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Cited by 11Digital Mental Health InterventionsMental Health Treatment and AccessTelemedicine and Telehealth Implementation

Digital prevention of depression for farmers? A qualitative study on participants' experiences regarding determinants of acceptance and satisfaction with a tailored guided internet intervention program

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Freund, Johanna, Buntrock, Claudia, Braun, Lina, Thielecke, Janika, Baumeister, Harald, Berking, Matthias, Ebert, David Daniel, Titzler, Ingrid·2022·Internet Interventions
DOI 10.1016/j.invent.2022.100566PMC PMC9418375
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Abstract

Farmers, forest workers and gardeners have a higher risk of developing depression compared to other occupational populations. As part of the German pilot project “With us in balance”, the potential of six guided internet- and mobile-based interventions (IMIs) to prevent depression among their insurants is examined. The IMI program is tailored to various risk factors of depression, individual symptoms, and needs. Although IMIs have been shown to be effective in reducing depressive symptoms, there is little qualitative research about the acceptance of digital preventive IMIs. The aim of this qualitative study is to gain insights into participants' experiences with the guided IMIs by focusing on determinants for acceptance and satisfaction. Semi-structured interviews were conducted with 22/171 (13 %) intervention group (IG) participants of a randomized controlled trial. The interview guide was developed based on theoretical models of user acceptance (Unified Theory of Acceptance and Use of Technology) and patient satisfaction (evaluation model, discrepancy theory). The interviews were evaluated independently by two coders performing a deductive-inductive content analysis and attaining a substantial level of agreement (K = 0.73). The qualitative analysis revealed 71 determinants for acceptance and satisfaction across ten dimensions: performance expectancy, organisation, e-coach, usability, training content and structure, training usage, training outcome, financing, social influence, and behavioural intention. The most frequently identified drivers for the IMI use include “location independence”, “positive relationship to the e-coach” (each n = 19, 86 %), “personal e-coach guidance”, “expertise of the e-coach”, “target group specific adaptation” (each n = 18, 82 %), “flexibility”, “high willingness for renewed participation” (each n = 17, 77 %), “fast and easy availability”, “training of health enhancing attitudes and behaviours” and “content with figurative expressions” (each n = 16, 73 %). The qualitative findings predominantly suggest the acceptance of and satisfaction with the IMI program for the prevention of depression in famers and related lines of work. Many identified positive drivers are related to the e-coach guidance, which emphasizes its importance in the preventive setting from the perspective of the participants. Nevertheless, some negative aspects have been identified which help to understand potential weaknesses of the IMI program. Participants indicated different needs in terms of IMI content and usage, which points towards the potential benefit of individualisation. The possibility of being able to use IMIs anonymously, flexibly and independently of location might be highly relevant for this specific target group.

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  • CBT-based interventions are often well accepted in rural settings.

    “and are often well accepted in rural settings [13, 14].”

    From Improving the mental health of farmers: what types of remote support are acceptable, feasible, and improve outcomes? A feasibility RCT (2024) · cites this paper as [14]

    The Results (Participants and intervention use; page unavailable) report high satisfaction with the online interventions among interviewed farmers, many of whom lived in rural areas. But the Methods (Intervention; page unavailable) say the most frequently chosen training was not CBT-based, and the Limitations note that the small, self-selected interview sample limits representativeness. The study therefore does not establish that CBT-based interventions are often well accepted across rural settings. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Recent studies suggest benefits of multi-modal approaches tailored to the farming community, as the aetiology of problems in this community is diverse.

    “These studies suggest the benefits of multi-modal approaches that are tailored to the farming community, as the aetiology of problems in this community is diverse.”

    From Improving the mental health of farmers: what types of remote support are acceptable, feasible, and improve outcomes? A feasibility RCT (2024) · cites this paper as [14]

    The Introduction (Background; page unavailable) lists diverse mental-health risk factors for farmers. The Results (Qualitative findings; page unavailable) report that participants valued farming-specific intervention content, supporting the tailoring point. The paper evaluates a guided internet intervention, however, and does not establish benefits of multi-modal approaches more broadly. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Low internet skills, lack of individual fit, and data security concerns are barriers for intervention use.

    “Low internet skills, lack of individual fit, and data security concerns, are on the other hand described as barriers for intervention use (Braun et al., 2022; Freund et al., 2022; Gerhards et al., 2011; Holst et al., 2017; Mayer et al., 2019).”

    From How to promote usage of telehealth interventions for farmers' mental health? A qualitative study on supporting and hindering aspects for acceptance and satisfaction with a personalized telephone coaching for depression prevention (2023) · cites this paper as Freund et al., 2022

    The Results (Qualitative findings; page not provided) identify low computer skills as a negative driver of training use and lack of individual fit as a negative driver of satisfaction. The copy does not describe data-security concerns as a barrier; searches for security, privacy, confidentiality, and data protection did not locate that point. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

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2 of the 89 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Lawler E. Pay and Organization Effectiveness: A Psychological View 1971 McGraw Hill New York

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Authors
Freund, J., Buntrock, C., Braun, L., Thielecke, J., Baumeister, H., Berking, M., Ebert, D. D., & Titzler, I.
Affiliations
  • Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
  • Universität Ulm (DE)
Corresponding author
Freund, Johanna
ORCID
Venue
Internet Interventions
Publisher
Elsevier BV
Published
2022-09
Volume
29
Pages
100566
ISSN
2214-7829 (ISSN-L)
DOI
10.1016/j.invent.2022.100566
PMC
PMC9418375
OpenAlex
W4290786654
Cited by
11
References
89
Citations by year
2025: 4 · 2024: 2 · 2023: 4 · 2022: 1
FWCI
2.43
Type
journal article
Language
en
Open access
Licence
Locations
  • Internet Interventions (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • mediaTUM (Technical University of Munich) (submittedVersion)
  • mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion, other-oa)
  • OPUS FAU (Kooperativer Bibliotheksverbund Berlin-Brandenburg (KOBV), on behalf of the Universitätsbibliothek Erlangen-Nürnberg) (submittedVersion, cc-by)
Funders
  • Friedrich-Alexander-Universität Erlangen-Nürnberg
  • Deutsche Forschungsgemeinschaft
  • European Commission (11/2017–03/2021)
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords
depression prevention, farmers, online intervention, mobile health, technology acceptance, patient satisfaction, personalized interventions, workplace mental health, user experience, individualization, social influence, behavioral intention, performance expectancy, usability, health insurance, forestry workers, gardeners

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