalized Anxiety Disorder scale (GAD-7), will be included. Those meeting diagnostic criteria for a depressive or anxiety disorder will be excluded. The primary outcome is change in disorder specific symptom severity from baseline to post-intervention. Secondary endpoints include self-reported depression and anxiety symptoms as well as time to onset of a mood or anxiety disorder until 12-month follow-up. Societal costs and quality of life will be assessed to estimate the intervention's cost-effectiveness compared to CAU. DISCUSSION:Transdiagnostic individually tailored Internet-based prevention could be a (cost-)effective approach to tackle the disease burden of depression and anxiety among college students. TRIAL REGISTRATION:Dutch trial register, NTR 6562 . Registered on 6 July 2017.

Project description:BackgroundPersonal health records (PHRs) can be useful in the emergency department, as they provide patient information in an accurate and timely manner and enable it to be used actively. This has an effect on patients' health outcomes and patient experience. Despite the importance of PHRs in emergencies, there are only a few studies related to PHRs in emergencies that evaluate patient experience.ObjectiveThis study aims to introduce the novel mobile PHR (mPHR) platform to emergency environments and assess user experience.MethodsThe study was conducted from October 2019 to November 2019. In total, 1000 patients or carers in the emergency departments of 3 hospitals were provided an application-based service called FirstER, which was developed to collect and utilize medical information for patients in the emergency department. This study was performed as a mixed methods study. After using FirstER, we investigated its usability and conducted a survey on the experience of obtaining medical information with a legacy system and with FirstER. Additionally, we interviewed 24 patients to gain insight into their experiences regarding medical information using FirstER. For the quantitative analysis, the survey results were analyzed using descriptive statistics (mean and standard deviation). For the qualitative analysis, we determined the keywords and their frequencies from each survey question and interview question.ResultsIn total, 1000 participants, consisting of both patients and carers, were recruited in this study. Their mean age was 41.4 (SD 13.3) years. We ascertained participants' satisfaction with FirstER and their mPHR needs through a survey and an in-depth interview. With the current system, participants were not well aware of their health conditions and medical information, and they were passive in the use of their medical information and treatment. However, they wanted their medical information for several reasons, such as information sharing and managing their health conditions. FirstER provided participants with their needed information and an easy way to access it. The mean System Usability Scale (SUS) value was 67.1 (SD 13.8), which was considered very near to acceptable.ConclusionsThis study is the first to implement mPHRs in the emergency department of large tertiary hospitals in the Republic of Korea. FirstER was found to enhance user experience in emergencies, as it provided necessary medical information and proper user experience. Moreover, the average SUS was 67.1, which means that participants found FirstER to be very near to acceptable. This is very encouraging in that FirstER was developed within a very short time, and it was a pilot study.Trial registrationClinicaltrials.gov NCT04180618; https://clinicaltrials.gov/ct2/show/NCT04180618.

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Project description:BACKGROUND:Registration of brain activity has become increasingly popular and offers a way to identify the mental state of the user, prevent inappropriate workload, and control other devices by means of brain-computer interfaces. However, electroencephalography (EEG) is often related to user acceptance issues regarding the measuring technique. Meanwhile, emerging mobile EEG technology offers the possibility of gel-free signal acquisition and wireless signal transmission. Nonetheless, user experience research about the new devices is lacking. OBJECTIVE:This study aimed to evaluate user experience aspects of emerging mobile EEG devices and, in particular, to investigate wearing comfort and issues related to emotional design. METHODS:We considered 7 mobile EEG devices and compared them for their wearing comfort, type of electrodes, visual appearance, and subjects' preference for daily use. A total of 24 subjects participated in our study and tested every device independently of the others. The devices were selected in a randomized order and worn on consecutive day sessions of 60-min duration. At the end of each session, subjects rated the devices by means of questionnaires. RESULTS:Results indicated a highly significant change in maximal possible wearing duration among the EEG devices (χ26=40.2, n=24; P<.001). Regarding the visual perception of devices' headset design, results indicated a significant change in the subjects' ratings (χ26=78.7, n=24; P<.001). Results of the subjects' ratings regarding the practicability of the devices indicated highly significant differences among the EEG devices (χ26=83.2, n=24; P<.001). Ranking order and posthoc tests offered more insight and indicated that pin electrodes had the lowest wearing comfort, in particular, when coupled with a rigid, heavy headset. Finally, multiple linear regression for each device separately revealed that users were not willing to accept less comfort for a more attractive headset design. CONCLUSIONS:The study offers a differentiated look at emerging mobile and gel-free EEG technology and the relation between user experience aspects and device preference. Our research could be seen as a precondition for the development of usable applications with wearables and contributes to consumer health informatics and health-enabling technologies. Furthermore, our results provided guidance for the technological development direction of new EEG devices related to the aspects of emotional design.

Dataset Information

User Experience and Effects of an Individually Tailored Transdiagnostic Internet-Based and Mobile-Supported Intervention for Anxiety Disorders: Mixed-Methods Study.

Publications

User Experience and Effects of an Individually Tailored Transdiagnostic Internet-Based and Mobile-Supported Intervention for Anxiety Disorders: Mixed-Methods Study.

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