Predictors of adherence by adolescents to a cognitive behaviour therapy website in school and community-based settings
Date
2009
Authors
Calear (previously Neil), Alison
Batterham, Philip
Christensen, Helen
Bennett (previously Brittliffe), Kylie
Griffiths, Kathleen
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of medical Internet Research
Abstract
Background: 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. Objective: 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. Methods: 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. Results: 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; t1088.62 = -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. Conclusion: Adherence is greater in monitored settings, and the predictors of adherence differ between settings. Understanding these differences may improve program effectiveness and efficiency.
Description
Keywords
Keywords: adolescent; adult; affect; article; Australia; child psychology; cognitive therapy; community mental health center; depression; human; methodology; patient compliance; prediction and forecasting; randomized controlled trial; regression analysis; rural pop Adolescent; Anxiety disorders; Internet; Mood disorders; Patient non-adherence; Prevention
Citation
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Source
Journal of Medical Internet Research
Type
Journal article
Book Title
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Restricted until
2037-12-31