Motivators and Motivations to Persist With Online Psychological Interventions: A Qualitative Study of Treatment Completers
Motivators and Motivations to Persist With Online Psychological Interventions: A Qualitative Study of Treatment Completers
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DOI：
10.2196/jmir.2100
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发表时间：
2012-05-01
影响因子：
7.4
通讯作者：
Glozier, Nick
中科院分区：
文献类型：
--
作者：
Donkin, Liesje;Glozier, Nick
背景：许多互联网干预的用户并没有坚持完整的治疗计划。由于持久性可能会影响这些干预措施的结果，因此能够最大限度地保持持久性至关重要。然而，虽然研究已经开始探讨辍学的预测因素在互联网干预，很少有探讨的原因，为什么用户坚持与程序，这可能不仅仅是相反的原因dropet.Objective：回答这个问题是什么影响持久性与在线干预。我们采访了心血管风险电子沙发抑郁结果（CREDO）的参与者，一项评估电子健康干预（电子沙发）在治疗抑郁症和心血管风险因素并存患者的抑郁症状方面的疗效的试验。访谈在本质上是半结构化的，并使用扎根理论方法进行分析。面试人数减少（n = 12）后，理论saturation.Results：所有参与者都报告了大量的障碍，完成程序，包括时间限制，竞争的优先事项，焦虑花时间在电脑上，和感知有限的干预价值。坚持试验的参与者报告了内在动机，如关于任务完成和控制感的个人价值观，并认识到有助于习惯发展的外部动机，并确定了可归因于该计划的个人利益。在线干预可以受益于增强内在动机的内容，例如具有控制感和能够认同该计划，并通过增加节目的相对价值来增强持久性。在试验环境中的持久性似乎可以通过关于支持他人的明确信息来改变。在激励因素方面，使用钩子来吸引由于好奇心而开始干预的参与者，以及使用提醒系统来提示参与者也可以提高持久性。应该使用依从性和结果指标来评估这些添加的价值。
Background: Many users of Internet interventions do not persist with the full treatment program. As persistence may influence outcomes of such interventions, being able to maximize persistence is vital. However, while studies have begun to explore the predictors of dropout in Internet interventions, few have explored reasons why users persist with the programs, which may not just be the converse of the reasons for dropout.Objective: To answer the question of what influences persistence with online interventions.Methods: We interviewed participants in the Cardiovascular Risk E-couch Depression Outcome (CREDO), a trial evaluating the efficacy of an eHealth intervention (e-couch) in treating depressive symptoms in those with comorbid depression and cardiovascular risk factors. Interviews were semistructured in nature and were analyzed using a grounded theory approach. Interview numbers were curtailed (n = 12) after theoretical saturation.Results: All participants reported substantial barriers to completing the program including time constraints, competing priorities, anxiety about spending time on the computer, and perception of limited worth of the intervention. Participants who persisted with the trial reported intrinsic motivations such as personal values about task completion and sense of control, and recognized external motivators that aided the development of habits and identified personal benefits attributable to the program.Conclusions: Online interventions may benefit from content that enhances the intrinsic motivations such as a having sense of control and being able to identify with the program, and by increasing the relative value of the program in order to enhance persistence. Persistence within a trial setting appears modifiable through explicit messages regarding supporting others. In terms of motivators, the use of a hook to engage participants who are starting the intervention due to curiosity and the use of reminder systems to prompt participants may also improve persistence. The worth of such additions should be evaluated using adherence and outcomes metrics.