Predictors of adherence by adolescents to a cognitive behavior therapy website in school and community-based settings.
Predictors of adherence by adolescents to a cognitive behavior therapy website in school and community-based settings.
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DOI：
10.2196/jmir.1050
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发表时间：
2009-02-23
影响因子：
7.4
通讯作者：
Griffiths KM
中科院分区：
文献类型：
--
作者：
Neil AL;Batterham P;Christensen H;Bennett K;Griffiths KM
在此之前，还没有关于预测青少年对网络抑郁和焦虑干预项目的依从性的变量的研究。然而，对青少年各种健康状况的传统干预方案的研究表明，健康知识、症状的类型和水平、种族、社会经济地位、治疗环境和支持可以预测依从性。目的是比较两个青少年样本在不同环境和不同支持条件下对认知行为治疗网站的依从率，并确定依从性的预测因素。作为随机对照试验的一部分，第一个青少年样本包括1000名在校学生，他们在五周的课堂环境中完成了MoodGYM项目。第二个样本由7207名青少年组成，他们自发地直接通过开放获取URL访问MoodGYM项目。在项目开始前，所有用户都完成了一份简短的调查，测量了背景特征、抑郁史、抑郁和焦虑症状以及功能失调的思维。校本样本的青少年完成在线练习的数量（mean = 9.38, SD = 6.84）显著高于开放获取社区样本的青少年（mean = 3.10, SD = 3.85; t 1088.62 =−28.39,P < .001）。多元线性回归显示，校本环境（P < .001）和女性性别（P < .001）可以预测更强的依从性，生活在农村地区（P < .001），校本样本的考试前焦虑（P = .04）分数较低，社区样本的考试前抑郁分数较高（P = .01）。在学校或社区样本中，抑郁史（P = 0.33）和测试前扭曲思想得分（P = 0.35）不能预测依从性。在监测环境中，依从性更强，不同环境中依从性的预测因素不同。了解这些差异可以提高程序的有效性和效率。
There have been no previous studies of the variables that predict adherence to online depression and anxiety intervention programs among adolescents. However, research of traditionally delivered intervention programs for a variety of health conditions in adolescence suggests that health knowledge, type and level of symptomatology, race, socioeconomic status, treatment setting, and support may predict adherence. The aim was to compare adherence rates and identify the predictors of adherence to a cognitive behavior therapy website in two adolescent samples that were offered the program in different settings and under different conditions of support. The first adolescent sample consisted of 1000 school students who completed the MoodGYM program in a classroom setting over five weeks as part of a randomized controlled trial. The second sample consisted of 7207 adolescents who accessed the MoodGYM program spontaneously and directly through the open access URL. All users completed a brief survey before the start of the program that measured background characteristics, depression history, symptoms of depression and anxiety, and dysfunctional thinking. Adolescents in the school-based sample completed significantly more online exercises (mean = 9.38, SD = 6.84) than adolescents in the open access community sample (mean = 3.10, SD = 3.85; t 1088.62 = −28.39, P < .001). A multiple linear regression revealed that school-based setting (P < .001) and female gender (P < .001) were predictive of greater adherence, as were living in a rural area (P < .001) and lower pre-test anxiety (P = .04) scores for the school-based sample and higher pre-test depression scores (P = .01) for the community sample. A history of depression (P = .33) and pre-test warpy thoughts scores (P = .35) were not predictive of adherence in the school-based or community sample. Adherence is greater in monitored settings, and the predictors of adherence differ between settings. Understanding these differences may improve program effectiveness and efficiency.
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