Suchergebnisse

Objective: This experiment aims to investigate the influence of narrative information varying in the degree of perceived similarity and source credibility in supplemented testimonials on the acceptance of digital mental health services (digi-MHSs).

Methods: In fall 2020, n=231 university students were randomly assigned to an active control group (aCG, n=55, "information only") or one of three intervention groups (IGs) receiving information plus different testimonials being presented either by nonacademic staff (IG1, n=60), university students (IG2, n=58) or experts (IG3, n=58). We assessed mediation effects of similarity and credibility on acceptance in terms of attitudes and usage intentions.
Results: Exposure to testimonials was associated with higher usage intentions (d=0.50) and more positive attitudes towards digi-MHSs (d=0.32) compared to mere information (aCG). Regarding source-related effects, one-way ANOVA showed group differences in intentions (ŋp2=.13) that were significantly higher after exposure to testimonials targeted at students than in the other groups after adjusting for baseline intentions (ŋp2=.24). Concerning underlying mechanisms, there were full mediation effects of similarity (IG1 versus IG2) on attitudes (95%CI [0.030, 0.441]) and intentions to use digi-MHSs (95%CI [0.100, 0.528]) and of credibility on attitudes (IG2 versus IG3; 95%CI [-0.217, -0.004]), all favoring students´ testimonials.

Conclusions: Overall, this study indicated that the acceptance of digi-MHSs can be substantially increased by providing a simple, context-sensitive information intervention including testimonials by university students. Since we identified mediating effects of credibility on cognitive attitudes and similarity on affect-driven intentions to use digi-MHSs, a future trial could vary these features using narrative versus statistic information.

E-mental health services (eMHSs) offer a promising approach to promote mental health among post-secondary students. Still, many university students are reluctant to use eMHSs, and little is known about effective communication strategies to improve attitudes as antecedents of eMHS acceptance. The aim of this experiment was thus to explore the effects of information varying in the degree of targeting on students ́attitudes towards eMHSs. Four hundred fifty-one students (Mean=32.6 years, SD=10.2, 75% female) were randomly assigned to one of four study arms. While all participants read the same general information that also served as control condition (arm 1, "information only", n=116), the other three experimental arms additionally received information and testimonials on specific eMHSs differing in addressed target groups. These testimonials were either unspecific (arm 2, n=112), targeted to employees (arm 3, n=115) or targeted to students (arm 4, n=108). We analyzed attitudes towards eMHSs for stress coping and therapy, as well as potential determinants of attitude change. Two-way ANOVA revealed no impact of providing information on the alteration of attitudes towards eMHSs for stress coping (d =0.20). Only a significant but small effect of targeted testimonial on attitudes towards online therapies was identified at post-intervention (d =0.29). Regression analyses revealed statistically significant positive influences of source credibility and perceived similarity on attitude (ps <0.01), as well as a partial mediation effect of perceived similarity in favor of testimonials targeted to students (95% CI [0.22, 0.50]). Overall, this study indicates no meaningful impact of the presented information on attitudes and limited evidence for positive effects of tailored information cues. However, attitudes were already positive at baseline. Further research with a representative sample of university students is needed to gain an in-depth understanding of contextual factors influencing attitudes and relevant attributes for the optimal design of psychoeducational information on eMHSs.

Here, we provide the anonymized data sets on the per-protocol (n=451) and the intention-to-treat (IIT) analyses (n=482) for non-commercial scientific purposes and as supplementary material for a publication. The online experiment explored the influence of narrative information cues on attitudes towards and the acceptance of eMHSs. Although the provided data sets include data for analyzing both study parts (attitudes and acceptance), we only present additional files on the attitude part that will be presented in an upcoming publication. Data set A (German original) and the data set B (with English translation of variable names) refers to the per protocol analysis of valid data sets according to predefined criteria (n=451), while data C includes data for the IIT-analysis (n=482). In addition, we have added the syntax files for the per protocol as well as the IIT analyses (SPSS; sav.files for data sets and sps.-files for the syntax files) and output files on the IIT analyses (pdf.-versions of the spv.files), since details on the IIT analyses will be only partly reported in an upcoming publication due to the length of the paper (i.e., demographic data, hypotheses 1-4). In the planned publication, we have mainly focused on the per protocol analyses. Furthermore, we have uploaded the study information, original full questionnaire including the instructions and text-based informational interventions for the experimental groups (German) and screen shots of the original code book. In the publication that is currently under review, we will provide English translations of the study materials (e.g., the stimulus materials, including testimonials) as well as additional ancillary results as supplementary files. The results on other outcomes, such intentions to use eMHSs (acceptance outcomes), will be potentially reported elsewhere (status date: January 15, 2021). The data for the GESIS repository was prepared and double-checked by two researchers (JAH and FW).

Findings of the online experiment have also been presented at two conferences:
Wopperer, J., Apolinário-Hagen, J., Wals, F., Harrer, M., Kemper, J., Salewski, C., Lehr, D., & Ebert, D.D. (05.09.2019). Exploring the usefulness of testimonials as a tool to improve the acceptance of e-mental health interventions among university students: preliminary results of a pilot RCT. Poster session, 6th Conference of the European Society for Research on Internet Interventions (esrii), 05.09. – 06.09.2019, Copenhagen, Denmark.

Apolinário-Hagen, J., Wopperer, J., Wals, F., Harrer, M., & Ebert, D.D. (14.05.2019). User testimonials to improve attitudes toward digital stress coping interventions among university students: preliminary results of a pilot RCT. Poster session, 1st Conference of the Norwegian society for research on Internet Interventions (NORSII), 14.05.2019, Bergen, Norway.

Keywords (MeSH terms): eHealth, mental health, attitude, acceptability, student health services, stress, personal narratives

Electronic mental health services represent innovative instruments to increase the dissemination of stress programs in primary prevention. However, little is known about facilitators of their uptake. This study aimed to explore determinants of the acceptance of centrally certified digital stress coping programs and preferences for service delivery modes among adult members of German statutory health insurances. Participants completed a multi-construct 45-item questionnaire covering acceptance of digital stress prevention (behavioral use intention) and potential predictors we assessed using hierarchical regression analysis—(1) socio-demographic variables and time spent online, (2) openness to experience, (3) perceived stress, and (4) attitudes toward e-mental health. Preferences in terms of the willingness to use online, face-to-face and blended programs were analyzed using paired t-tests. Participants (N = 171, 66% female, 18-69 years) reported a moderate acceptance of digital stress management ( M = 2.76, SD = 1.16, range: 1-5). We identified younger age (ß = -0.16, P = .009), openness to experience (ß = 0.17, P = .003), and positive attitudes (ß = 0.61, P < .001) as predictors of acceptance ( R2 = .50, P < .001). Face-to-face was preferred over online (d = 0.40) and blended (d = 0.33), and blended over stand-alone online delivery mode (d = 0.19; all P < .001). Our findings indicate that promoting favorable attitudes toward digital stress prevention through tailored information may be a starting point to facilitate their adoption.