Overcoming Depression on the Internet (ODIN) (2): A Randomized Trial of a Self-Help Depression Skills Program With Reminders
Open accessAbstract
BACKGROUND: Guided self-help programs for depression (with associated therapist contact) have been successfully delivered over the Internet. However, previous trials of pure self-help Internet programs for depression (without therapist contact), including an earlier trial conducted by us, have failed to yield positive results. We hypothesized that methods to increase participant usage of the intervention, such as postcard or telephone reminders, might result in significant effects on depression. OBJECTIVES: This paper presents a second randomized trial of a pure self-help Internet site, ODIN (Overcoming Depression on the InterNet), for adults with self-reported depression. We hypothesized that frequently reminded participants receiving the Internet program would report greater reduction in depression symptoms and greater improvements in mental and physical health functioning than a comparison group with usual treatment and no access to ODIN. METHODS: This was a three-arm randomized control trial with a usual treatment control group and two ODIN intervention groups receiving reminders through postcards or brief telephone calls. The setting was a nonprofit health maintenance organization (HMO). We mailed recruitment brochures by US post to two groups: adults (n = 6030) who received depression medication or psychotherapy in the previous 30 days, and an age- and gender-matched group of adults (n = 6021) who did not receive such services. At enrollment and at 5-, 10- and 16-weeks follow-up, participants were reminded by email (and telephone, if nonresponsive) to complete online versions of the Center for Epidemiological Studies Depression Scale (CES-D) and the Short Form 12 (SF-12). We also recorded participant HMO health care services utilization in the 12 months following study enrollment. RESULTS: Out of a recruitment pool of 12051 approached subjects, 255 persons accessed the Internet enrollment site, completed the online consent form, and were randomized to one of the three groups: (1) treatment as usual control group without access to the ODIN website (n = 100), (2) ODIN program group with postcard reminders (n = 75), and (3) ODIN program group with telephone reminders (n = 80). Across all groups, follow-up completion rates were 64% (n = 164) at 5 weeks, 68% (n = 173) at 10 weeks, and 66% (n = 169) at 16 weeks. In an intention-to-treat analysis, intervention participants reported greater reductions in depression compared to the control group (P = .03; effect size = 0.277 standard deviation units). A more pronounced effect was detected among participants who were more severely depressed at baseline (P = .02; effect size = 0.537 standard deviation units). By the end of the study, 20% more intervention participants moved from the disordered to normal range on the CES-D. We found no difference between the two intervention groups with different reminders in outcomes measures or in frequency of log-ons. We also found no significant intervention effects on the SF-12 or health care services. CONCLUSIONS: In contrast to our earlier trial, in which participants were not reminded to use ODIN, in this trial we found a positive effect of the ODIN intervention compared to the control group. Future studies should address limitations of this trial, including relatively low enrollment and follow-up completion rates, and a restricted number of outcome measures. However, the low incremental costs of delivering this Internet program makes it feasible to offer this type of program to large populations with widespread Internet access.
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Difficulties in recruiting patients are a well-known problem in clinical trials, and long recruitment periods seem common.
“Finally, difficulties in recruiting patients is a well-known problem in clinical trials (Clarke et al., 2005; De Graaf et al., 2009; Mead et al., 2005) and long recruitment periods seem to be a common problem.”
From Internet-Based Therapy for Mild to Moderate Depression in Swedish Primary Care: Short Term Results from the PRIM-NET Randomized Controlled Trial (2014) · cites this paper as Clarke et al., 2005
Participants were more likely to use the program as recommended if they received reminders, and this increased use was present regardless of the type of reminder (telephone versus postcard).
“Clarke and colleagues’ [23] comparison of the Overcoming Depression on the Internet websites found that participants were more likely to use the program as recommended if they received reminders, and that this increased use was present regardless of the type of reminder (telephone versus postcard) that they received.”
From A Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies (2011) · cites this paper as [23]
Number of logins was not found to be related to outcomes in studies targeting depression.
“Number of logins was not found to be related to outcomes in studies targeting depression [23,41].”
From A Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies (2011) · cites this paper as [23]
Several studies categorized participants into adherent or not, or usage categories such as low, medium, and high, while others used continuous variables or a combination of these.
“Several studies categorized participants into adherent or not [49,54,57,75], or usage categories such as low, medium, and high [60], while others used continuous variables [23,24,33-36,38-41,43-45,50-52,55,56,58,59,61,76] or a combination of these [42,46,53,64-66,77].”
From A Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies (2011) · cites this paper as [23]
Use of reminders enhances engagement with eMental Health interventions.
“This finding aligns with those of previous research showing that use of reminders enhances engagement with eMental Health interventions [28].”
From Breaking open the black box: isolating the most potent features of a web and mobile phone-based intervention for depression, anxiety, and stress (2015) · cites this paper as [28]
Cognitive therapy and web-based self-help programs based on Beck's cognitive therapy were successfully used in the treatment of depression.
“Recently, cognitive therapy and web-based self-help programs based on Beck's cognitive therapy were successfully used in the treatment of depression (14, 15).”
From Computer-assisted avatar-based treatment for dysfunctional beliefs in depressive inpatients: A pilot study (2021) · cites this paper as [14]
Efficacy of Internet applications has been established for a number of health problems, including anxiety, depression, eating disorders, body image, insomnia, headache, back pain, diabetes management, encopresis, tinnitus, and smoking cessation.
“efficacy (is the intervention successful when delivered under controlled conditions [7]) of Internet applications has now also been established for a number of health problems”
From Directions for the International Society for Research on Internet Interventions (ISRII) (2006) · cites this paper as [16]
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MethodResultThe Effectiveness of Prompts to Promote Engagement With Digital Interventions: A Systematic Review
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“01; I(2) = 0), and Clarke and colleagues [35] (d = 0.”
On the HORYZON: Moderated online social therapy for long-term recovery in first episode psychosis
Alvarez-Jimenez, M., Bendall, S., Lederman, R., Wadley, G., Chinnery, G., Vargas, S., Larkin, M., Killackey, E., McGorry, P. D., & Gleeson, J. F. (2013) · Schizophrenia Research · doi:10.1016/j.schres.2012.10.009 · Cited by 224 · see citing works
“, 2006), and even online interventions incorporating support and tracking by interviewers or counselors (Christensen et al., 2004; Clarke et al., 2005).”
BackgroundGeraghty, A. W. A., Wood, A. M., & Hyland, M. E. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2010.03.007 · Cited by 241 · see citing works
“Previous research has addressed cohort maintenance (see Clarke et al., 2005).”
Clinician-Assisted Internet-Based Treatment is Effective for Depression: Randomized Controlled Trial
Perini, S., Titov, N., & Andrews, G. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670902873722 · Cited by 231 · see citing works
Titov, N., Andrews, G., Choi, I., Schwencke, G., & Mahoney, A. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802512107 · Cited by 221 · see citing works
“The limited available evidence suggests that reminders are required to help participants complete self-guided CCBT [24,39], and the form and frequency of these needs to be further explored.”
BackgroundResultVernmark, K., Lenndin, J., Bjärehed, J., Carlsson, M., Karlsson, J., Öberg, J., Carlbring, P., Eriksson, T., & Andersson, G. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.01.005 · Cited by 226 · see citing works
“…Andrews, 2009; Spek, Nyklicek et al., 2007), to somewhat less effective or not effective at all effective against no treatment or treatment as usual control groups (Clarke et al., 2005; Clarke et al., 2002; de Graaf et al., 2009; O’Kearney, Gibson, Christensen, & Griffiths, 2006).”
BackgroundHilvert-Bruce, Z., Rossouw, P. J., Wong, N., Sunderland, M., & Andrews, G. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.04.001 · Cited by 193 · see citing works
“In internet interventions for depression and social phobia, telephone and email reminders increase adherence (Clarke et al., 2005).”
BackgroundResponse to a relational agent by hospital patients with depressive symptoms
Bickmore, T. W., Mitchell, S. E., Jack, B. W., Paasche-Orlow, M. K., Pfeifer, L. M., & O’Donnell, J. (2010) · Interacting with Computers · doi:10.1016/j.intcom.2009.12.001 · Cited by 218 · see citing works
“Technologies for depression intervention and treatment 187 Investigators have reported mixed results from clinical trials of 188 internet-based depression screening and treatment programs 189 (Christensen et al., 2004; Clarke et al., 2002, 2005).”
MethodEstablishing Guidelines for Executing and Reporting Internet Intervention Research
Proudfoot, J., Klein, B., Barak, A., Carlbring, P., Cuijpers, P., Lange, A., Ritterband, L., & Andersson, G. (2011) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2011.573807 · Cited by 202 · see citing works
“…assistance, offer open access via the web or free and open-to-all online communication and thus have extremely broad reach (Christensen et al., 2004; Clarke et al., 2005; Farvolden, Denisoff, Selby, Bagby, & Rudy, 2005; Proudfoot et al., 2007) but potentially with limited treatment adherence.”
BackgroundKersting, A., Dölemeyer, R., Steinig, J., Walter, F., Kroker, K., Baust, K., & Wagner, B. (2013) · Psychotherapy and Psychosomatics · doi:10.1159/000348713 · Cited by 210 · see citing works
Muñoz, R., Lenert, L., Delucchi, K., Stoddard, J., Perez, J., Penilla, C., & Pérez‐Stable, E. (2006) · Nicotine & Tobacco Research · doi:10.1080/14622200500431940 · Cited by 208 · see citing works
Computerised cognitive-behavioural therapy for depression: systematic review
Kaltenthaler, E., Parry, G., Beverley, C., & Ferriter, M. (2008) · British Journal of Psychiatry · doi:10.1192/bjp.bp.106.025981 · Cited by 206 · see citing works
“Beating the Blues consists of a 15-min introductory video and eight 1-h interactive computer sessions using CBT strategies.”
BackgroundMethodMethodological issues in research on web-based behavioral interventions
Danaher, B. G., & Seeley, J. R. (2009) · Annals of Behavioral Medicine · doi:10.1007/s12160-009-9129-0 · Cited by 193 · see citing works
“When recruitment is limited to members of a known population (e.g., members of the military or a HMO [22, 47]), then it becomes more feasible to compare the characteristics of recruits to nonparticipants, as recommended in the RE-AIM framework [9].”
BackgroundArtificial Intelligence-Assisted Online Social Therapy for Youth Mental Health
D'Alfonso, S., Santesteban-Echarri, O., Rice, S., Wadley, G., Lederman, R., Miles, C., Gleeson, J., & Alvarez-Jimenez, M. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00796 · Cited by 192 · see citing works
“, 2004), and also compared to online interventions comprising some kind of moderation by interviewers or counselors (Christensen et al., 2004; Clarke et al., 2005).”
BackgroundO'Mahen, H. A., Woodford, J., McGinley, J., Warren, F. C., Richards, D. A., Lynch, T. R., & Taylor, R. S. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.03.005 · Cited by 202 · see citing works
de Graaf, L. E., Gerhards, S. A. H., Arntz, A., Riper, H., Metsemakers, J. F. M., Evers, S. M. A. A., Severens, J. L., Widdershoven, G., & Huibers, M. J. H. (2009) · British Journal of Psychiatry · doi:10.1192/bjp.bp.108.054429 · Cited by 190 · see citing works
Amstadter, A. B., Broman-Fulks, J., Zinzow, H., Ruggiero, K. J., & Cercone, J. (2009) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.04.001 · Cited by 189 · see citing works
“Clarke and colleagues conducted a second RCT for adults with self-reported depression (Clarke et al., 2005).”
BackgroundWatts, S. E., Turnell, A., Kladnitski, N., Newby, J. M., & Andrews, G. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.12.025 · Cited by 188 · see citing works
Leykin, Y., Thekdi, S. M., Shumay, D. M., Muñoz, R. F., Riba, M., & Dunn, L. B. (2012) · Psycho-Oncology · doi:10.1002/pon.1993 · Cited by 192 · see citing works
“Such skills can be taught online, as demonstrated by a growing body of research on Internet interventions [31].”
BackgroundO'Kearney, R., Gibson, M., Christensen, H., & Griffiths, K. M. (2006) · Cognitive Behaviour Therapy · doi:10.1080/16506070500303456 · Cited by 183 · see citing works
“In order to deal with the low rate of access, Clarke et al. (2005) conducted a second randomized controlled trial.”
BackgroundKaryotaki, E., Kemmeren, L., Riper, H., Twisk, J., Hoogendoorn, A., Kleiboer, A., Mira, A., Mackinnon, A., Meyer, B., Botella, C., et al. (2018) · Psychological Medicine · doi:10.1017/s0033291718000648 · Cited by 167 · see citing works
“Three eligible datasets were excluded from the present IPD meta-analysis as data were unavailable (Clarke et al. 2002; Clarke et al. 2005; Clarke et al. 2009).”
MethodO'Kearney, R., Kang, K., Christensen, H., & Griffiths, K. (2009) · Depression and Anxiety · doi:10.1002/da.20507 · Cited by 179 · see citing works
Birney, A. J., Gunn, R., Russell, J. K., & Ary, D. V. (2016) · JMIR mHealth and uHealth · doi:10.2196/mhealth.4231 · Cited by 159 · see citing works
“The CWD-based Overcoming Depression on the Internet program provided early evidence that a Web-based program with reminders was effective in reducing depression symptoms, particularly among individuals with mild-to-moderate depression [57,58].”
The Effectiveness of Telemental Health Applications: A Review
Hailey, D., Roine, R., & Ohinmaa, A. (2008) · The Canadian Journal of Psychiatry · doi:10.1177/070674370805301109 · Cited by 176 · see citing works
Gamification and Adherence to Web-Based Mental Health Interventions: A Systematic Review
Brown, M., O'Neill, N., van Woerden, H., Eslambolchilar, P., Jones, M., & John, A. (2016) · JMIR Mental Health · doi:10.2196/mental.5710 · Cited by 178 · see citing works
“However, seven provided clear, detailed descriptions of intervention features, including screenshots and illustrations [27,51,70,76-78].”
BackgroundMethodSantarossa, S., Kane, D., Senn, C. Y., & Woodruff, S. J. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.8480 · Cited by 172 · see citing works
Lintvedt, O. K., Griffiths, K. M., Sørensen, K., Østvik, A. R., Wang, C. E. A., Eisemann, M., & Waterloo, K. (2013) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.770 · Cited by 157 · see citing works
Clarke, G., Kelleher, C., Hornbrook, M., DeBar, L., Dickerson, J., & Gullion, C. (2009) · Cognitive Behaviour Therapy · doi:10.1080/16506070802675353 · Cited by 154 · see citing works
“We also report results for the subsamples of female participants and persons with higher depression scores at baseline (PHQ-8 total score > 10), because previous research suggested better outcomes among these subgroups (Clarke et al., 2002, 2005).”
BackgroundMethodResultInfluentialSelf-citationLillevoll, K. R., Vangberg, H. C. B., Griffiths, K. M., Waterloo, K., & Eisemann, M. R. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-14 · Cited by 150 · see citing works
“Overall, findings suggest that adding reminders encourages sustained usage of intervention web sites [38-42].”
BackgroundPreschl, B., Maercker, A., & Wagner, B. (2011) · BMC Psychiatry · doi:10.1186/1471-244x-11-189 · Cited by 158 · see citing works
“Moreover, studies on entirely self-guided programs have shown not only reduced treatment effects, but also substantial attrition rates of up to 41% [7-11].”
BackgroundShoji, K., Lesnierowska, M., Smoktunowicz, E., Bock, J., Łuszczyńska, A., Benight, C. C., & Cieślak, R. (2015) · PLoS ONE · doi:10.1371/journal.pone.0136730 · Cited by 168 · see citing works
“[49] echoed such a concern regarding measures of depression in critiquing their randomized trial.”
Backgroundvan der Zanden, R., Kramer, J., Gerrits, R., & Cuijpers, P. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.2033 · Cited by 152 · see citing works
“The proportions of improved and recovered participants (56% in the MYM group vs 20% in the control group) seem in line with those for Web-based interventions for adult depression [57-59].”
ResultPromisingInterventions, O’Connell, M. E., Boat, T. F., & Warner, K. E. (2009) · Cited by 159 · see citing works
Mood disorders and complementary and alternative medicine: a literature review
Qureshi, N. A., & Al-Bedah (2013) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s43419 · Cited by 155 · see citing works
Defining Participant Exposure Measures in Web-Based Health Behavior Change Programs
Danaher, B. G., Boles, S. M., Akers, L., Gordon, J. S., & Severson, H. H. (2006) · Journal of Medical Internet Research · doi:10.2196/jmir.8.3.e15 · Cited by 145 · see citing works
“In response to this finding, a number of published reports of Web-based interventions have described website usage statistics, including number and duration of visits as well as the number and type of Web pages viewed [2-11].”
BackgroundHilty, D. M., Crawford, A., Teshima, J., Chan, S., Sunderji, N., Yellowlees, P. M., Kramer, G., O'neill, P., Fore, C., Luo, J., et al. (2015) · International Review of Psychiatry · doi:10.3109/09540261.2015.1091292 · Cited by 170 · see citing works
“High-intensity options are TP, Internet-based cognitive behavioural therapy (ICBT) or in-person MH services with professionals (Andersson et al., 2006; Celio et al., 2000; Christensen et al., 2006; Clarke et al., 2005; Ljotsson et al., 2007; Mucic et al., 2015; Ritterband et al., 2006).”
BackgroundLuo, C., Sanger, N., Singhal, N., Pattrick, K., Shams, I., Shahid, H., Hoang, P., Schmidt, J., Lee, J., Haber, S., et al. (2020) · eClinicalMedicine · doi:10.1016/j.eclinm.2020.100442 · Cited by 167 · see citing works
Spek, V., Cuijpers, P., Nyklíček, I., Smits, N., Riper, H., Keyzer, J., & Pop, V. (2008) · Psychological Medicine · doi:10.1017/s0033291707002590 · Cited by 139 · see citing works
“The short-term effectiveness of this type of treatment for symptoms of depression has been proven in several studies (Christensen et al. 2004 ; Andersson et al. 2005 ; Clarke et al. 2005).”
Bell, V. (2007) · Journal of Mental Health · doi:10.1080/09638230701482378 · Cited by 140 · see citing works
“In fact, minimal prompts have been found to reduce dropout rates, and consequently improve treatment effects, in online therapy for depression (Clarke et al., 2005).”
BackgroundFarrer, L., Christensen, H., Griffiths, K. M., & Mackinnon, A. (2011) · PLoS ONE · doi:10.1371/journal.pone.0028099 · Cited by 140 · see citing works
A randomized controlled trial of internet-based therapy in depression
Moritz, S., Schilling, L., Hauschildt, M., Schröder, J., & Treszl, A. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.04.006 · Cited by 140 · see citing works
Directions for the International Society for Research on Internet Interventions (ISRII)
Ritterband, L. M., Andersson, G., Christensen, H. M., Carlbring, P., & Cuijpers, P. (2006) · Journal of Medical Internet Research · doi:10.2196/jmir.8.3.e23 · Cited by 132 · see citing works
Zarski, A.-C., Lehr, D., Berking, M., Riper, H., Cuijpers, P., & Ebert, D. D. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.4493 · Cited by 114 · see citing works
“Adherence-focused guidance also seems promising in fostering treatment completion with the added benefit of keeping coaching demands—in terms of time spent per participant—to a minimum [26,35-39].”
Towards a chatbot for digital counselling
Cameron, G., Cameron, D., Megaw, G., Bond, R., Mulvenna, M. D., O’Neill, S. M., Armour, C., & McTear, M. (2017) · Electronic workshops in computing · doi:10.14236/ewic/hci2017.24 · Cited by 138 · see citing works
“DIs have been created to help with weight loss [8], smoking [9], anxiety management [10] [11] and other mental health disorders such as depression [12] and Borderline”
BackgroundInternet‐Based Treatment for Panic Disorder: Does Frequency of Therapist Contact Make a Difference?
Klein, B., Austin, D., Pier, C., Kiropoulos, L., Shandley, K., Mitchell, J., Gilson, K., & Ciechomski, L. (2009) · Cognitive Behaviour Therapy · doi:10.1080/16506070802561132 · Cited by 123 · see citing works
“The total amount of feedback provided to a patient can vary from a couple of minutes (Clarke et al., 2005) to more than 5 hr (Klein, Richards, & Austin, 2006).”
BackgroundSo, M., Yamaguchi, S., Hashimoto, S., Sado, M., Furukawa, T. A., & McCrone, P. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-113 · Cited by 129 · see citing works
“On the other hand, for the eight comparisons from seven trials with modern imputation techniques [38,39, 43-45,47,49], the SMD was −0.”
BackgroundMethodResultInfluentialWeb-Based Intervention Programs for Depression: A Scoping Review and Evaluation
Renton, T., Tang, H., Ennis, N., Cusimano, M. D., Bhalerao, S., Schweizer, T. A., & Topolovec-Vranic, J. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3147 · Cited by 116 · see citing works
“Examining the existing literature, completion rates in RCTs of Web-delivered treatments for depression have primarily ranged from 55%-67% [49-54] with rates as low as 20% [55].”
An evaluation of an online peer support forum for university students with depressive symptoms
Horgan, A., McCarthy, G., & Sweeney, J. (2013) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2012.12.005 · Cited by 127 · see citing works
“Clarke et al. (2005) reported that online CBT helped people with depression, whereas Clarke et al. (2002) reported that it made no statistical significant difference.”
BackgroundCoull, G., & Morris, P. G. (2011) · Psychological Medicine · doi:10.1017/s0033291711000900 · Cited by 126 · see citing works
Telemedicine for Depression: A Systematic Review
García-Lizana, F., & Muñoz-Mayorga, I. (2010) · Perspectives in Psychiatric Care · doi:10.1111/j.1744-6163.2010.00247.x · Cited by 120 · see citing works
E-Therapy for Mental Health Problems: A Systematic Review
Postel, M. G., de Haan, H. A., & De Jong, C. A. J. (2008) · Telemedicine and e-Health · doi:10.1089/tmj.2007.0111 · Cited by 125 · see citing works
MomMoodBooster Web-Based Intervention for Postpartum Depression: Feasibility Trial Results
Danaher, B. G., Milgrom, J., Seeley, J. R., Stuart, S., Schembri, C., Tyler, M. S., Ericksen, J., Lester, W., Gemmill, A. W., Kosty, D. B., et al. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2876 · Cited by 124 · see citing works
Status of computerized cognitive behavioural therapy for adults
Titov, N. (2007) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670601109873 · Cited by 120 · see citing works
“However, there is evidence that CCBT without therapist contact can result in improvements in some participants [48] and, given the cost-effective nature of such interventions, they may T a b le 1 .”
BackgroundInfluentialMak, W. W., Chan, A. T., Cheung, E. Y., Lin, C. L., & Ngai, K. C. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.3746 · Cited by 110 · see citing works
“The effectiveness of Internet-based mental health promotion was also demonstrated in community samples in Western countries [10,12-14,”
Beintner, I., Jacobi, C., & Schmidt, U. H. (2014) · Clinical Psychology Review · doi:10.1016/j.cpr.2014.01.003 · Cited by 118 · see citing works
“The samewas true for self-help studies addressingmental disorders other than eating disorders (e.g., Christensen, Griffiths, Korten, Brittliffe, & Groves, 2004; Clarke et al., 2005; Kenwright, Marks, Graham, Franses, & Mataix-Cols, 2005; Simon et al., 2011).”
BackgroundAlfonsson, S., Olsson, E., & Hursti, T. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5352 · Cited by 118 · see citing works
“However, strategies such as repeated reminding of treatment goals and using everyday prompts may be alternatives for further investigation [50].”
Randomized Controlled Trial of Web-Based Treatment of Social Phobia Without Clinician Guidance
Titov, N., Andrews, G., Choi, I., Schwencke, G., & Johnston, L. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670903179160 · Cited by 122 · see citing works
“the literature [9], used an enhanced self-guided programme that included frequent email and short messaging service (SMS) reminders and compared this to a group who, in addition, received short weekly telephone calls from a research assistant.”
BackgroundResulteHealth communication and behavior change: promise and performance
Neuhauser, L., & Kreps, G. L. (2010) · Social Semiotics · doi:10.1080/10350330903438386 · Cited by 110 · see citing works
“In their study of a workplace program, Cook et al. (2007) found that the Internet intervention received higher user ratings and was more effective in improving workers’ diets than print materials, but not for increasing physical activity. Steele, Mummery, and Dwyer (2009) concluded that face-to-face and Internet deliv…”
BackgroundResultInfluentialAn Internet-Based Intervention for Chronic Pain
Lin, J., Paganini, S., Sander, L., Lüking, M., Ebert, D. D., Buhrman, M., Andersson, G., & Baumeister, H. (2017) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2017.0681 · Cited by 110 · see citing works
Atema, V., van Leeuwen, M., Kieffer, J. M., Oldenburg, H. S. A., van Beurden, M., Gerritsma, M. A., Kuenen, M. A., Plaisier, P. W., Lopes Cardozo, A. M. F., van Riet, Y. E. A., et al. (2019) · Journal of Clinical Oncology · doi:10.1200/jco.18.00655 · Cited by 105 · see citing works
Effectiveness of Web-based Psychological Interventions for Depression: A Meta-analysis
Cowpertwait, L., & Clarke, D. (2013) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-012-9416-z · Cited by 101 · see citing works
“Treatment groups were excluded as follows: One study (Clarke et al. 2005), had a treatment group that received telephone reminders which was excluded over a group that received postcard reminders as the first was complicated by human interaction.”
BackgroundImamura, K., Kawakami, N., Furukawa, T. A., Matsuyama, Y., Shimazu, A., Umanodan, R., Kawakami, S., & Kasai, K. (2014) · PLoS ONE · doi:10.1371/journal.pone.0097167 · Cited by 104 · see citing works
Capurro, D., Ganzinger, M., Perez-Lu, J., & Knaup, P. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.2812 · Cited by 103 · see citing works
“Among many examples, we can find a study conducted by Clarke et al [4] that demonstrated that patients allocated to receive an Internet self-help intervention had a greater reduction in depressive symptoms than the control group.”
- Authors
- Clarke, G., Eubanks, D., Reid, E., Kelleher, C., O'Connor, E., DeBar, L. L., Lynch, F., Nunley, S., & Gullion, C.
- Affiliations
- Kaiser Permanente Center for Health Research (US)
- Kaiser Permanente (US)
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2005-06-21
- Volume
- 7
- Issue
- 2
- Pages
- e16
- ISSN
- 1438-8871 (ISSN-L)
- OpenAlex
- W2057875472
- Cited by
- 372
- References
- 36
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 11 · 2023: 7 · 2022: 8 · 2021: 14 · 2020: 13 · 2019: 11 · 2018: 15 · 2017: 18 · 2016: 19 · 2015: 29 · 2014: 22 · 2013: 25 · 2012: 27
- FWCI
- 25.60
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depression, guided self-help, reminders, telephone reminders, intervention adherence, depressive symptoms, health-related quality of life, health care utilization, health maintenance organizations, adults with depression, racial and ethnic minorities, low-income adults, low-literacy adults
- MeSH terms
- Adult, Cues, Depression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Self Care, Severity of Illness Index, Telephone, Treatment Outcome, Internet
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